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Caring for terminally ill persons: comparative analysis of attitudes (thanatophobia) of practicing physicians, student nurses, and medical students.

To investigate why some caregivers desire to avoid patients with terminal illnesses, a thanatophobia scale assessing caregivers' uncomfortable feelings and sense of helplessness was developed and evaluated among practicing physicians and student nurses and medical students. As a group, student nurses scored lower on the thanatophobia scale than practicing physicians and medical students. Higher scores on intolerance to clinical uncertainty were associated with higher thanatophobia scores in all groups. Scores for depressed mood, decreased sensitivity, and Machiavellianism were statistically significant predictors in some groups. Higher thanatophobia scores also predicted lower scores for ratings of self-esteem in caring for elderly patients. Among senior medical students, those with lower thanatophobia scores tended to enter primary care residencies. Health professional educators may find this scale helpful both in pinpointing sources of caregivers' angst and useful in counseling students in management of terminally ill persons.

Adult↗

Student assistance program: a new approach for student success in addressing behavioral health and life events.

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.

Counseling↗

Nursing student-patient relationship: experiences of students and patients.

This study dealt with nursing students' and patients' experiences of their relationship. Qualitative data were collected conducting semi-structured interviews with 30 nursing students and 30 patients on medical wards in Finland. The results, analysed using inductive content analysis, revealed student-patient relationships of three types: mechanistic, authoritative and facilitative relationships. Factors promoting or impeding the relationship were divided into student-related factors, patient-related factors, length of time together and atmosphere during activity and were found to influence the type and quality of the relationship. The findings also indicate that the relationship has many positive consequences for both students and patients. The results of the study have implications for nursing, pointing out the important role of both staff nurses and nurse educators in supporting students' learning about individualised patient-centred care.

Adult↗

Making a movie on kidney transplantation: a medical school graduation thesis to explain kidney transplantation from students to students.

The aim of this study was to report on the production and the opinions of a video movie on transplantation and organ donation. The video was developed by a medical school student with the help of the students and teachers of a high school for applied arts. For this task, the making of the video was included in the high school program of the participating class. The students were tutored by their photography teacher. The video movie lasts about 50 minutes. Each "scene" lasts no more than 5 minutes, to avoid reducing the attention level. The choice of a nonmedical frame helped to have some moments to digest the technical information and to stress the importance of the patient-physician relationship. The video was employed as a part of small-group lessons in the nephrology course. A semistructured anonymous questionnaire gathered the opinion of 65 students at the end of the lessons. Student satisfaction was high; the median score was the highest (8, range 6 to 10) for the lesson based upon the movie, as compared with the conventional ones on chronic kidney disease or dialysis (7, range 5 to 10). As far as the authors know, this is the first experiment of a multimedia approach, dedicated to medical and nonmedical targets, developed as a graduation thesis in an Italian Medical School. In conclusion, the positive opinions of the students, who highly appreciated the peer-developed message, may suggest implementing such nonconventional educational approaches to support human resources and enthusiasm for kidney transplantation among the new generations.

Adolescent↗

Computing facilities available to final-year students at 3 UK dental schools in 1997/8: their use, and students' attitudes to information technology.

OBJECTIVE: To identify computer facilities available in 3 dental schools where 3 different approaches to the use of technology-based learning material have been adopted and assess dental students' perception of their own computer skills and their attitudes towards information technology. DESIGN: Multicentre cross sectional by questionnaire. SUBJECTS: All 181 dental students in their final year of study (1997-8). RESULTS: The overall participation rate was 80%. There were no differences between schools in the students' self assessment of their IT skills but only 1/3 regarded themselves as competent in basic skills and nearly 50% of students in all 3 schools felt that insufficient IT training had been provided to enable them to follow their course without difficulty. There were significant differences between schools in most of the other areas examined which reflect the different ways in which IT can be used to support the dental course. CONCLUSIONS: 1. Students value IT as an educational tool. 2. Their awareness of the relevance of a knowledge of information technology for their future careers remains generally low. 3. There is a need to provide effective instruction in IT skills for those dental students who do not acquire these during secondary education.

Attitude↗

Self-esteem and student nurses: a cross-cultural study of nursing students in Thailand and the UK.

Self-esteem is a key feature in a person's perception of their own worth. This report is of a study of the reported self-esteem levels of two groups of student nurses: one in Thailand and one in the UK. Purposive samples of 120 Thai students and 101 UK undergraduate nursing students were given the Culture-Free Self-Esteem Inventory (CFSEI-2). The CFSEI-2 is a self-reported inventory, which measures an individual's perception of self. The findings of the study indicate that the perceptions of own self-esteem in undergraduate student nurses in the UK and in Thailand were comparable to the normal ranges of self-esteem as assessed by the instrument. An independent sample t-test revealed that there were no significant differences in mean overall and subscale self-esteem scores between UK and Thai nursing students. There were no indications of differences in levels of self-esteem for UK and Thai nursing students experiencing different parts of their training.

Adolescent↗

Student interest in activities in a secondary physical education curriculum: an analysis of student subjectivity.

Situational interest is defined as a student's perception of interest inherent in an activity. Holding interest is conceptualized as a specific situational interest perceived by a student based on his or her subjective understanding of the activity's meaningfulness. It motivates the student to continuously participate in that activity. This research was designed to examine the patterns of holding interest for physical activities in a state physical education curriculum for secondary schools. A group of college students (N = 35) who completed their entire secondary education in the state was invited to construct their perceptions of interest in the activities selected from their secondary physical education curriculum. Q methodology was used to determine and analyze patterns of the interest. Four patterns of holding interest were determined: fitness, socialization, activity variation, and self-expression. Specific activities associated with each pattern were identified, and relationships among the four patterns were described. Findings (a) support the notion that holding interest is based on students' subjective understanding and valuing of the unique meanings in physical activities and (b) suggest that holding interest is person- and activity-specific, implying that physical educators should focus on student-activity matching when making curricular decisions.

Adult↗

The career planning, athletic identity, and student role identity of intercollegiate student athletes.

The purpose of this study was to examine the career planning of university student athletes and relationships between their career planning and athletic and student role identities. Two retrospective in-depth interviews were held with four male and four female university student athletes. Participants entered university with vague or nonexistent career objectives and invested heavily in their athletic roles. In the latter years of their college career, the participants discarded their sport career ambitions and allowed the student role to become more prominent in their identity hierarchies. The current findings support Brown and Hartley's (1998) suggestion that student athletes may invest in both the athlete and student role identities simultaneously and that investing in the latter may permit the exploration of nonsport career options.

Adult↗

Tutoring deaf students in higher education: a comparison of baccalaureate and sub-baccalaureate student perceptions.

Seventy-three deaf college students completed a survey examining perceptions about tutoring outcomes and emphases, characteristics of tutors, and responsibilities associated with learning through tutoring. The comparisons revealed that while baccalaureate and sub-baccalaureate students have many similar perceptions about tutoring, there are also some striking differences. In particular, as compared to the sub-baccalaureate students, baccalaureate students have a stronger preference for focusing on course content and for working with tutors who actively involve them during the tutoring sessions. In addition, baccalaureate students prefer to decide the focus of the tutoring themselves while sub-baccalaureate students tend to leave the decision to the tutor. The results of the analyses with three scales measuring perceptions of tutoring dimensions are summarized and recommendations for the selection and preparation of tutors, as well as for future research, are provided.

Adolescent↗

Anxiety in medical students: is preparation for full-time clinical attachments more dependent upon differences in maturity or on educational programmes for undergraduate and graduate entry students?

INTRODUCTION: The transition to full-time clinical studies holds anxieties for most medical students. While graduate entry medical education has only recently begun in the UK, the parallel undergraduate and graduate entry MBBS courses taught at our school allowed us to study how 2 differently prepared groups perceived this vital time at a comparable stage in their training. METHOD: An anonymous questionnaire collected demographic data and graded anxiety in 13 statements relating to starting full-time clinical attachments. Two open questions allowed free text comment on the most positive and negative influences perceived during this time. Both a statistical analysis and a qualitative assessment were performed to compare the 2 groups of students. RESULTS: The 2 groups were similar with respect to gender but the graduate entry students were significantly older. The graduate entry students were significantly less anxious about most aspects of the transition period compared to the undergraduates. These course differences remained after adjusting for age and sex. When adjusted for course and age, male students expressed less anxiety. The main positive qualitative statements related to continual clinical and communication skills training in the graduate entry group. The main qualitative concerns in both groups related to 'fitting in' and perceived lack of factual knowledge. DISCUSSION: These data support the early introduction of clinical skills teaching, backed up by a fully integrated clinically relevant curriculum with continued assessment, in preparing students and reducing levels of anxiety before they start full-time clinical attachments. These course design differences appear to be more important than any differences in maturity between the 2 groups.

Adaptation, Psychological↗

Combining traditional and RN students in a senior capstone experience: the student perspective.

BACKGROUND: This study explored the students' perspective related to combining traditional and RN student populations in a senior capstone course. METHOD: In the final semester in a senior baccalaureate program, nursing students (N = 340) completed an investigator-designed 5-item survey. Data were reviewed independently by three investigators for emergent themes. RESULTS: While the course content was applied differently by two student populations, both appreciated a seminar format that allowed increased creativity, autonomy, and flexibility. CONCLUSIONS: Merits of an integrated course were more explicitly stated by traditional students, who viewed the RNs as a source of reality-based learning. Faculty sensitivity to the unique learning needs of each student population is recommended.

Attitude of Health Personnel↗

An international nursing student exchange program: an educational experience that enhanced student cognitive development.

Increased attention to international nursing has lead to the development of study abroad programs for students. Participants in such programs describe the experiences as positive; however, studies of measured impact have not been reported. Student development theory provides an objective perspective from which to assess the level of cognition of undergraduate students and permits assessment of change in students' thinking maturity over time. This study documents the change of senior students' levels of cognition over one academic semester. Results indicate that those who participated in an international student nurse exchange program demonstrated significantly more growth than those who did not. As nursing moves to a global perspective, the author recommends similar evaluation of all such exchange programs.

Cognition↗

Medical student career intentions at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part II.

AIMS: To record career preferences for medical students at the Christchurch School of Medicine and Health Sciences and investigate factors, including student debt, that might influence career decisions. METHODS: A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. The survey included questions relating to preferred career intentions and factors influencing career decisions, including the decision to leave New Zealand to practise medicine. RESULTS: The response rate was 88%. 80% intend to practise medicine in New Zealand immediately after graduation, however 82% indicated that they would leave within two years of graduation. Financial opportunities overseas and level of debt were the strongest motivating factors to leave. Repayments towards student loans and increased salaries were factors that might retain people in New Zealand. Medical and surgical specialities were the most popular career choices. Personal interest was the strongest motivator for career choice. Practising in a rural community was not popular. CONCLUSION: Debt is one of a number of important factors influencing medical student career decisions including the decision to leave New Zealand. Initiatives addressing debt may be useful in retaining medical graduates in this country.

Adult↗

Surgical inclination in senior medical students from the University of Auckland: results of the 2005 Senior Students Survey.

AIMS: To determine the proportion of senior medical students who are surgically inclined and to assess whether gender differences exist in surgical inclination. STUDY DESIGN: Cross-sectional survey. Twenty-five point questionnaire. Likert scale response ranking. SETTING: University of Auckland Medical School, New Zealand. PARTICIPANTS: 218 surveys were emailed to functioning addresses of fourth and fifth year students.156 students emailed responses (71.60% response rate). RESULTS: Twenty percent of students were found to be surgically inclined (95% CI 0.15-0.26). The proportion of surgically inclined males was significantly higher than females (p<0.01). A greater proportion of surgically inclined students found time spent in the operating theatre educationally valuable than non-surgically inclined students (p<0.01). No difference exists in the number of different procedures undertaken by students (p<0.05). CONCLUSION: Males are significantly more likely to be surgically inclined than females at the University of Auckland Medical School.

Adult↗

Psychosocial characteristics of diabetic students at Sporting Students Hospital in Alexandria.

Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. The aim of the present work was to study the psychosocial characteristics of diabetic students and to determine predictors of diabetes control. A cross-sectional study of 150 diabetic students who attended the diabetic school health insurance clinic of Sporting Student's Hospital in Alexandria governorate within a period of one month was conducted. A pre-designed interviewing questionnaire was used to collect--from the child and/or his/her parents--personal data, data about the child social relationships and school and disease characteristics. School adjustment index and stress symptom index were used to assess the school performance and the stress symptoms respectively. The result revealed that 34% of the diabetic students were maladjusted to school and 31.3% were symptomatic based on the stress index. Generally speaking, diabetic children reported good relationship to peers (65.3%), parents (57.3%) and siblings (51.3%), most of them have good friendship (82%) and those involved in one or more kind of hobby were about three fourth of all. Both age (P<0.05), sex (P<0.05), social class (P<0.05), disease duration (P<0.05) and stress symptoms (P<0.05) were all significantly associated with the disease control. However after adjustment for other variables, students of low social class families (OR=5.1, p<0.01) and those of longer disease duration (6-10 years) (OR=7.9, p<0.05) were significant predictors of diabetes control. In conclusion diabetes per se might have no significant association with academic performance or social relationship. Students with large diabetic duration-especially those of low social class families--are at increased risk of suboptimal glycaemic control and should be targeted for interventional strategies.

Adaptation, Psychological↗

Basic science confidence in senior medical students from the University of Auckland, New Zealand: results of the 2005 Senior Students Survey.

AIMS: To determine the proportion of senior medical students who feel their knowledge of the basic sciences is adequate for safe medical practice. DESIGN: Cross-sectional survey. Twenty-five point questionnaire. Likert scale response ranking. SETTING: University of Auckland School of Medicine, Auckland, New Zealand. PARTICIPANTS: 218 surveys were emailed to functioning addresses of fourth and fifth year students. 156 students emailed responses (71.60% response rate), comprising 55% of the total fourth and fifth year student population. RESULTS: Thirty-three percent of respondents (95% CI 0.26-0.41) felt their knowledge of anatomy was adequate. Seventeen percent (95% CI 0.12-0.24) of students felt their knowledge of pharmacology was adequate. Fifty-six percent (95% CI 0.48-0.64) of all respondents felt their knowledge of physiology was adequate. Forty-six percent (95% CI 0.38-0.54) of all respondents felt their knowledge of pathology was adequate Seventy-six percent (95% CI 0.69-0.83) felt their behavioural science knowledge was adequate. A greater proportion of respondents were confident in behavioural science than any other basic science (p<0.01). CONCLUSION: Respondents to the 2005 senior medical students survey from the University of Auckland School of Medicine are most confident in their behavioural sciences knowledge. Respondents are least confident in their knowledge of pharmacology.

Adult↗

Students teaching AIDS to students: addressing AIDS in the adolescent population.

Adolescents are at high risk for developing acquired immunodeficiency syndrome (AIDS) because of their sexual curiosity and exploration, drug experimentation, and lack of knowledge. At present, the only way to reduce this risk is through education. In an effort to increase AIDS education among adolescents, a program called Students Teaching AIDS to Students (STATS) is proposed. The goal of this project is to help train medical students to become AIDS educators in the schools, churches, and youth organizations of their local communities. The project involves preparation and distribution of a package of materials which can be used by medical students to initiate a STATS program. The package consists of a manual which explains the essentials of starting a youth health education project, suggests how to gain approval for the project within the community, and contains curriculums with basic AIDS information and exercises. The curriculum material is tailored for presentation to students over two school-class periods on separate days and contains age-appropriate information. Another component of the package is the slide show tailored to explain STATS to school boards, parent groups, and the leaders of other youth organizations. A video tape to help answer difficult questions put by students has been selected to be part of the curriculum for school grade levels 7 to 12. These materials are geared to facilitate the start of a successful AIDS education program for adolescents.

Acquired Immunodeficiency Syndrome↗

Use of a student support group to reduce student stress in a nurse anesthesia program.

Stress in nurse anesthesia programs may be excessive at times, especially in new students. While some degree of stress is necessary to motivate learning, excessive or prolonged stress can interfere with the normal learning process, thereby prolonging a student's clinical and academic progress. In the extreme, excessive stress may even preclude a student's successful completion of the educational program. Active faculty intervention through a student support group is advocated as a method for controlling stress levels and facilitating student learning. The positive effects of such intervention also increase the overall productivity of a program and better prepare nurse anesthesia students for their future careers.

Efficiency↗