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Herd immunity to measles virus in a population of student nurses and medical students following a widespread outbreak of clinical measles in Ibadan, Nigeria.

Following an outbreak of serologically--and virologically--confirmed measles requiring large-scale hospitalisation of children in Ibadan, Nigeria, the herd immunity to measles virus among medical students and student nurses was determined. Of the 200 students tested, none lacked haemagglutination--inhibiting antibody to measles virus. The titre of HI--antibody ranged from 2(5) to 2(10). Describing a titre of 2(9) as very high, a significantly higher proportion of student nurses than medical students (P < 0.05) had very high antibody titres to measles virus. There was however no statistical difference between the sexes (P > 0.05). Using a commercial Enzyme Immuno Assay kit (EIA), anti measles IgM could not be detected from any of the students. Thus a clear evidence of recent infection with measles virus during the outbreak could not be detected among the students, a probable indication that student nurses and medical students may not participate in the maintenance of wild measles virus within the hospital environment in developing countries like Nigeria.

Antibodies, Viral↗

Predicting medical student success in a clinical clerkship by rating students' nonverbal behavior.

OBJECTIVE: To evaluate the relative contribution of affective and cognitive skills to ratings of students' clinical performance by their supervisors. METHODS: Each students' nonverbal behavior was analyzed by examining 33 nonverbal behavioral characteristics in videotape of each of 36 students interviewing a parent or patient three times during a 4-week pediatric clerkship. These ratings were then compared with the student's formal academic evaluation. RESULTS: The 33 nonverbal behavioral characteristics rated for each student were reduced to five composite variables. Three of these correlated significantly with the final grade, providing an affective profile of the highly rated student. Regression analysis of the five composite variables revealed that affective skills accounted for at least 46% of the variance in the students' final grades (multiple R = .68, P = .0015). CONCLUSIONS: Ratings of students' affective characteristics were highly related to clinical evaluations in this pediatric setting. Students who were evaluated highly had a specific affective profile that could be described by analysis of their nonverbal behaviors.

Adult↗

A shortened common foundation programme for graduates--the students' experience of student-centred learning.

This paper examines the students' experience of student-centred teaching and learning strategies within a shortened Common Foundation Programme (CFP) for Graduates. The perceptions of 'student-centreness' and its use as experienced by the students is addressed using material generated from on-going research using new-paradigm methodology within an action research framework. Graduates enter nurse training from the background of a subject area and possessing the academic skills required to access and assimilate knowledge effectively. These qualities underpin the design of this course, which concentrates on enabling the students to achieve the learning outcomes of the CFP within a flexible structure concentrating on skill acquisition and reflective practice according to the needs of the individual. The differing expectations of the course, the need for clear, externally set objectives, and the question of the ability of the students to self-motivate arise as the pertinent issues from the evaluation. These are discussed with reference to the students perceived needs, levels of achievement and differing learning styles. The author concludes that student-centred methods are appropriate for nurse education, but that these have significant implications for course design, course content and staff development, if the course is to satisfy both students and teachers.

Curriculum↗

Is the introduction of a student-centred, problem-based curriculum associated with improvements in student nurse well-being and performance? An observational study of effect.

AIMS: To explore the impact of curriculum redesign and innovation on student well-being and performance, including essay and examination marks and sickness absence. BACKGROUND: While the emotional impact of preparing to be a health professional can be reduced by helping students to adapt, the positive effect of curriculum innovation and redesign is rarely evaluated. DESIGN, SAMPLE AND METHODS: Student nurse well-being and performance was compared at weeks 24/25 and 40/50 following course entry between comparable independent cohorts of students undertaking a traditional programme (N=406, 83% return rate) with those on an innovative, student-centred, problem-based educational programme (N=447, 79% return rate). The setting was a School of Nursing and Midwifery in the North-East of Scotland. Measures included stress and mental health outcomes and measures of performance including academic marks and sickness absence. RESULTS: At week 25 into the course students on the innovative course had fewer academic, clinical and personal worries than students in the previous more traditional programme and were more likely to report using adaptive direct, problem-solving coping at week 50. While students on the innovative course reported less distress in their first year of the course, they scored less well on comparable essay assignments and had reliably greater sickness absence totals than those educated by traditional methods. CONCLUSION: In this setting, curriculum innovation was associated with positive changes in student well-being but not on performance.

Absenteeism↗

The influence of friends, family, and older peers on smoking among elementary school students: low-risk students in high-risk schools.

BACKGROUND: This study examined how older smoking peers at school and the smoking behaviour of friends and family members are related to youth smoking. METHODS: Multi-level logistic regression analysis was used to examine correlates of ever smoking in a sample of 4286 grade 6 and 7 students from 57 elementary schools in Ontario, Canada (2001). RESULTS: Each 1% increase in the smoking rate among grade 8 students increased the odds that a student in grades 6 or 7 was an ever smoker versus never smoker [OR 1.05, 95% CI 1.02 to 1.08]. A low-risk student (no family or friends who smoke) was almost three times more likely to try smoking if he/she attended an elementary school with a relatively high prevalence of senior students who smoke than if he/she attended a school with a low prevalence of senior students who smoke. CONCLUSION: Low-risk grade 6 and 7 students are at significantly greater risk of smoking if they attend an elementary school with a relatively high prevalence of smoking among senior students. Prevention programs should target both at-risk schools and at-risk students.

Adolescent↗

Assessing practice of student nurses: methods, preparation of assessors and student views.

AIMS: To describe the methods of measuring progress in achieving competence of preregistration nursing and midwifery students used by institutions of higher and further education in Scotland and to describe the philosophy and approaches to competence assessment in each institution. BACKGROUND: Institutions of higher and further education in Scotland operate a variety of schemes to assess the clinical practice of student nurses. These are based on different philosophies and practices and this raises the question of which are valid and reliable. METHODS: All institutions in Scotland providing validated Diploma of Higher Education programmes for preregistration nursing and midwifery participated in this study. Data were collected by postal questionnaire, review of programme documentation and supplemented with interviews with key stakeholders. The directors of the 13 programmes (seven nursing and six midwifery programmes) were surveyed and also 12 group interviews with students (six nursing and six midwifery student groups) from seven institutions. Students from all four branches were represented and 72 students (36 nurses and 36 midwives) were interviewed. RESULTS: Four key findings were identified and related to competence assessment methods, preparation of practice assessors, consequences of failure to meet expected level of outcome and students' views. CONCLUSIONS: There has been a change in theoretical frameworks of assessment instruments used since the 1992 programmes commenced and only a limited number of approaches to clinical assessment are used in Scotland. Students' views suggested that they had little confidence in methods of clinical competence assessment and there was no formal validity and reliability testing within institutions. A lack of consistency in the training of student assessors in the clinical areas was identified. Some of these issues may be resolved with the development of a national instrument for competence assessment.

Clinical Competence↗

Assessing medical student effectiveness from the psychiatric patient's perspective: the Medical Student Interviewing Performance Questionnaire.

This study sought to develop and pilot-test a patient-completed rating scale of medical student effectiveness while training in psychiatry. Specifically, the study focused on: (1) examining the statistical reliability and validity of a new scale; (2) using the measure to assess patient satisfaction with medical student care during the psychiatry clerkship; and (3) providing some experience-based recommendations about utilizing patient feedback when training medical students in psychiatry. Data were collected over an entire academic year and involved 35 third-year medical students and ratings of their performance provided by 102 psychiatric inpatients. Participants were recruited from three inpatient units and the rate of participation was 62.5%. Principle components analyses of the Medical Student Interviewing Performance Scale (MSIPQ) showed that the overall scale consisted of two, theoretically relevant subscales called 'Rapport' and 'Treatment Feedback.' Each subscale had adequate reliability. In addition, the two subscales were shown to each account for unique variance in two separate questions assessing the patient's overall ratings of rapport and treatment helpfulness. Finally, patients' mean ratings of medical student effectiveness were examined and showed very high levels of satisfaction with the student-patient relationship and the quality of care received. This study is among the first to examine patient satisfaction with medical student providers among a general population of psychiatric inpatients. Recommendations are made about the ways in which the MSIPQ can be used to strengthen the training of medical students in psychiatry.

Adult↗

What do medical students read and why? A survey of medical students in Newcastle-upon-Tyne, England.

OBJECTIVES: There is increasing interest in the role of medical humanities within the undergraduate curriculum, but we know little about medical students' views on this or about their reading habits. Our study explored the reading habits of medical students, and their attitudes towards literature and the introduction of humanities into the curriculum. DESIGN: Self-completion questionnaire survey. SETTING: Newcastle University and Medical School. SUBJECTS: All first-, second- and third-year undergraduate medical students (384), biology students (151) and a random sample of law students (137) were sent a self-completion questionnaire to assess reading levels, attitudes towards literature and the medical humanities (medical students) and the perceived benefits of reading. RESULTS: Medical students read widely beyond their course and articulate a range of benefits from this, including: increasing awareness of life outside their experience; introspection or inspiration; emotional responses; and stimulation of an interest in reading or literature. Of the medical students, 40% (103/258) read one or more fiction books per month, but 75% (193) read fewer non-curricular books since starting university, largely because of time pressures, work, study or academic pressures and restricted access to books. A total of 77% (194) thought that medical humanities should definitely or possibly be offered in the curriculum, but of these 73% (141) thought it should be optional and 89% (172) that it should not be examined. CONCLUSIONS: Medical students read literature for a variety of very positive and valued reasons, but have found leisure reading harder to maintain since starting university. They support inclusion of the humanities in medical education, but have mixed views on how this should be done.

Attitude↗

Student health policy of a German medical school--results of a cross sectional study concerning students' immunity to vaccine-preventable diseases.

Medical students come into contact with infectious materials early in their medical education. Aim of this study was to assess medical students' immunity to vaccine-preventable diseases and to ensure immunity against hepatitis B. An occupational health medical was offered to all medical students with special emphasis on preclinical students. The examination included a check of the certificates of vaccination and serological tests concerning hepatitis B virus, hepatitis C virus and, on request, HIV. A lecture on occupational risks and general precautions was given to the students. In 7 of 804 tested students serological markers of a previous hepatitis B infection were discovered, fortunately none of the students was infectious. No case of infection with the hepatitis C virus (n=804) or HIV (n=700 tested voluntary) was identified. For 52 percent of the students vaccination against hepatitis B was necessary to guarantee protective immunity. Documented protection against other vaccine-preventable diseases as tetanus (71%), diphtheria (67%), poliomyelitis (56%), pertussis (2%), measles (32%), mumps (24%) and rubella (25%) was also insufficient. As a result a vaccination against hepatitis B in childhood without documented response doesn't guarantee a sufficient protection. An occupational health medical at the beginning of preclinical training seems to be an adequate method of making medical students aware of occupational risks, immunization policies and the importance of occupational medicine.

Adult↗

Insights into medical students' career choices based on third- and fourth-year students' focus-group discussions.

PURPOSE: To identify previously unrecognized factors influencing medical students' career choices and to better characterize the effects of educational experiences, role models, and educational debt on career decisions. METHOD: Fifty-two third- and fourth-year students were recruited from three California medical schools to participate in focus-group discussions. The students were assembled into 12 groups of about four classmates from the same school, each facilitated by a medical student from another school. Focus-group discussions were audiotaped and qualitatively analyzed using content analysis. RESULTS: The students' perceptions of their abilities to influence patients' outcomes and to cope with a large knowledge base differentiated those interested in primary care fields from those attracted to procedure-oriented specialties. Negative role models, based on the students' assessments of interpersonal interactions and career satisfaction, were particularly influential in closing doors to certain fields. Many of the women reported an absence of role models. Most of the students denied any effect of debt or potential income on career choice; while many cited their small debts, some of the women alluded to the anticipation of being in dual-income families. CONCLUSION: Students' career decisions are complex, dynamic, and individualized processes. The use of qualitative measures helps bolster understanding of these processes by identifying new factors (such as mastery of knowledge) and by further characterizing known factors (such as role models and financial considerations). A comprehensive and valid understanding of students' career-decision making is necessary to develop successful strategies to sustain and encourage the choice of primary care careers.

California↗

Students of physical therapy. A comparative study of student profiles at a college and university in Israel.

This study focuses on the attributes of students of physical therapy in order to compare the profiles of students of physical therapy (PT) in two institutions of higher learning in Israel: Ben Gurion University (BGU) and the Academic College of Judea and Samaria (ACJS). This study focuses on a department where studies have an occupational/ applicative/practical orientation and high status in the higher education system. Findings of this study indicate broad similarities in the profiles of students at both institutions in relation to their age, family status, country of origin, number of siblings, parental education, and financial status of student family of origin. On the other hand, students at both institutions differed in terms of gender composition, students' employment status, the source of payment for tuition, and in their academic attainments prior to admission. Specifically, students of physical therapy at ACJS had lower academic achievements prior to their admission and reported having been rejected by other physical therapy programs. Students at ACJS placed higher importance on factors relating to the quality of instruction including teacher involvement, competitiveness, organization, control, and orientation to the study material. Students at BGU attributed greater importance to teachers' support. Findings support a thesis of a converging system of higher education in Israel, traditionally dominated by national universities and regional colleges, a relatively recent phenomenon.

Israel↗

Approaches to learning and studying in medical students: validation of a revised inventory and its relation to student characteristics and performance.

INTRODUCTION: Inventories to quantify approaches to studying try to determine how students approach academic tasks. Medical curricula usually aim to promote a deep approach to studying, which is associated with academic success and which may predict desirable traits postqualification. AIMS: This study aimed to validate a revised Approaches to Learning and Studying Inventory (ALSI) in medical students and to explore its relation to student characteristics and performance. METHODS: Confirmatory factor analysis was used to validate the reported constructs in a sample of 128 Year 1 medical students. Models were developed to investigate the effect of age, graduate status and gender, and the relationships between approaches to studying and assessment outcomes. RESULTS: The ALSI performed as anticipated in this population, thus validating its use in our sample, but a 4-factor solution had a better fit than the reported 5-factor one. Medical students scored highly on deep approach compared with other students in higher education. Graduate status and gender had significant effects on approach to studying and a deep approach was associated with higher academic scores. CONCLUSIONS: The ALSI is valid for use in medical students and can uncover interesting relationships between approaches to studying and student characteristics. In addition, the ALSI has potential as a tool to predict student success, both academically and beyond qualification.

Age Factors↗

What does "disability" mean for medical students? An exploration of the words medical students associate with the term "disability".

CONTEXT: Disability teaching is a core theme in undergraduate medical education. Medical students bring a range of experiences of disability to their medical training. AIM: The principal aim of this study was to explore the words that medical students associate with the term "disability" and to consider how the resulting information could inform teaching. A secondary aim was to see if a short disability course changed the word associations. METHODS: Students were asked to write down 2 words that came to mind when they heard the word "disability", before and after a 4-day course in disability. Words from 4 cohorts were analysed by frequency and the following word dichotomies: visual icons/personal attributes; loss/enabling, and medical model/social model. A random sample of students took part in focus groups at the beginning and end of the course. RESULTS: A total of 381 students provided 667 before-course words and 189 students provided 336 after-course words. Before the course, words denoting visual icons of disability, and loss were prominent, accounting for 85% of the words, and 74% of the words describing personal attributes were negative. Focus group responses at this stage reflected an eagerness to help but patronising terms were prominent, along with concern about political correctness. Students also expressed nervousness about encountering disabled people. In response, teaching was adapted to make it more learner-focused, to offer a safe environment in which students can test out their language, to build on the positive associations and to develop a range of pre-course creative activities with disabled people. After the course a considerable and significant shift in emphasis was observed, with a reduction in the use of visual icon words, an increase in words denoting enablement, and an increase in words relating to the social model of disability and to positive personal attributes (P < 0.001). Focus group participants at this stage reported greater confidence in approaching disabled people but continued to question political correctness. CONCLUSIONS: Medical students associate disability predominantly with depersonalised or negative words. A short disability course appears to change these associations. Reasons for this and implications for teaching are discussed.

Attitude of Health Personnel↗

Where students go when they are ill: how medical students access health care.

BACKGROUND: Doctors have high levels of self-treatment, investigation and referral, but little is known about how medical students seek health care. Methods We carried out a questionnaire survey of Year 2 and 4 students, exploring their health-seeking behaviour and attitudes to self-care. SETTING: A London medical school. RESULTS: The response rate was 80%. Nearly all students (99%) were registered with a general practitioner (GP). A total of 43% had informally consulted doctors who were friends or relatives in the previous 12 months (61% of those with a doctor as a family member had informally consulted, and 33% of those without a doctor as a family member had informally consulted; P = 0.001). In all, 13% of Year 4 students and 2.2% of Year 2 students had received a prescription from a friend (P = 0.007). Almost a quarter (22%) of Year 4 and 1.3% of Year 2 students reported having directly contacted a specialist (P = 0.01). A third (32%) (43% Year 4, 1.3% Year 2; P = 0.006) of those referred in the previous 12 months had contacted the consultant directly. In all, 9.2% (0% Year 2, 20% Year 4; P = 0.001) had initiated their own investigations, and 25% (47% Year 4, 7% Year 2; P = 0.001) had been examined by a colleague. Students agreed that it was appropriate for doctors to self-investigate (52%), self-refer (59.1%) and self-prescribe (39.2%). CONCLUSION: Medical students appear to bypass their GPs and initiate investigations, referrals or treatment. This is associated with increased clinical access or access through family members. Self-management of illness is learnt early on in students' careers and is increased with availability and increasing clinical access.

Adult↗

Acceptance of deaf students by hearing students in regular classrooms.

Peer relations are of great importance during adolescence. Belonging to a group and feelings of acceptance or rejection by other members are paramount. The article explores the attitudes of 792 hearing students from 10 to 20 years of age in 22 different schools in Spain toward the classroom mainstreaming of deaf students. In general terms, the results, obtained from a scale similar to the Likert and consisting of 19 questions, show that the deaf student is well received socially by hearing classmates. Hearing students in general felt that deaf students might be better looked after at a special school and that deaf students did not work as hard as hearing students. Young female hearing students reported the strongest support for mainstreaming of deaf students. Teachers were perceived as dedicated and patient.

Adolescent↗

Remediation of mutually aversive interactions between a problem student and four teachers by training the student in reinforcement techniques.

This study tested the effect of a social reinforcement training procedure for a problem student on the verbal and nonverbal approval and disapproval of four of the student's teachers. A design incorporating aspects of a multiple baseline within an extended reversal design (ABABA) was employed. Data were taken on the four teachers' approval and disapproval of a student regarded as a major discipline problem and the target student's approval and disapproval of the four teachers during baseline 1, experimental condition 1, baseline 2, experimental conditon 2, and a postcheck or baseline 3 condition six weeks after experimental condition 2. Results showed that increased student approval and decreased disapproval were attributable to training procedures. The increased student approval increased three of the four teachers' approval and decreased the disapproval of all four teachers. Six weeks after experimental condition 2, both approval and disapproval by three of the four teachers and the student and disapproval by all four teachers and the student remained changed over baseline conditions. Student and teacher approval and disapproval were highly correlated at statistically significant levels.

Adolescent↗

MMPI-2 schizophrenia spectrum profiles among schizotypal college students and college students who seek psychological treatment.

The MMPI-2 schizophrenia spectrum profiles of 25 college students with extreme scores on the Perceptual Aberration and Magical Ideation Scales were compared to those of 27 students who requested psychological treatment at a university psychology clinic. Moldin, Gottesman, and Erlenmeyer-Kimling's 1987 classification strategy for schizophrenia spectrum disorders identified 66% of the students who did not seek psychological treatment and had high scores on the Perceptual Aberration and Magical Ideation Scales as having an 8-6, 8-9, or a 9-8 MMPI-2 profile. Of the students who requested psychological treatment, 25% produced MMPI-2 schizophrenia spectrum profiles. Of these, 63% produced a 2-7-8 code profile. Additional analyses showed that only some of the students who requested psychological treatment and produced a 2-7-8 MMPI-2 profile exhibited schizotypal features and that this group stayed in therapy longer than students without schizophrenia spectrum profiles. These results suggest that only a subset of the students with high scores on the Perceptual Aberration and Magical Ideation Scales produce schizophrenia spectrum MMPI-2 profiles and that these profiles are substantially different from those produced by students with high scores on the Revised Social Anhedonia Scale and from schizotypal college students who seek psychological treatment.

Adult↗

Students' academic performance in nursing as a function of student and faculty learning style congruency.

The purposes of this study were to identify learning styles of traditional baccalaureate nursing students, registered nurse baccalaureate students, baccalaureate nursing students holding a previous non-nursing degree, and nursing educators and to determine the effects of teacher/student learning style congruency on academic performance, when controlled for students' previous academic achievement. Kolb's Learning Style Inventory and a Descriptive Data Questionnaire were administered to 334 nursing students and their respective nurse educators from two nursing schools in Mississippi. Learning style scores were computed and faculty and student learning style congruency was described as: 1) matched on both abstract-concrete and active-reflective dimensions; 2) matched on only the abstract-concrete dimension; 3) matched on only the active-reflective dimension; or 4) not matched on either dimension. There were no significant differences in learning style among the three groups of nursing students, and learning style congruency between student and faculty did not appear to significantly affect academic performance of students.

Achievement↗