BACKGROUND: The acquisition and nurturing of humanistic skills and attitudes constitute an important aim of medical education. In order to assess how conducive the physician-learning environment is to the acquisition of these skills, the authors determined the extent to which clinical teachers are perceived by their trainees as humanistic with patients and students, and they explored whether undergraduate and graduate students share the same perceptions. METHODS: A mail survey was conducted in 1994/95 of all senior clerks and second-year residents at Laval University, University of Montreal and University of Sherbrooke medical schools. Of 774 trainees, 259 senior clerks and 238 second-year residents returned the questionnaire, for an overall response rate of 64%. Students' perceptions of their teachers were measured on a 6-point Likert scale applied to statements about teachers' attitudes toward the patient (5 items) and toward the student (5 items). RESULTS: On average, only 46% of the senior clerks agreed that their teachers displayed the humanistic characteristics of interest. They were especially critical of their teachers' apparent lack of sensitivity, with as many as 3 out of 4 declaring that their teachers seemed to be unconcerned about how patients adapt psychologically to their illnesses (75% of clerks) and that their teachers did not try to understand students' difficulties (78%) or to support students who have difficulties (77%). Compared with the clerks, the second-year residents were significantly less critical, those with negative perceptions varying from 27% to 58%, 40% on average. Except for this difference, their pattern of responses from one item to another was similar. INTERPRETATION: This study suggests the existence of a substantial gap between what medical trainees are expected to learn and what they actually experience over the course of their training. Because such a gap could represent a significant barrier to the acquisition of important skills, more and urgent research is needed to understand better the factors influencing students' perceptions.
Physicians are generally poorly trained to recognize, treat or refer adolescents at risk for intimate partner violence (IPV). Participation in community programs may improve medical students’ knowledge, skills, and attitudes about IPV prevention.
To determine whether the experience of serving as educators in a community-based adolescent IPV prevention program improves medical students’ knowledge, skills, and attitudes toward victims of IPV, beyond that of didactic training.
One hundred and seventeen students attending 4 medical schools.
Students were randomly assigned to didactic training in adolescent IPV prevention with or without participation as educators in a community-based adolescent IPV prevention program. Students assigned to didactic training alone served as community educators after the study was completed.
Knowledge, self-assessment of skills and attitudes about intimate partner violence and future plans to pursue outreach work.
The baseline mean knowledge score of 10.25 improved to 21.64 after didactic training (p ≤ .001). Medical students in the “didactic plus outreach” group demonstrated higher levels of confidence in their ability to address issues of intimate partner violence, (mean = 41.91) than did students in the “didactic only” group (mean = 38.94) after controlling for initial levels of confidence (p ≤ .002).
Experience as educators in a community-based program to prevent adolescent IPV improved medical students’ confidence and attitudes in recognizing and taking action in situations of adolescent IPV, whereas participation in didactic training alone significantly improved students’ knowledge.
Electronic supplementary material
The online version of this article (doi:10.1007/s11606-008-0624-y) contains supplementary material, which is available to authorized users.
adolescent; community-based intervention; intimate partner violence; medical students
In medical training, statistics is considered a very difficult course to learn and teach. Current studies have found that students’ attitudes toward statistics can influence their learning process. Measuring, evaluating and monitoring the changes of students’ attitudes toward statistics are important. Few studies have focused on the attitudes of postgraduates, especially medical postgraduates. Our purpose was to understand current attitudes regarding statistics held by medical postgraduates and explore their effects on students’ achievement. We also wanted to explore the influencing factors and the sources of these attitudes and monitor their changes after a systematic statistics course.
A total of 539 medical postgraduates enrolled in a systematic statistics course completed the pre-form of the Survey of Attitudes Toward Statistics −28 scale, and 83 postgraduates were selected randomly from among them to complete the post-form scale after the course.
Most medical postgraduates held positive attitudes toward statistics, but they thought statistics was a very difficult subject. The attitudes mainly came from experiences in a former statistical or mathematical class. Age, level of statistical education, research experience, specialty and mathematics basis may influence postgraduate attitudes toward statistics. There were significant positive correlations between course achievement and attitudes toward statistics. In general, student attitudes showed negative changes after completing a statistics course.
The importance of student attitudes toward statistics must be recognized in medical postgraduate training. To make sure all students have a positive learning environment, statistics teachers should measure their students’ attitudes and monitor their change of status during a course. Some necessary assistance should be offered for those students who develop negative attitudes.
Medical postgraduate; Statistics; Survey of attitudes toward statistics
Research training is essential in a modern undergraduate medical curriculum. Our evaluation aimed to (a) gauge students' awareness of research activities, (b) compare students' perceptions of their transferable and research-specific skills competencies, (c) determine students' motivation for research and (d) obtain students' personal views on doing research.
Undergraduate medical students (N=317) completed a research skills questionnaire developed by the Centre for Excellence in Teaching and Learning in Applied Undergraduate Research Skills (CETL-AURS) at Reading University. The questionnaire assessed students' transferable skills, research-specific skills (e.g., study design, data collection and data analysis), research experience and attitude and motivation towards doing research.
The majority of students are motivated to pursue research. Graduate entrants and male students appear to be the most confident regarding their research skills competencies. Although all students recognise the role of research in medical practice, many are unaware of the medical research activities or successes within their university. Of those who report no interest in a career incorporating research, a common perception was that researchers are isolated from patients and clinical practice.
Students have a narrow definition of research and what it entails. An explanation for why research competence does not align more closely with research motivation is derived from students' lack of understanding of the concept of translational research, as well as a lack of awareness of the research activity being undertaken by their teachers and mentors. We plan to address this with specific research awareness initiatives.
undergraduate; research skills; translational research; training; scholarly activity programmes
Community-based education has been introduced in many medical schools around the globe, but evaluation of instructional quality has remained a critical issue. Community-based education is an approach that aims to prepare students for future professional work at the community level. Instructional quality should be measured based on a program's outcomes. However, the association between learning activities and students' attitudes is unknown. The purpose of this study was to clarify what learning activities affect students' attitudes toward community health care.
From 2003 to 2009, self-administered pre- and post-questionnaire surveys were given to 693 fifth-year medical students taking a 2-week clinical clerkship. Main items measured were student attitudes, which were: "I think practicing community health care is worthwhile" ("worthwhile") and "I am confident about practicing community health care" ("confidence") using a visual analogue scale (0-100). Other items were gender, training setting, and learning activities. We analyzed the difference in attitudes before and after the clerkships by paired t test and the factors associated with a positive change in attitude by logistic regression analysis.
Six hundred forty-five students (93.1%), 494 (76.6%) male and 151(23.4%) female, completed the pre- and post-questionnaires. The VAS scores of the students' attitudes for "worthwhile" and "confidence" after the clerkship were 80.2 ± 17.4 and 57.3 ± 20.1, respectively. Both of the scores increased after the clerkship. Using multivariate logistic regression analysis, "health education" was associated with a positive change for both attitudes of "worthwhile" (adjusted RR: 1.71, 95% CI: 1.10-2.66) and "confidence" (1.56, 1.08-2.25).
Community-based education motivates students to practice community health care. In addition, their motivation is increased by the health education activity. Participating in this activity probably produces a positive effect and improves the instructional quality of the program based on its outcomes.
Objective. To understand technicians’ attitudes toward teaching student pharmacists and students’ attitudes toward learning from technicians.
Methods. Survey data concerning technicians’ perceived importance of pharmacy skills and their confidence in teaching those skills to student pharmacists were collected, as was survey data concerning students’ comfort level with learning skills from technicians. Skills included in each survey aligned with common student pharmacist competencies and the pharmacy technician certification examination.
Results. Fifty-eight (92.1%) responses were received from technicians and 141(97.9%) student survey instruments were returned. The skills that pharmacy technicians perceived to be most important and felt most comfortable teaching included filling a prescription and communicating effectively with patients. With the exception of communication, these skills also aligned with what the students were most comfortable learning from technicians.
Conclusions. Student pharmacists have learning goals that align with the daily tasks of pharmacy technicians. The survey results highlight areas in which technicians could be used to educate student pharmacists.
introductory pharmacy practice experiences; pharmacy technicians; survey
Objectives. To assess the validity and reliability of an instrument to measure pharmacy students’ attitudes toward physician-pharmacist collaboration, and compare those attitudes to the attitudes of medical students.
Methods. One hundred sixty-six first-year pharmacy students and 77 first-year medical students at Midwestern University completed the Scale of Attitudes Toward Physician-Pharmacist Collaboration.
Results. Findings confirmed the validity and reliability of the Scale of Attitudes Toward Physician-Pharmacist Collaboration in pharmacy students, as observed previously for medical students. Pharmacy students’ mean score was significantly higher (56.6 ± 7.2) than that of medical students (52.0 ± 6.1). Maximum likelihood factoring confirmed the 3-factor solution of responsibility and accountability, shared authority, and interdisciplinary education for pharmacy students.
Conclusions. The Scale of Attitudes Toward Physician-Pharmacist Collaboration can be used for the assessment of interdisciplinary educational programs, for patient outcome assessment of interprofessional collaboration, and for group comparisons. Findings that pharmacy students expressed more positive attitudes toward collaboration than medical students have implications for interdisciplinary education.
interprofessional collaboration; interprofessional education; health professions students; reliability; validity; psychometrics; attitudes
Oral presentation skills are central to physician-physician communication; however, little is known about how these skills are learned. Rhetoric is a social science which studies communication in terms of context and explores the action of language on knowledge, attitudes, and values. It has not previously been applied to medical discourse. We used rhetorical principles to qualitatively study how students learn oral presentation skills and what professional values are communicated in this process.
Inpatient general medicine service in a university-affiliated public hospital.
Twelve third-year medical students during their internal medicine clerkship and 14 teachers.
One-hundred sixty hours of ethnographic observation. including 73 oral presentations on rounds. Discoursed-based interviews of 8 students and 10 teachers. Data were qualitatively analyzed to uncover recurrent patterns of communication.
Students and teachers had different perceptions of the purpose of oral presentation, and this was reflected in performance. Students described and conducted the presentation as a rule-based, data-storage activity governed by “order” and “structure.” Teachers approached the presentation as a flexible means of “communication” and a method for “constructing” the details of a case into a diagnostic or therapeutic plan. Although most teachers viewed oral presentations rhetorically (sensitive to context), most feedback that students received was implicit and acontextual, with little guidance provided for determining relevant content. This led to dysfunctional generalizations by students, sometimes resulting in worse communication skills (e.g., comment “be brief” resulted in reading faster rather than editing) and unintended value acquisition (e.g., request for less social history interpreted as social history never relevant).
Students learn oral presentation by trial and error rather than through teaching of an explicit rhetorical model. This may delay development of effective communication skills and result in acquisition of unintended professional values. Teaching and learning of oral presentation skills may be improved by emphasizing that context determines content and by making explicit the tacit rules of presentation.
medical education; professional competence; communication; feedback; language; socialization; social sciences
To assess a community geriatrics advanced pharmacy practice experience (APPE) that aimed to improve students' attitudes towards older adults and provide a student-directed learning experience.
Students provided blood pressure monitoring and medication counseling to older adults living in a low-income residential facility as part of a required 6-week ambulatory care service-learning APPE. Pre-experience and post-experience essays on students' perceptions of the elderly and their intended and actual learning were retrospectively reviewed using a qualitative process to determine whether the course objectives were met.
Many students initially described older adults in factual terms or using negative descriptors. Most expressed a desire to increase their knowledge of diseases commonly occurring in and drugs commonly prescribed for the elderly or to improve specific skills. Many students initially had difficulty articulating clear and measurable learning objectives and appropriate assessment metrics, which are important components of self-directed learning. The final essays revealed many students learned more about the humanistic aspects of care than they had anticipated.
This community-based geriatrics experience improved students' attitudes towards working with older adults and provided practice in developing and assessing their personal learning objectives.
student-directed learning; community pharmacy geriatrics; advanced pharmacy practice experience; service learning
As more and more information technology (IT) resources become available both for support of campus- based medical education and for Web-based learning, it becomes increasingly interesting to map the information technology resources available to medical students and the attitudes students have towards their use.
To determine how extensively and effectively information handling skills are being taught in the medical curriculum, the study investigated Internet and computer availability and usage, and attitudes towards information technology among first-year medical students in Aarhus, Denmark, during a five-year period.
In the period from 1998 to 2002, students beginning the first semester of medical school were given courses on effective use of IT in their studies. As a part of the tutorials, the students were asked to complete a web-based questionnaire which included questions related to IT readiness and attitudes towards using IT in studies.
A total of 1159 students (78%) responded. Overall, 71.7% of the respondents indicating they had access to a computer at home, a number that did not change significantly during the study period. Over time, the power of students' computers and the use of e-mail and Internet did increase significantly. By fall 2002, approximately 90% of students used e-mail regularly, 80% used the Internet regularly, and 60% had access to the Internet from home. Significantly more males than females had access to a computer at home, and males had a more positive attitude towards the use of computers in their medical studies. A fairly constant number of students (3-7%) stated that they would prefer not to have to use computers in their studies.
Taken together with our experience from classroom teaching, these results indicate optional teaching of basic information technology still needs to be integrated into medical studies, and that this need does not seem likely to disappear in the near future.
Information technology; Internet; e-mail; students, medical; education, medical
Objective. To compare 3 strategies for pharmacy student learning of motivational interviewing skills, knowledge of motivational interviewing principles, and confidence in and attitudes toward their application.
Design. Following a motivational interviewing lecture, first-year students were randomized to perform practice activities (written dialogue, peer role-play, or mock-patient counseling activities). Motivational interviewing skills, knowledge, confidence, and attitudes were measured.
Assessment. All students demonstrated improvement in skills, knowledge, and confidence. Students in the mock-patient counseling group demonstrated significantly better motivational interviewing skills during practice and trended toward higher scores on the summative evaluation. They also demonstrated a significant improvement in knowledge compared with that of the written dialogue group during practice. Feedback at the end was generally positive, with students expressing recognition for the value of motivational interviewing.
Conclusions. Students demonstrated their best performance of motivational interviewing during assessments using interactions with mock or standardized patients.
objective structured clinical examinations; motivational interviewing; behavioral change counseling index; standardized patient
Purpose: To evaluate whether medical student participation in TimeSlips (TS), a creative group-based storytelling program, with persons affected by dementia would improve student attitudes toward this patient population. Design and Methods: Fifteen fourth-year medical students from Penn State College of Medicine participated in a month-long regimen of TS sessions at a retirement community. Student course evaluations were analyzed at the conclusion of the program to examine perceived qualitative changes in attitude. Findings: Qualitative data revealed insights into the manner in which student attitudes toward a geriatric patient population became more positive. Implications: This is the first known pilot study to suggest that participation in a creative group-based storytelling program might improve medical student attitudes toward persons with dementia.
Dementia; Alzheimer's disease; Geriatric education; Storytelling
Psychiatry is given very less importance in the Indian undergraduate medical curriculum and this affects the attitudes of students toward psychiatry and mentally ill patients.
To study the attitude of undergraduate medical students and interns toward psychiatry and mentally ill patients.
Materials and Methods:
Undergraduate medical students and interns of a private medical college and research institute in South India consented to form our sample. We studied the General Health Questionnaire, overall level of satisfaction in ongoing Medical course using Visual Analog Scale, attitudes toward psychiatry scale and the attitudes toward mentally ill patient's scale of the students, with their informed consent. SPSS version 18 was used for analysis of data.
Participation rate was 96%. Mean age of entire sample was 20.56 years. The total mean score on the General Health Questionnaire was 13.52 in first year but became worse toward internship (18.2). The level of satisfaction in the medical course dipped from 86% at baseline to 20% during internship. Equally high scores were noted in the attitude toward mentally ill scale. On the attitude toward psychiatry scale, there were more views on psychiatry as being an unscientific specialty, psychiatrists being considered poor role models, and psychiatric teaching was of low quality and psychiatry was the least preferred career choice.
The undergraduate medical students have a very unfavorable attitude toward psychiatry and mentally ill patients.
Internship; mentally ill; psychiatry
Undergraduate students may be attracted to science and retained in science by engaging in laboratory research. Experience as an apprentice in a scientist's laboratory can be effective in this regard, but the pool of willing scientists is sometimes limited and sustained contact between students and faculty is sometimes minimal. We report outcomes from two different models of a summer neuroscience research program: an Apprenticeship Model (AM) in which individual students joined established research laboratories, and a Collaborative Learning Model (CLM) in which teams of students worked through a guided curriculum and then conducted independent experimentation. Assessed outcomes included attitudes toward science, attitudes toward neuroscience, confidence with neuroscience concepts, and confidence with science skills, measured via pre-, mid-, and postprogram surveys. Both models elevated attitudes toward neuroscience, confidence with neuroscience concepts, and confidence with science skills, but neither model altered attitudes toward science. Consistent with the CLM design emphasizing independent experimentation, only CLM participants reported elevated ability to design experiments. The present data comprise the first of five yearly analyses on this cohort of participants; long-term follow-up will determine whether the two program models are equally effective routes to research or other science-related careers for novice undergraduate neuroscientists.
OBJECTIVE: To assess the smoking-related knowledge and attitudes of senior medical students and to compare knowledge and attitude changes in students exposed to four different smoking cessation skills training interventions. DESIGN: A survey questionnaire, assessing knowledge and attitudes, was administered pre- and post-intervention for each of the four intervention conditions. SUBJECTS: A cohort of 219 fifth-year medical students at the University of Sydney. INTERVENTIONS: Students were randomised into one of four intervention conditions: (1) a traditional didactic lecture mode (control group); (2) the use of role plays and audiotaped feedback; (3) role plays with peer feedback; and (4) video feedback. MAIN OUTCOME MEASURES: Knowledge on morbidity and mortality associated with smoking, intervention strategies, intervention effectiveness, and cessation practices; anticipated clinical behaviour related to smoking; and attitudes towards medical practitioner involvement in smoking cessation. RESULTS: Smoking knowledge was significantly greater at post-test (mean unweighted scores of 69% before and 74% after intervention). All groups had improved knowledge levels at post-test. However, after controlling for pre-test differences, the control group, video feedback, and peer feedback groups were found to have improved significantly over the audio feedback group. Scores were higher on items related to morbidity and mortality and intervention effectiveness than for items on intervention strategies and cessation practices. Positive student attitudes towards their role in smoking cessation were also found. There was an almost universally held view that doctors can have a significant impact on reducing smoking levels. Although most students perceived smoking intervention to be a worthwhile activity, they remained pessimistic about the ease with which patients' smoking behaviour could be changed. CONCLUSIONS: Positive smoking cessation knowledge changes can be readily achieved through training. However, specific smoking cessation training is needed for medical trainees to develop appropriate skills and strategies. Attention to particular weaknesses related to specific intervention strategies and cessation practices is required to develop competence in this area and to maximise the chances of new medical graduates fully using the opportunities available to them.
Development of students' teaching skills is increasingly recognised as an important component of UK undergraduate medical curricula and, in consequence, there is renewed interest in the potential benefits of cross-year peer tutoring. Whilst several studies have described the use of cross-year peer tutoring in undergraduate medical courses, its use in the clinical setting is less well reported, particularly the effects of peer tutoring on volunteer tutors' views of teachers and teaching. This study explored the effects of participation in a cross-year peer tutoring programme in clinical examination skills ('OSCE tutor') on volunteer tutors' own skills and on their attitudes towards teachers and teaching.
Volunteer tutors were final year MBChB students who took part in the programme as part of a Student Selected Component (SSC). Tutees were year 3 MBChB students preparing for their end of year 'OSCE' examination. Pre and post participation questionnaires, including both Likert-type and open response questions, were used. Paired data was compared using the Wilcoxon signed-rank test. All tests were two-tailed with 5% significance level.
Tutors reflected their cohort in terms of gender but were drawn from among the more academically successful final year students. Most had previous teaching experience. They were influenced to participate in 'OSCE tutor' by a desire to improve their own teaching and associated generic skills and by contextual factors relating to the organisation or previous experience of the OSCE tutor programme. Issues relating to longer term career aspirations were less important. After the event, tutors felt that participation had enhanced their skills in various areas, including practical teaching skills, confidence in speaking to groups and communication skills; and that as a result of taking part, they were now more likely to undertake further teacher training and to make teaching a major part of their career. However, whilst a number of students reported that their views of teachers and teaching had changed as a result of participation, this did not translate into significant changes in responses to questions that explored their views of the roles and qualities required of a good clinical teacher.
Findings affirm the benefits to volunteer tutors of cross-year peer tutoring, particularly in terms of skills enhancement and reinforcement of positive attitudes towards future teaching responsibilities, and have implications for the design and organisation of such programmes.
Objective. To implement and assess an elective course that engages pharmacy students’ interest in and directs them toward a career in academia.
Design. A blended-design elective that included online and face-to-face components was offered to first through third-year pharmacy students
Assessment. Students’ knowledge, skills, and attitudes toward academic pharmacy were measured by pre- and post-course assessments, online quizzes, personal journal entries, course assignments, and exit interviews. The elective course promoting academic pharmacy as a profession was successful and provided students with an awareness about another career avenue to consider upon graduation. The students demonstrated mastery of the course content.
Conclusions. Students agreed that the elective course on pharmacy teaching and learning was valuable and that they would recommend it to their peers. Forty percent responded that after completing the course, they were considering academic pharmacy as a career.
academic pharmacy; teaching; student awareness; faculty; career
To longitudinally assess pharmacy and medical students' attitudes toward the medically underserved.
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.
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.
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.
attitudes; medical students; pharmacy students; underserved
Objective. To develop and assess the impact of an elective course (HealthWISE) on student pharmacists’ skills in communication and health promotion and elementary school students’ knowledge of and attitudes toward science.
Design. Three colleges and schools of pharmacy collaborated to develop a 1-credit elective course that used online and classroom teaching and learning techniques to prepare student pharmacists to teach science in elementary school classrooms. Student pharmacists delivered 6 science lessons to elementary students over the course of 2 months.
Assessment. In weekly journal reflections and a final paper, student pharmacists reported improved communication and health promotion skills. Elementary teachers reported they were satisfied with student pharmacists’ performance in the classroom. On pretest and posttest evaluations, elementary students demonstrated increased science knowledge and enhanced enthusiasm for science following the lessons taught by student pharmacists.
Conclusions. The HealthWISE elective course provided positive benefit for student pharmacists, elementary school teachers, and elementary students.
service-learning; communication skills; health promotion; STEM education
Positive attitudes towards prisoners are important in securing the effectiveness of various correctional rehabilitation programs and the successful reintegration of prisoners after release. We wanted to investigate the attitudes towards prisoners among prison inmates, prison employees and college students.
The Attitudes Toward Prisoners scale was completed by 298 inmates in 4 Norwegian prisons, 387 employees working in the same prisons, and 183 college students. In addition, all respondents were asked a number of general questions about prisoners, crime and punishment.
The study groups differed significantly in their attitudes towards prisoners, as measured by the Attitudes Toward Prisoners scale, with prison inmates holding the most positive attitudes. Prison officers held more negative attitudes than other prison employees. Prison employees working in female-only facilities held more positive attitudes than those working in male-only facilities. Students differed significantly in their attitudes, with those studying business economics holding more negative attitudes than those studying nursing. A number of strong correlations emerged between negative attitudes towards prisoners and more pessimistic and punitive answers on general questions about prisoners, crime and punishment.
The attitudes towards prisoners differed markedly among the groups investigated. The findings could have important implications, particularly for the preventive work carried out in our prisons. Whether attitudes toward prisoners can be influenced by educational programs and the dispersion of factual information needs to be investigated.
There is a long history of certain medical conditions being associated with stigma, stereotypes, and negative attitudes. Research has shown that such attitudes can have a detrimental effect on patients presenting with stigmatised medical conditions and can even flow on to impact their family. The objective of this study was to measure the attitudes of undergraduate students enrolled in six different health-related courses at Monash University toward patients with intellectual disability, substance abuse, and acute mental illness.
A convenience sample of undergraduate students enrolled in six health-related courses in first, second and third years at Monash University were surveyed. The Medical Condition Regard Scale - a valid and reliable, self-report measure of attitudes - was administered to students along with a brief demographic form. Mean scores, t-tests, and ANOVA were used to analyse student attitudes. Ethics approval was granted.
548 students participated. Statistically significant differences were found between the courses (p = 0.05), year of the course (p = 0.09), and gender (p = 0.04) for the medical condition of intellectual disability. There was no statistically significant difference between the courses, year of the course, gender, and age group for substance abuse or acute mental illness conditions.
The findings suggest that students in undergraduate health-related courses, as a group, have a strong regard for patients with intellectual disability and some regard for patients with acute mental illness, but not for patients presenting with substance abuse problems.
This study investigated the use of a Web-based community health simulation as a problem-based learning (PBL) experience for undergraduate students majoring in public health. The study sought to determine whether students who participated in the online simulation achieved differences in academic and attitudinal outcomes compared with students who participated in a traditional PBL exercise.
Using a nonexperimental comparative design, 21 undergraduate students enrolled in a health-behavior course were each randomly assigned to one of four workgroups. Each workgroup was randomly assigned the semester-long simulation project or the traditional PBL exercise. Survey instruments were used to measure students' attitudes toward the course, their perceptions of the learning community, and perceptions of their own cognitive learning. Content analysis of final essay exams and group reports was used to identify differences in academic outcomes and students' level of conceptual understanding of health-behavior theory.
Findings indicated that students participating in the simulation produced higher mean final exam scores compared with students participating in the traditional PBL (p=0.03). Students in the simulation group also outperformed students in the traditional group with respect to their understanding of health-behavior theory (p=0.04). Students in the simulation group, however, rated their own level of cognitive learning lower than did students in the traditional group (p=0.03).
By bridging time and distance constraints of the traditional classroom setting, an online simulation may be an effective PBL approach for public health students. Recommendations include further research using a larger sample to explore students' perceptions of learning when participating in simulated real-world activities. Additional research focusing on possible differences between actual and perceived learning relative to PBL methods and student workgroup dynamics is also recommended.
Purpose: This evaluation study sought to assess the impact of an evidence-based medicine (EBM) course on students' self-perception of EBM skills, determine their use of EBM skills, and measure their performance in applying EBM skills in a simulated case scenario.
Methods: Pre- and post-surveys and skills tests were developed to measure students' attitudes toward and proficiency in EBM skills. Third-year students completed the voluntary survey and skills test at the beginning and completion of a twelve-week clerkship in internal medicine (IM) co-taught by medical and library faculty. Data were analyzed using the Mann-Whitney U test for a two-tailed test.
Results: A statistically significant increase was found in the students' self-assessment of skills. Students reported using the journal literature significantly more frequently during the clerkship than before, although textbooks remained their number one resource. A majority of students reported frequent use of EBM skills during the clerkship. Statistically significant improvement in student performance was also found on the posttest, although the level of improvement was more modest than that found on the post-surveys.
Conclusion: The introduction of EBM skills to students during a clinical clerkship provides students an opportunity to practice EBM skills and reinforces the use of evidence in making patient-care decisions.
With an increasing awareness of health disparities, medical schools are challenged to develop training in cultural competency for their students. We developed and evaluated the effectiveness of an interactive workshop designed to improve third-year students' attitudes, beliefs and cross-cultural communication skills. METHODS: At the start of a six-week required family medicine clerkship, 196 medical students participated in small group (20-24 students) workshops. Didactics included facts about health disparities and a model of cultural competency. During a skill-building component, students were exposed to live vignettes portraying ineffective and effective cross-cultural doctor-patient interactions. Impact on students' attitudes, perceived bias and knowledge of techniques was assessed by comparing pre- and postworkshop scores. RESULTS: Participants increased their cultural awareness on most items of a cultural awareness scale. Fifty-five-, 71- and 66% of the sample agreed or strongly agreed the program was valuable, appropriate and effective, respectively. Conversely, only 17-, 6- and 9% of the sample disagreed or strongly disagreed, respectively. CONCLUSIONS: A workshop for third-year students led to an increase in cultural awareness and was considered appropriate and valuable. Further study, including longitudinal training and evaluation, is needed regarding effective methods to increase cultural competence in clinical practice.
The purpose of this study was to explore the long term effect of a service learning project on medical and nursing students’ knowledge in aging and their attitudes toward older adults. A total of 124 students were recruited and then randomized to intervention group (IG) and control group (CG). A pre-and-post-intervention design measured students’ knowledge in aging (using modified Palmore’s Fact on Aging Quiz) and attitudes toward older adults (using Kogan’s Old People Scale). A total of 103 students completed all the activities and questionnaires. After the intervention, there were significant differences between the IG and CG on Palmore’s mental health (MH) (P = .04), Palmore’s total score (P = .02) and Kogan’s negative attitudes toward older adults (P = .001). All students increased their positive attitude toward older adults after the intervention. However, both the IG and CG showed a decrease in positive attitudes 1 month after the interventon, and such decrease varied, depending on the programme which students attended. The current study showed that the 10-week service learning activities significantly increased medical and nursing students’ overall knowledge of aging and their understanding of mental health needs in old age, and reduced their negative attitudes toward older adults. However, the effect is not long-lasting. On the other hand, its effect on positive attitudes toward older adults cannot be concluded. Periodic contacts with older adults via service learning activities may be needed to sustain attitude change toward older adults.
Service learning; Medical and nursing students; Older adults; Attitude; Knowledge about aging