Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “STUDENTS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources

Medical students taking the role of the mother in paediatric interview evaluation.

BACKGROUND: Medical students develop the skills required to interview parents and children through practice and by receiving feedback. Parental perceptions of medical student skills in child health interviews can be used to enhance student learning. OBJECTIVES: To integrate maternal perspectives of medical student interviews into student learning, and to compare student and maternal evaluations of simulated medical student interviews. METHODS: A sample of 45 medical students viewed 2 standardised videotapes in which a 'medical student' interviewed the mother of a sick child. The videotapes demonstrated contrasting levels of 'student' clinical competence and patient-centeredness. After each interview students were asked to rate their satisfaction and recall of information as if they were the mother in the interview. Student satisfaction was measured using the Interpersonal Skills Rating Scale (IPS). Recall of interview information was assessed by questionnaire, with student answers coded independently before analysis. Following both videotapes, students reviewed transcripts of the interviews and discussed their evaluations. Student responses were compared with maternal satisfaction and recall responses after viewing of the same videotapes. RESULTS: Student IPS ratings were higher following the high clinical competence, high patient-centred interview (P < 0.0001). Student recall of specific information was greater for some items following the high clinical competence, high patient-centred interview, but was lower for others. Maternal and student satisfaction and recall were similar following the 2 interviews. CONCLUSION: Students and mothers agreed on the qualities of a successful interview. Experiencing an interview through the 'eyes' of a mother provided students with valuable insights regarding interview skills.

Clinical Competence↗

Changes in the awareness of oral health among new students newly enrolled at the University of Tokyo over the past 15 years.

OBJECTIVE: The aim of this study was to examine changes in awareness of oral health among Japanese university students. METHODS: Between 1990 and 2004, a total of 51,650 students newly enrolled at the University of Tokyo responded to an annual written questionnaire on oral health. RESULTS: (i) Approximately 60% of the students brushed their teeth twice a day. Female students brushed more frequently than male students. (ii) The percentage of students who brushed for 2-3 min per time decreased, while the percentage who brushed four or more minutes increased. (iii) The number of students who had learned how to brush properly increased. This trend was particularly clear-cut among male students, although the proportion of female students who had learned to brush properly remained higher than that of male students. (iv) The percentage of female students who sought treatment for malocclusion was higher than that of male students. The percentage of students who underwent orthodontic treatment increased from 11.6 to 19.7%. The percentage of female students who received orthodontic treatment was approximately twofold that of male students. (v) The percentage of students who had temporomandibular disorders was 0.7% in males and 1.5% in females. (vi) More than 40% of the students had periodontal diseases, with a higher prevalence among male students than female students. (vii) Approximately 20% of the students wanted to consult our service centre. CONCLUSIONS: The awareness of oral health among new undergraduates at the University of Tokyo has improved over the past 15 years.

Adult↗

Do benefits accrue from longer rotations for students in Rural Clinical Schools?

INTRODUCTION: The Australian Government has provided funding for Rural Clinical Schools (RCS) to provide substantial rural clinical experience to medical students. The strategy aims to acculturate students into rural living with the intended long-term outcome of increasing the availability and viability of rural health services. When evaluators from two of the Rural Clinical Schools discussed findings and insights relating to rural rotations from their in-depth evaluation studies of their respective schools they found a range of similarities. This article is a collaboration that articulates parallel findings from evaluations over 2 years, using three different approaches to students' placements across the two RCS: (1) students based long term in one centre (with only a few days away at a time); (2) students based long term in one centre with short-term rotations of 3-6 weeks away from home base; and (3) week rotations without a home base. METHOD: The two RCS, as part of their initial establishment, put comprehensive internal evaluation processes in place, including the employment of dedicated evaluators extant from the teaching and assessment of the rural medical curriculum. Data were collected and analysed according to standard education evaluation procedures. RESULTS: Home-base preference: most students preferred having a home base in one centre and having as little time as possible away from that centre, while recognising that sometimes the requirement to go and learn elsewhere was useful. The reasons for this were three-fold: academic, clinical and social. Academic benefits: students enjoyed the excellence of teaching and learning opportunities in their rural sites and did not want their discipline of learning interrupted by what they perceived as unnecessary change. Students with a home base used their learning opportunities qualitatively differently from those students who had 6 week rotations. Their learning became self-directed and students sought opportunities to extend and consolidate areas of need. Clinical benefits: contributions to the clinical team: students in their clinical years want to feel useful and to be allowed to become contributors to the medical care, even as they are learning. A longer rotation allows them to become known to their teachers who are then able to easily assess the type of contribution that is appropriate for their students to undertake. Students then become full participating members of the healthcare team, rather than observing learners. Social benefits: all students with a home base actively participated in a wide range of community activities outside their role as medical students. Those students undertaking short rotations without a home base seldom connected in the same way to any rural community. CONCLUSION: Evaluation from these two RCS has shown that short rotations are likely to be less optimal than longer rotations for meeting the broader goals of the RCS to build future workforce capacity. Our results suggest that one opportunity to acculturate students into the rural lifestyle is lost when students' placements are insufficiently long for them to put down roots in their community, and to understand how to 'live' there more broadly. Good rural experiences and teaching and learning opportunities are not sufficient in themselves. Students' emotional attachment to rural living comes from experience related to time and the connection to local people that comes as a result of time spent in the community. Students on short rotations do not make that local connection.

Australia↗

Final examination performance of medical students from ethnic minorities.

It has recently been claimed that UK medical students from ethnic minorities perform less well than White students in final undergraduate examinations and that this results from discrimination in clinical examinations. In this paper the authors examine the performance of students in two prospective studies of 1981 and 1986 entrants to London medical schools taking finals in 1986, 1987, 1991 and 1992. Overall, 18.2% of students in the survey failed one or more examinations at finals. UK ethnic minority students were 2.09 times more likely to fail one or more examinations than were UK White students. Male students were also 1.65 times more likely to fail an examination than female students. More detailed analysis of individual marks confirmed that UK ethnic minority students performed less well than UK White students, although non-UK ethnic minority students performed better than UK White students. The difference between UK White and ethnic minority students could not be explained by differences in educational achievement, study habits or clinical experience. The poorer performance of UK ethnic minority students extended across multiple-choice questions (MCQ), essay, clinical and oral examinations. Ethnic minority students performed particularly poorly on examinations in medicine and surgery as compared with pathology and clinical pharmacology. Although UK-born ethnic minority students perform less well in final examinations than UK White students, this is unlikely to be explained by racial discrimination as the difference is present in MCQ examinations marked by machine and as non-UK ethnic minority students perform better than UK White students. The cause of the difference in performance is therefore not clear and requires further study.

Educational Measurement↗

A study of stress in medical students at Seth G.S. Medical College.

BACKGROUND: It is usually observed that medical students undergo tremendous stress during various stages of the MBBS course. There is a high rate of suicide among them. METHODS: To determine incidence of stress and factors controlling stress in medical students at various stages of MBBS course at Seth G S Medical college, 238 students (First year 98, Second 76, Third 64) were asked to complete a questionnaire on personal data (gender, stay at hostel, mode of travel, time spent in travel every day, medium of study in school, place of school education.), Stress inducing factors, Zung's depression scale, ways of coping, stress relievers, perceived social support and personality type. Statistical tests used were ANOVA, critical ratio and Student's 't' test. RESULTS: Majority of medical students (175/238--73%) perceived stress. Stress was found to be significantly more in Second and Third MBBS students rather than First MBBS levels (p < 0.05). Stress was not found to differ significantly on the basis of sex, stay at hostel, model of travel, time spent in travel every day, medium of study in school, place of school education. Stress was found to be significantly more in students having more than 95% of marks at 12th Standard as compared to others. Academic factors were greater perceived cause of stress in medical students. There was no significant difference in the students at different levels of MBBS regarding academic factors and social factors as a stress inducing factors. Physical factors were found to be significantly more in Second and Third MBBS students as compared to First MBBS students. Emotional factors were found to be significantly more in First MBBS students as compared to Second & Third MBBS students. Stress was more common in medical students who have dominant strategy of coping as positive reappraisal, accepting responsibility and planful problem solving. Stress was less common in medical students at Seth G S Medical College who have dominant strategy of coping as escaping and distancing from difficult situation. Family and Friend as perceived social supports were more in Second MBBS than First MBBS medical students. Stress was not found to be significantly more in students having their personality factor contributing to stress (Type A--52/67) as compared to others (Type B--123/171). This indicates that the stress was not trait oriented but was process oriented (p = NS). CONCLUSION: Stress in medical students is common and is process oriented. It is more in second and third year. Academic factors are greater perceived cause of stress in medical students at Seth G S medical college. Emotional factors are found to be significantly more in First MBBS. It is dependent on person's ways of coping and social support.

Adaptation, Psychological↗

Appraisal of the dental school learning environment: the students' view.

The majority of studies examining dental school curriculum have addressed organization, structure, and content issues from the perspectives of administrators, faculty, practitioners/alumni, and professional organizations. However, few studies have focused on students' opinions of dental school. The purpose of this study was to determine students' perceptions of the learning environment, intellectual climate, and teacher-student relationships in dental school. This report describes how the "dental version" of the Medical Student Learning Environment Survey (MSLES) was used to identify students' perceptions of their dental education. Freshman and junior dental students' perceptions were measured with the Dental Student Learning Environment Survey (DSLES), which evaluates learning environment, intellectual climate, and relationships among students and teachers in seven areas: flexibility, student-to-student interaction, emotional climate, supportiveness, meaningful experience, organization, and breadth of interest. The DSLES was mailed to twenty-three dental schools in North America with eighteen of the schools distributing the inventory. A total of 619 dental students responded. Results were differentiated between freshman and junior dental students. Both freshman and junior students provided the highest (most positive) ratings for the DSLES subscales of "breadth of interest" (interest in dentistry and outside interests are encouraged) and "meaningful learning experience" (significance of courses to dentistry). Freshman students provided the lowest (least positive) ratings for "emotional climate" (students' responses to the way their courses were conducted and stress levels), and junior students provided the least positive ratings for "faculty supportiveness" (extent of faculty support and encouragement provided to students). The DSLES identified students' perceptions of their educational experience and localized areas for improvement. By addressing these areas of concern, faculty can increase student satisfaction with their dental education.

Curriculum↗

Team-based versus preceptor-based assignment of junior surgery students.

BACKGROUND: Clinical evaluations of junior surgery students frequently lack sufficient detail for effective formative or summative feedback. We hypothesized that this was in part due to a lack of personal accountability associated with large general surgery teams, and that altering the format to assign students to specific surgical faculty preceptors rather than to teams would affect the clinical evaluation products. METHODS: Over a 1-year period, 154 junior medical students grouped into 8 successive clerkships were assigned alternately in the usual Team (3-5 junior students, with 2-4 general surgery faculty, 2-4 residents, and 0-2 senior students) or a new Preceptor format (1-2 students to each faculty preceptor). In order to keep the ratio of students to faculty low, approximately one-third of the Preceptor format students were assigned to subspecialists. RESULTS: The preceptor format resulted in the use of more adjectives to describe students in the open-ended portions of the faculties' clinical evaluations (mean of 3.2 as compared with 2.5, P = 0.003), and a greater proportion of students recommended for overall clinical Honors (47% as compared with 25%, P = 0.004). The clerkship format had no impact on exam performance, students' perceptions of the faculty, or the amount of students' self-reported clinical activity. Nevertheless, twice as many Team format students felt they had too few patients, whereas twice as many Preceptor students felt their informal instruction had been less than "good." CONCLUSIONS: Preceptor assignment increased the number of students recommended for Honors, but this did not correlate with students' exam performance. From the students' standpoint, each format had advantages and disadvantages. Limiting the number of students on the general surgery teams and adding structured formative feedback from faculty before the end of the clerkship might give students the instructional advantages of the Preceptor format without sacrificing those of the Team format.

Adult↗

Special education for students with disabilities: analysis and recommendations.

Twenty years ago, the educational rights of students with disabilities were dramatically and firmly established in law and practice. Prior to that time, many students were refused enrollment or special educational services. As recently as 1973, at least one million students were denied enrollment in public schools solely on the basis of their disabilities, and at least two million others were not receiving an education appropriate to their needs. Although every state has provided some form of special education throughout this century, these services were largely at the discretion of local school districts. Only since a federal court case in 1972 and the passage of federal legislation in 1975 have all states been mandated to provide a free, appropriate public education to all students with disabilities. Today, as Parrish and Chambers point out in this journal issue, special education for students with disabilities is the largest categorical program in public schools, costing an estimated $32 billion. Since the passage of Public Law 94-142 in 1975 (later retitled the Individuals with Disabilities Education Act, or the IDEA), the number of elementary and secondary students receiving special education has increased from 3.7 million to 4.6 million, increasing also from 8% to 11% of all students in public schools. According to Parrish and Chambers, the population of students eligible for special education is expected to continue to rise. The IDEA governs the educational rights of individuals from birth to age 21, though only students in elementary and secondary school are addressed in this journal issue. The IDEA allowed access to the public schools for many students who had previously been denied enrollment. The IDEA has also been given partial credit for decreasing the rate of institutionalization of individuals with disabilities. Before the IDEA, many parents had the sole responsibility of meeting all the needs of their severely disabled children 24 hours per day; once schools began to provide extensive services to students with severe disabilities, more families were able to avoid institutionalization. Under the IDEA, states and local districts were given a mandate to provide specialized educational programs to students with special needs, and students and parents were given a mechanism for enforcement of their rights. In a 1989 survey, 94% of parents of students with disabilities agreed that services for these students had improved since the implementation of the IDEA. Yet special education today is widely criticized as expensive, ineffective, inadequately coordinated with regular education, and/or culturally biased. The National Association of State Boards of Education has recommended radical reduction in the size of special education. Special education also has its champions, who argue that many students perform better academically and have better self-esteem when provided with special services, often in a separate setting. This analysis addresses five questions concerning special education under the IDEA: (1) Why are so many students considered disabled? (2) What are the educational needs of students with disabilities? (3) How should appropriate, individualized services be funded? (4) Are the IDEA's procedural protections necessary? (5) Can regular education meet the needs of more students?

Adolescent↗

Academic profile of students who transferred to Zagreb School of Medicine from other medical schools in Croatia.

AIM: To assess the academic performance of students who transferred to the Zagreb School of Medicine from other three medical schools in Croatia. METHODS: Academic performance of medical students who moved from Rijeka, Osijek, or Split University Medical Schools to the Zagreb University School of Medicine at the second or third year was compared with academic performance of students enrolled at the Zagreb University School of Medicine. Using the Zagreb Medical School's registry, we made a list of 57 transfer students to Zagreb Medical School in the 1985-1994 period. Control group was formed of students enrolled at the Zagreb School of Medicine in the same period, whose names followed in alphabetical order after the names of transfer students. Students' performance was analyzed according to their grade average before transfer, grade average in the first year after transfer, total grade average after transfer, overall grade average, and duration of studies. We also analyzed the proportion of students in each group who did not pass the admission test at the Zagreb School of Medicine in the year before the enrollment in Zagreb, Osijek, Rijeka, and Split Medical Schools. Nineteen transfer students, transferred between 1985 and 1988, and their controls were excluded from the analysis because of incomplete data. RESULTS: Transfer students had significantly lower grade average before transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03, Student t-test), lower grade average in the first year after transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03), lower total grade average after transfer (3.6-/+0.5 vs 4.0-/+0.6, p<0.001), and lower overall grade average (3.5-/+0.5 vs 3.9-/+0.6, p<0.001) than control students. Median time to graduate for transfer students was 7 years (range, 5-9) and 6 years (range, 5-9) for control students (p=0.375, Mann-Whitney test). There were significantly more students among transfer students who did not pass the admission test at the Zagreb School of Medicine in the year before the final enrollment than their controls (15/38 vs 4/38, p=0.009, chi-square test). CONCLUSION: Transfer students had poorer academic performance than students who passed the admission test and were enrolled at the Zagreb School of Medicine from the first year of studies.

Career Choice↗

[Clinical clerkship of home care for medical students].

UNLABELLED: A clinical clerkship of home care has been introduced in our program for third-year medical students since 1998 at this university. In our clinical clerkship of home care, medical students are not only dispatched to visiting nursing stations, but they also participate in home care service activities with visiting nursing people at patients' homes. Through these experiences the students have an opportunity to study the policy of community medicine and home care, and to gain the knowledge of teamwork. OBJECTIVE AND METHOD: The clerkship of home care (1 week program) was introduced to all of the third-year medical students. The students were dispatched to visiting nursing stations and they had to take part in home care service activities at patients' homes with community care visiting nurses. After this program was finished, questionnaires were given to all the students and visiting nurses to examine the necessity and scheduling of this program and to evaluate the students by the visiting nurses, etc. RESULT: A total of 621 students participated in our program for the past 6 years since 1998, and 90 visiting nurses from 30 visiting nursing stations gave actual trainings to our students every year at patients' homes. 98% of the students as well as 97% of the home care nurses returned questionnaires. After the program, 95.1% of the students and 97.8% of the visiting nurses agreed that this program was meaningful for both sides and it should be continued. Furthermore, regarding a question of the suitability of the third-year medical students to be in the program, 70% of the students and 48% of the visiting nurses agreed. As to a question of the training duration, 80% of the students and 87% of the visiting nurses also agreed. Both students and visiting nurses were in agreement that this home care clerkship was important. Meanwhile, both students and visiting nurses also expressed a degree of some difficulty for this clinical clerkship training. These results suggested that there were some factors to be resolved in order to carry out the clinical clerkship as a success. The clinical trainings for community-based home care are not carried out sufficiently under present medical education because clinical clerkships are always performed at a bedside of a university hospital. It is hard for the students to learn community-based home care and the time related progression of a patient's disease. Therefore, clinical clerkship of home care is a good and effective method to educate the students in those areas.

Clinical Clerkship↗

Use of information and communication technology among dental students at the University of Jordan.

The aim of this study was to investigate the current knowledge, skills, and opinions of undergraduate dental students at the University of Jordan with respect to information communication technology (ICT). Dental students from the second, third, fourth, and fifth years were asked to complete a questionnaire presented in a lecture at the end of the second semester in the 2002-03 academic year. The response rate was 81 percent. Besides free and unlimited access to computers at the school of dentistry, 74 percent of the students had access to computers at home. However, 44 percent did not use a computer regularly. Male students were more regular and longer users of computers than females (p<0.001). A significant number of students (70 percent) judged themselves competent in information technology (IT) skills. More males felt competent in basic IT skills than did females (p<0.05). More than two-thirds acquired their computer skills through sources other than at the university. The main educational use of computers was accessing the Internet, word processing, multimedia, presentations, Medline search, and data management. More clinical students felt competent in word-processing skills (p<0.05) and many more used word processing for their studies (p<0.001) than did preclinical students. More males used word processing for their studies than females (p<0.001). Students used computers for personal activities more frequently than for academic reasons. More males used computers for both academic (p<0.01) and personal activities (p<0.001) than did females. All students had access to the Internet at the university, and 54 percent had access at home. A high percentage of students (94 percent) indicated they were comfortable using the Internet, 75 percent said they were confident in the accuracy, and 80 percent said they were confident in the relevance of information obtained from the Internet. Most students (90 percent) used email. Most students (83 percent) supported the idea of placing lectures on the web, and 61.2 percent indicated that this would not influence lecture attendance. Students used the Internet more for personal reasons than for the study of dentistry. More clinical students used the Internet for dentistry than preclinical students (p<0.001). More males than females used the Internet for dentistry (p<0.01) as well as for pleasure (p<0.01). Time and availability were the main obstacles to Internet use. Dental students at the University of Jordan have access to substantial IT resources and demonstrated attitudes toward the computer and Internet technology and use that were similar to other students in other nations. However, the educational use of ICT among Jordanian students remains low.

Computer Literacy↗

Comprehensive school-based health care: high school students' use of medical, mental health, and substance abuse services.

OBJECTIVES: To explore adolescent students' use of school based health and medical care and mental health and substance abuse counseling services and to compare adolescents' patterns of use of medical, mental health, and substance abuse services located in school-based and traditional settings. DESIGN: Retrospective analysis of computer-stored, standardized data for all student visits during a 4-year period. SETTING: Three high school-based student health centers. SUBJECTS: A total of 3818 adolescent students who used services provided by the school-based health centers (SBHCs). OUTCOME MEASURES: Frequencies of student visits to medical providers and mental health and substance abuse counselors and frequencies of diagnostic assignments. RESULTS: During a 38-month period, 3818 students attending senior high school made a total of 27 886 visits to three SBHCs. They represented 63% of students enrolled in the SBHCs and approximately 42% of the total school population. There were no significant demographic differences between students attending the SBHCs and the overall student body. However, compared with students who were enrolled in the SBHCs but did not use them, users were more likely to be female and Hispanic. Ninety-four percent of students using the services had visits with medical providers; 25% had visits with mental health counselors; and 8% of students had visits with substance abuse counselors. The total annual mean number of student visits was 4.7, and the annual mean numbers of visits for students who used the following services were: medical, 3.3; mental health, 5.8; and substance abuse, 6.8. An average of 1.4 diagnoses were made per visit. The most common major diagnostic categories were emotional problems (29% of all diagnoses), health supervision (13%), respiratory problems (11%), reproductive health problems (11%), and substance abuse problems (8%). Almost one fourth of the students had contact with more than one of the three categories of service provicer. Visit frequency increased significantly for students who used two categories of provider (13 to 15 mean total visits compared with 4 to 5 mean total visits for students who used just one category of provider) and escalated to a mean of 32 total visits if all three categories of service were used. CONCLUSIONS: Adolescents attending SBHCs had higher rates of visits for health and medical care than adolescents using traditional sources of medical care. The proportions of student users of SBHC mental health and substance abuse counseling services were commensurate with the estimated prevalences of these problems in this country's adolescent population. In addition, the mean numbers of visits to mental health counselors in SBHCs compared favorably with adolescent visit rates for mental health services in other settings. Too little information is available about adolescent use of substance abuse services in non-school-based settings to make similar comparisons. In summary, adolescent users of SBHCs seemed to have a higher use of medical, mental health, and probably substance abuse counseling services than did adolescents in the general populations. These findings are consistent with the interpretation that SBHCs do enhance adolescents' access to care for medical, mental health, and substance abuse problems.

Adolescent↗

Research attitudes among chiropractic college students.

OBJECTIVE: To explore the attitudes of chiropractic students toward research and factors influencing it. DESIGN: This study was conducted through the use of a survey questionnaire. Students were given a questionnaire with no prior knowledge of the survey to ensure that their responses were spontaneous and to increase the possibility that the responses reflected their true feelings. SETTING: This study was conducted at a small southern chiropractic college. PARTICIPANTS: Students were selected from all quarters (1st-13th) to determine the effect of educational level on research attitude. RESULTS: Seventy students (51 men and 19 women, representing 40% of college student population) completed the questionnaire. Of those students, 51.62% indicated they were interested in research in general; 70.96% thought chiropractic research was important; 35.65% were interested in conducting research before coming to chiropractic college; 90.32% had experienced something interesting in chiropractic and wanted to know more about it; 64.52% had at some time thought about a chiropractic research topic; 35.48% had thought about other research topics; 67.75% agreed that there are many things that need to be researched in chiropractic; 25.81% had research experience in some setting; 45.16% thought basic research technique and statistics should be taught in chiropractic college; 19.36% thought research training should be a requirement in chiropractic college; and 61.29% would participate in chiropractic research if given the opportunity while in chiropractic college. Age and gender had very little effect on the research attitude of students in this study. The level of education in chiropractic college affected the students' general interest in research. Middle quarter-level students who had not taken the required research and chiropractic courses showed greater willingness to participate in research than senior students did. Students with previous research training and experience showed significant positive attitudes toward research in almost all questions. However, providing research training in school did not change students' attitudes toward research significantly in a short period of time. Lack of research experience and family concerns were the major factors affecting the students' interest in participating in research while in school. CONCLUSIONS: Most students completing the survey indicated an interest in research but were reluctant to take extra courses in research. A majority indicated an interest in participating in research. Students interested in doing research were most likely to be students who had some previous research experience or a personal interest as a result of some personal experience. Reasons given for the students' lack of desire to participate in research included family responsibilities, heavy study workload and lack of personal interest and/or previous experience. The overwhelming concern to the students in terms of participating in research was the additional time requirement.

Adult↗

An advanced communication skills course for fourth-year, post-clerkship students.

OBJECTIVE: A novel five-module advanced communication skills course entitled "Doctor-Patient Relationships" was planned and implemented in 2000-01 at the University of British Columbia (UBC). The course was part of the final four-month component of the new MD undergraduate program: Effective Skills for Medical Practice. The goals of the communication skills course were to (1) address problems experienced by the students so far; (2) address deficiencies in achieving the UBC exit competencies; (3) help the students pass the Medical Council of Canada examinations, in particular objectives related to the Considerations of the Legal, Ethical, and Organizational aspects of the practice of medicine (CLEO); and (4) help students prepare for their roles beyond undergraduate medicine (residency, independent practice). DESCRIPTION: The course was developed by an interdisciplinary team (family practice, pathology, pediatrics, psychiatry, surgery) with input from students. The broad strengths and weaknesses of their communication skills training were identified by seven third-year medical students who kept logs over the course of their clinical clerkships to document their learning of communication skills. Analysis of these logs plus feedback meetings with the students revealed attitudinal and skills issues that needed to be addressed in the new course. The goals and principles of the course were in part agreed upon by focus groups with students, attended by faculty observers, to ensure their relevance to students. The first module "Beyond the Mask: Surviving and Thriving in Residency Training" is designed to focus students' attention on the personal relevance of developing excellence in communication skills in preparation for residency training. It includes a video of residents talking about their experiences of communication problems to trigger reflection and discussion. In the remaining four modules the students are required to put communication skills together with their medical knowledge. Each module includes pre-readings, video demonstrations (in sessions 4 and 5), practice with standardized patients (total of 14 scenarios) and structured feedback from SPs, students, and tutor. The themes of the sessions are "Dealing with Emotionally Challenging Patient Situations (informing about bad news), "Compliance and Patient Information," "Informed Consent and Shared Decision Making," and "Difficult Physician-Patient Encounters." Each module lasts two hours. The course was implemented for 120 students, facilitated by 14 tutors (seven to eight students per group). DISCUSSION: Student involvement in many different ways provided an important reality check and made us think about how to present the new course so that it was relevant and interesting to students. Attention to student input was a major contributor to the good evaluations given the course. Students rated the course highly: the relevance of the weekly themes was rated 4.21 on a five-point scale; the effectiveness of the SP interviews, 4.10; the effectiveness of the group discussion and feedback, 4.18; and overall course effectiveness in enhancing communication skills, 3.91. The tutors also rated the course highly, and the students rated the tutors highly. Minor changes will be made to the course next year based on the specific suggestions for improvement, which were identified.

British Columbia↗

[Smoking behavior, knowledge and attitudes of freshmen students].

A questionnaire on smoking behavior, knowledge of smoking-related diseases and attitudes toward the passive exposure to smoking was administered and results analyzed for differences in (1) region, (2) major area of study in the university, (3) grade and (4) date of survey on smoking behavior, knowledge and attitude of the freshmen students. (1) 294 urban and 217 provincial university students, (2) 138 freshmen at the Department of Pharmacology and 156 freshmen at the Department of Technology, (3) 136 freshmen of Y. University and 158 freshmen in senior high school of Yamaguchi prefecture, and (4) 217 freshmen surveyed in 1990 and 136 freshmen surveyed in 1995 were the subjects. The results were as follows; 1) The percentage who had smoked once ranged from 0 to 3% among the senior high school girls and female students at minor universities. However, the percentage for male students ranged from 26% to 44% in each survey. There were clear gender differences in smoking behavior. 2) The proportion of students who admitted that they had smoked cigarettes was 30.9% for urban students and 38.6% for provincial university students, but was not a significant difference. There were no significant differences between urban and provincial students regarding knowledge of smoking-related diseases or attitudes toward passive smoke. 3) The proportion of students who admitted that they had smoked cigarettes was 44.0% for the Department of Pharmacology and 26.2% for the Department of Technology, a significant difference. There were no significant differences between pharmaceutical and engineering students in knowledge of smoking-related diseases or attitudes toward passive smoke. 4) The proportion of students who admitted that they had smoked cigarettes was 27.4% for university freshmen and 1.6% for senior high school freshmen. There was a significant difference between the two. The percentage who replied that the smoker must be considerate to non-smokers tended to be higher in the senior high school students than the university students. However, there was no significant differences between the two groups of students in knowledge of smoking-related diseases or attitudes toward passive smoke. 5) Although the proportion of students who admitted that they had smoked cigarettes was 38.6% in the 1990 survey and 27.4% in the 1995 survey, this was not a significant difference. The percentage of students in the 1990 survey who indicated an awareness of the relationship between smoking and coronary heart diseases was significantly greater than the percentage of students who indicated a similar awareness in the 1995 survey. These results suggest that the differences in the grade and the department of the university (or the nature of school) must be considered when surveying smoking behavior. It does not appear to be necessary, however, to consider regional differences or the date of survey, if students were surveyed relatively recently, concerning smoking behavior, knowledge of smoking-related diseases and attitudes toward the effect of passive exposure to smoking.

Adolescent↗

Identification of communication apprehension in medical students starting a surgery rotation.

BACKGROUND: Most methods used to critically evaluate young surgeons for advancement or certification in surgery require oral communication skills, eg, case and research presentations, rounds, morbidity and mortality conferences, interviews, journal clubs and oral examinations. The irony, though, is that much of surgery training focuses on technical skill lists, and the rhetorical aspects are often neglected until the surgeon encounters failure in an oral examination or is sued for not "talking" appropriately. Early identification of those at risk for difficulty with oral skills would provide programs with time needed to arrange for the appropriate types of interventions. Therefore, the purpose of this study was to identify those medical students with high communication apprehension scores in dyadic, group, or public speaking situations before they encountered failure and caused problems, not only for themselves, but also for their programs and practices. METHODS: Two scales, Willingness to Communicate (WTC) and the Personal Report of Communication Apprehension (PRCA-24), were administered to medical students at two large university medical centers during new student orientation to the surgery rotation. The WTC is a 20-item probability-estimate scale designed to measure one's predisposition toward approaching or avoiding the initiation of communication. The PRCA-24 is a scale designed to measure one's fear associated with either real or anticipated communication in four different contexts. In addition to the 44 items, a lengthy list of demographic items was added for possible correlations. These items were based on the student's perception of the communication or language environment in which he was raised. Therefore, a student ranked past and future socioeconomic status (eg, blue collar or white collar) according to his or her own criteria. The chairman was provided with a list of individual scores. Those students who were below the group means on skills required during a surgery rotation were identified for immediate intervention. RESULTS: The published data show a norm mean of 65.6 for PRCA-24 and 65.2 for WTC for college students. The current study found medical students to be more willing to communicate (WTC) and less anxious about communication (PRCA-24) than college students (mean 70.7 versus 65.2, P = 0.003, and 61.6 versus 65.6, P = 0.01, respectively). This difference was accentuated for blue-collar medical students compared with college students and persisted when blue-collar medical students were compared with white-collar medical students (73.9 blue-collar versus 70.9 college students, P = 0.15 for WTC, and 58.5 blue-collar versus 63.6 white-collar, P = 0.002 for PRCA-24). Male medical students were found to be less anxious about communication than female medical students. CONCLUSIONS: These instruments are easily administered at orientation and produce simple class lists with individual scores. They can be used to identify students who are below the mean for specific forms of communication before they encounter failure.

Clinical Clerkship↗

Becoming professional: when and how does it start? A comparative study of first-year medical and law students in the UK.

AIM: The purpose of this study is to investigate whether differences identified between first-year law and medical students in North America in the 1950s apply in the UK in the 1990s. First-year law and medical students are compared in terms of commitment to career, alternative career choices and length of time the student has wished to study for his/her chosen profession. METHOD: Questionnaires were administered to first-year law students at the University of East Anglia and Essex University and to first-year medical students at Liverpool University Medical School and St George's Hospital Medical School. A total of 162 questionnaires were completed by law students and 195 questionnaires from medical students. ANALYSIS: The questionnaire responses provided by law and medical students were analysed using a series of two-sample comparisons. Differences between the two groups were examined using t and chi-squared tests. In each of the seven questions answered by students, the differences between the law and medical students were found to be significant. This suggests a difference in career aspirations and perceptions between the two groups. RESULTS AND CONCLUSIONS: The study shows a greater commitment of medical students than law students to their chosen career. This is demonstrated by medical students' greater desire to pursue their career, their greater satisfaction with their choice of career and finding that more medical students would persist with reapplying for medicine than law students would in reapplying for law. It is also shown that medical students are twice as likely as law students to have a family member within the profession.

Attitude↗

Redefining medical students' disease to reduce morbidity.

OBJECTIVES: To gain a clearer conceptual understanding of medical students' disease and its impact on students, by separating the process of thinking that one may have a particular illness under study from the emotional distress that may accompany these thoughts. METHOD: In a questionnaire survey, the responses of 92 first-year and 85 third-year medical students were compared with those of 82 law students, with regard to medical students' disease perception, medical students' disease distress, hypochondriacal beliefs, concerns about health, the value placed on health, and recent visits to doctors in the past 12 months. SETTING: The University of Auckland, New Zealand. RESULTS: Both groups of medical students scored higher on medical students' disease perception than law students. First-year students scored higher on medical students' disease distress and hypochondriacal concerns than both law and third-year medical students. While medical students place a higher value on health, there were no differences with regard to health visits in the past year. CONCLUSIONS: The results support the separation of medical students' disease into perceptual and emotional components. This conceptualization of medical students' disease as a normal process rather than a form of hypochondriasis may be used to brief medical students when they enter medical school, in order to reduce the distress associated with the condition. Medical students' disease can also be used as a personally relevant example in teaching about how patients make sense of symptoms.

Adaptation, Psychological↗