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PubMed2002

Differences in clinical experiences based on gender of third-year medical students in a required family medicine preceptorship.

PURPOSE: To investigate whether the gender of a student or preceptor affects the students' level of experience with clinical skills in a preceptorship. METHOD: A total of 451 third-year medical students completed a required family medicine preceptorship during three academic years (1997-2000) at one medical school. Students recorded their highest levels of experience with 57 clinical skills at the completion of the preceptorship using a five-point scale. Mean levels of experience were compared according to student and preceptor gender and by student-preceptor gender dyads. RESULTS: For the majority of clinical skills, levels of experience did not differ according to gender of the student or preceptor. However, women students received more experience with seven of 12 female-specific skills and men students received more experience with two of three male-specific skills. Women preceptors provided more experience with seven of 12 female-specific skills, as well as with depression and anxiety; men preceptors provided more experience with procedures. For the vast majority of gender-specific skills, the highest levels of student experience were received by pairs of students and preceptors of the same gender who were seeing patients of their same gender; the lowest levels of experience occurred in student-preceptor pairs of the same gender seeing patients of the opposite gender. There was no evidence for student-preceptor interactions. CONCLUSIONS: The gender of a student and that of the preceptor affect the level of experience the student receives with a number of gender-specific skills and procedures. Ways should be found to minimize these differences in training.

Adult↗
PubMed2005

The impact of U.S. medical students' debt on their choice of primary care careers: an analysis of data from the 2002 medical school graduation questionnaire.

PURPOSE: To examine the hypothesis that medical students' rising total educational debt is one of the factors that explains the recent decline in students' interest in family medicine and primary care. METHOD: The authors used results from questions on the Association of American Medical Colleges' 2002 Medical School Graduation Questionnaire that focused on students' debt and career choices. Logistic regression was used to determine the independent association of students' debt with career choices, while controlling for students' demographic characteristics. RESULTS: In 2002, 83.5% of graduating students were in debt, and the average student owed US $86,870. Minority students had higher levels of debt. Students reported that higher levels of debt influenced their future career choices, and there was an inverse relationship between the level of total educational debt and the intention to enter primary care, with the most marked effect noted for students owing more than $150,000 at graduation. Total debt was associated with a lower likelihood of choosing a primary care career, but factors such as gender and race appeared to have more explanatory power. Female students were much more interested in primary care-and especially pediatrics-than were male students; African American students were more interested in inner-city practice than was any other identified racial or ethnic group. CONCLUSION: In 2002, students' debt levels were high and increasing. Although students with higher debt levels were less likely than were their counterparts to pursue a career in primary care, the effect was modest when demographic characteristics were taken into consideration.

Adult↗
PubMed2005

Student-teacher connection: a place of possibility.

AIM: This paper expands the understanding of student-teacher connection and offers direction for educators in supporting connection as a place of possibility. BACKGROUND: The evolution of a humanistic paradigm in nursing education is evident in research exploring student-teacher relationships. Connection is described within humanistic student-teacher relationships, reported as part of experiences of students, educators and clinicians within emancipatory curricula, and emerged as a central metaphor in a metasynthesis of caring in nursing education. Additionally, student-teacher connection in clinical nursing education has been reported as creating positive outcomes for students' learning experiences and professional socialization. DISCUSSION: In this paper, student-teacher connection is envisioned as having a value beyond these tangible outcomes - a value that arises from the essence of connection itself. The qualities inherent in the essence of connection - knowing, trust, respect and mutuality - create a transformative space in which students are affirmed, gain insight into their potential, and grow toward fulfilling personal and professional capacities: student-teacher connection emerges as a place of possibility. The possibilities that exist for students and teachers in a connected relationship are exemplified as connection is proposed as a cornerstone in supporting students at risk of failing a clinical nursing course. CONCLUSION: Acknowledging student-teacher connection as a place of possibility highlights the importance of student-teacher relationship to students' learning and raises implications for preparation and evaluation of educators, and educational practice within the international nursing arena. Of note is the need for the preparation of educators to include a focus of developing relational competence as well as evaluation processes that consider the teacher-in-relationship. Regardless of the educational setting, educators are challenged to consider their beliefs and actions and the influence these exert on relationships with students. Further research exploring specific possibilities within connection is required.

Curriculum↗
PubMed1994

A programme for treating chemically dependent medical students.

The first American programme for chemically dependent medical students at the University of Tennessee, Memphis is described. The goals of the Aid for the Impaired Medical Student (AIMS) Program are to provide confidential treatment for chemically dependent medical students, to assure that recovering students are able to resume their education, and to protect patients and others from the harm that may be caused by impaired students. The Program is administered by the AIMS Council, consisting of medical professionals and elected student representatives. The Council oversees the management of cases, including investigation of students who may be impaired, intervention when chemical dependency is suspected, diagnostic evaluation, treatment and aftercare, and post-recovery advocacy for students. The Program's experience includes 18 cases of suspected chemical dependency, with four self-referrals and 14 students referred by third parties. Eleven students have been diagnosed as chemically dependent and have completed treatment programmes. Nine have maintained recovery and eight have graduated. One student subsequently relapsed and committed suicide. Obstacles in programme implementation have involved absence of perceived need, the view that chemically dependent students should be dismissed from school, and reluctance of students to report classmates. Resources have included highly respected student representatives, a supportive administration, assistance of the impaired physicians programme, and medical insurance and professional courtesy to defray costs. Although the number treated has been modest, the AIMS Program is an important vehicle for training students regarding chemical dependency and their professional obligations toward impaired colleagues.

Health Promotion↗
PubMed1996

Voluntary active euthanasia and doctor-assisted suicide: knowledge and attitudes of Dutch medical students.

The objective of the study was to gain insight into the knowledge of and attitudes towards voluntary active euthanasia and doctor-assisted suicide (EEDAS) of Dutch medical students, and to determine whether knowledge and attitudes change after a 1-day informative conference about EDAS. Data were collected by means of two self-administered questionnaires. Questionnaire 1 had to be completed before the start of the conference and questionnaire 2 after the conference. In both questionnaires, students were asked by means of two open-ended questions to define euthanasia and doctor-assisted suicide. They were also asked to indicate which of eight statements met with the requirements for prudent practice. Finally, the students were asked to what extent they agreed or disagreed with each of seven statements about attitudes towards EDAS. To determine if a selection occurred among students who returned both questionnaires, their background characteristics, and knowledge and attitudes towards EDAS were compared with those who returned only the first questionnaire. Forty-seven students returned only the first questionnaire, while both questionnaires were returned by 137 students. No differences were found between students who returned both questionnaires and those who returned only the first questionnaire with regard to age, religion, knowledge of and attitudes towards EDAS. Students' knowledge of the definitions of EDAS and the requirements for prudent practice improved significantly. Students' reactions to the statements on attitudes towards EDAS showed that a large majority had a fairly positive attitude towards EDAS. There was no significant difference before and after the conference. Male students and students with a religion were more opposed to EDAS than female students and students without a religion. The fact that the students' knowledge of EDAS improved after a 1-day conference does not imply sufficient understanding of the issue. Because EDAS is allowed only under strict conditions in the Netherlands, medical students require special training. Only then will they be equipped to deal with requests for EDAS during their future careers.

Adolescent↗
PubMed2005

The attitude of patients towards medical students in a sexual health clinic.

OBJECTIVES: To determine patient attitudes toward medical students in the sexual health clinic, and to describe factors associated with patient refusal of medical student involvement. METHOD: A self administered questionnaire was given to 259 consecutive patients attending the general genitourinary medicine clinic. Participants were asked to indicate their attitude to questioning and/or examination by medical students. Information was also collected on sex, age, ethnicity, and previous visits to sexual health clinics and previous exposure to medical students. The proportion of patients reporting comfort with student involvement, and association with age, sex, country of birth, language spoken, and previous experience of student and/or genitourinary medicine clinics are reported. RESULTS: 82.6% of patients agreed to participate. The proportion reporting feeling comfortable with students ranged from 64% for female students questioning them with a doctor present to 35% for a male student questioning them alone. Comfort levels were associated with the sex of the student and previous exposure to medical students, but not age, country of birth, language spoken, or previous attendance at a sexual health clinic. The most common reasons for feeling uncomfortable with students were privacy concerns and poorer quality of care. CONCLUSION: Many patients feel uncomfortable with medical student involvement in a sexual health clinic consultation; particularly patients with no previous contact with medical students. Privacy and standard of care were the most common concerns, which are potentially amenable to change through better explanation of the students' role in the clinic.

Adolescent↗
PubMedDate not supplied

Dental health knowledge, attitudes and behaviour among students at the Kuwait University Health Sciences Centre.

OBJECTIVE: The aim of the study was to determine the extent of dental health knowledge among students at the Kuwait University Health Sciences Centre (HSC), as well as their attitudes toward dental health and their oral hygiene habits. METHODS: A structured questionnaire was distributed to 450 of the 800 students enrolled in 3 faculties of the HSC from March to April 2000. The questionnaire was completed anonymously by the students. RESULTS: Four hundred and ten students (91.1%) completed the questionnaire. Of these, 64.6% believed that the main cause of tooth decay was 'not brushing properly'. Only 19.3% of the students believed that sugar could cause dental decay. Half of the students did not know if sugar-free drinks are harmful to their teeth, and 29.5% did not know about any measures to prevent gums from bleeding. Self-assessment questions showed that 84.5% of the students were satisfied with their dental health. A large majority of the students (94.8%) brushed their teeth at least once a day. Female students brushed their teeth more frequently than male students, as did those students who had visited a dentist in the past 6-12 months and those who rated their dental health to be very good. The main reason given for a dental visit was toothache (70.0%). Coffee was consumed daily by 68.9% of students, 76.6% of whom added sugar to their coffee. CONCLUSIONS: The findings indicate that although most of the students at the HSC seem to be satisfied with their dental health, they did not have correct knowledge about the causes and prevention of dental diseases. In general, female students were more aware and concerned about dental health issues and more engaged in dental behaviour than male students.

Adolescent↗
PubMed2003

Computer and internet use by first year clinical and nursing students in a Nigerian teaching hospital.

BACKGROUND: The internet is an important source of up-to-date medical information. Although several studies in different countries have explored the extent to which health science students use the computer and the internet, few researches are available on this subject in Nigeria. The aim of this study was to assess the uptake of computer and internet by health science students studying in the country. METHODS: One hundred and eighty three first year medical and nursing students of the University College Hospital, Ibadan, Nigeria, completed a-25 item questionnaire during routine Library Orientation Program in the medical library. The EPI-Info software was used for data analysis. RESULTS: The mean ages for medical students and the student nurses were 22 and 24.6 years respectively. Overall, 42.6% of the entire sample could use the computer, 57.4% could not. While more than half (58%) of the medical students are computer literate, majority (75.9%) of the student nurses are not. Slightly more than two thirds (60.7%) of the entire students had ever used the internet, 33. 9% had not. E-mail was the most popular of internet services used by the students (76.4%) and the cyber café was the common place where students had accessed these services. The students' mean scores on a 15-point perceived self-efficacy scale for internet-related tasks was 3.8 for medical and 0.7 for nursing students (p = 0.00). Students who are computer literate had superior mean scores (4.8) than those without (0.6) (p = 0.000). CONCLUSION: First year clinical and nursing students in Ibadan Nigeria have not fully utilised the opportunity that the use of computer and internet offer for medical education. Improved efforts such as inclusion of computer education in medical and nursing curricular and establishment of computer laboratories are required to increase the student's access to computers and internet.

Adolescent↗
PubMed1996

The effect of sexual experience on the attitudes of medical students to learning gynecological examinations.

The influence of sexual experience and gender on the attitudes of medical students to the methods of teaching the gynecological examination was studied. Data were obtained by questionnaire from students who had completed their obstetric/gynecological and family medicine clinical terms. Two hundred and eighty-six students agreed to participate. Ninety of the male students (53%) and 63 (54%) of the female students had experienced sexual intercourse. Students, male and female, who were sexually experienced felt they were more able to conduct a gynecological examination with sensitivity, put the woman at ease and to explain to the women what was being done and why. Male students who had not experienced sexual intercourse felt less able to perform a speculum examination, to do a Papanicolaou smear or be able to detect an abnormality. There were no gender differences between the preferred methods of learning to conduct a gynecological examination but non-sexually experienced students ranked higher the examination of a woman under anesthesia. The suggestion of student volunteers was more acceptable to sexually experienced women and non-sexually experienced male students. Students varied in their response to being volunteers for students learning to conduct vaginal or rectal (if male) examinations. If only the same sex were present 31% of non-sexually experienced male students would possibly volunteer for rectal examination and 39% of sexually experienced female students for vaginal examination. Sexual experience influences students' choice of methods for learning to conduct a gynecological examination.

Adult↗
PubMed2003

Prevalence and risk factors of smoking among secondary school students in Nairobi.

OBJECTIVES: To determine the prevalence of smoking and investigate factors that may influence smoking behaviour in secondary school students in Nairobi. DESIGN: Cross-sectional survey in which a self-administered questionnaire was issued to the students. SETTING: Sampled public and private secondary schools in Nairobi. PARTICIPANTS: All the students in the selected secondary schools were included in the study. RESULTS: Five thousand, three hundred and eleven (74.1%) secondary school students were covered. There were 3658 boys and 1653 girls in the study. The mean age was 16.7 years SD +/- 1.48. The study covered 3065 (77.3%) and 2246 (70.1%) of the public and private school students respectively. A total of 1709 (32.2%) were ever-smokers. The overall rate of ever-smoking by gender among the students was 38.6% of males and 17.9% of the females. Experimentation with smoking started at five years and regular smoking at 10 years but majority of students (72.2%) started at between age 12 and 16 years. Parents' and teachers' smoking habits influenced initiation of smoking by young children while peer pressure, advertising and type of school influenced older children to smoking. About 67% of the ever-smokers stopped the habit giving various reasons. There was a strong relationship between age of smoking initiation and stoppage. Majority of the students smoked either to enhance their personalities or for stimulation. Most students smoked less than five cigarettes per day. General shops, kiosks and cigarette stalls which sell cigarettes in both packets and single sticks were the main source to students. Students smoked mostly in the evening and at night. Most student smokers were not discouraged by health warnings on the cigarette packets and awareness of the dangers of smoking. Enforceable legislation that would ban advertising and make smoking illegal was the main recommendation from the students. CONCLUSIONS: Smoking is a problem among Kenyan students. The habit starts quite early in life. Peer pressure, advertising, type of school and age influenced smoking among the students. Banning the sale of cigarettes in single sticks is recommended. Anti-smoking campaigners and specially trained school teachers should encourage attitude shaping among school children towards self confidence and adequacy.

Adolescent↗
PubMedDate not supplied

[A study on male high school students' smoking patterns].

This study aims to investigate smoking patterns in high school student and to give student smoker effective information. The sample of 250 male high school students out of two different schools in Tae-Jŏn was questioned from July 10th to 15th, 1995. In analyzing these date, the statistics shows the realities by means of number of students. The results are summarized into 17 items as follows. Regarding the level of smoking, 140 students out of 250 admit that they have ever smoked, 52.1% of smoking students say that the motivation of beginning smoking is mainly curiosity. The survey shows that 22.9% of smoking students feel very good when smoking. It also shows that 30.0% of smoking students began smoking in the first grade of high school. With regard to the volume of smoking per day, 41.4% of smoking students smoke variably, 42.1% drink when smoking, 15.0% spend more than W 70,000 a month. About the question who knows the fact of their smoking, 51.5% answer that their friends know the fact of their smoking. In regard to the reslationship between smoking and school performance, 18.2% of non smoking students make poor grades as compared with 40% of smoking students, 9.3% of smoking students say that they are satisfied with the school life, but 35.7% of them are not satisfied. Regarding the attitude to smoking teachers, 35% of smoking students state that they are affected by them. 69.3% of smoking students say that they will stop smoking, while the remaining 30.7% say that they will keep smoking. The reason of 63.9% to stop smoking is that smoking is bad for the health. The reason of 46.5% to keep smoking is the acquired habit of smoking. 97.2% know the fact that the major element of cigarettes is nicotine and it is very harmful to the health. 40.8% recognize the harmful effect of smoking by TV and radio programs. 97.2% know that smoking could cause lung cancer. From the above results. I propose as follows We should make specific plan to keep smoking by simple curiosity from being developed into habitual smoking. We should teach them how harmful smoking is and make them stop smoking by themselves. It is very essential for family members and teachers to give continuous interest since childhood. As the teacher affect the students very much, they should give up smoking first. The incidence of smoking should be identified in each of the middle and high schools, smoking prohibition programs relevant to each school should be developed and implemented. The local community should ban cigarette vending machines. Cigarettes should not be sold to adolescents. By setting every place where adolescents gather including schools non-smoking area, we should decrease their impulse to smoke, then smoking opportunities, and harmful effects to them caused by passive smoking.

Adolescent↗
PubMedDate not supplied

Paramedic student performance: comparison of online with on-campus lecture delivery methods.

INTRODUCTION: Colleges and universities are experiencing increasing demand for online courses in many healthcare disciplines, including emergency medical services (EMS). Development and implementation of online paramedic courses with the quality of education experienced in the traditional classroom setting is essential in order to maintain the integrity of the educational process. Currently, there is conflicting evidence of whether a significant difference exists in student performance between online and traditional nursing and allied health courses. However, there are no published investigations of the effectiveness of online learning by paramedic students. HYPOTHESIS: Performance of paramedic students enrolled in an online, undergraduate, research methods course is equivalent to the performance of students enrolled in the same course provided in a traditional, classroom environment. METHODS: Academic performance, learning styles, and course satisfaction surveys were compared between two groups of students. The course content was identical for both courses and taught by the same instructor during the same semester. The primary difference between the traditional course and the online course was the method of lecture delivery. Lectures for the on-campus students were provided live in a traditional classroom setting using PowerPoint slides. Lectures for the online students were provided using the same PowerPoint slides with prerecorded streaming audio and video. RESULTS: A convenience sample of 23 online and 10 traditional students participated in this study. With the exception of two learning domains, the two groups of students exhibited similar learning styles as assessed using the Grasha-Riechmann Student Learning Style Scales instrument. The online students scored significantly lower in the competitive and dependent dimensions than did the on-campus students. Academic performance was similar between the two groups. The online students devoted slightly more time to the course than did the campus students, although this difference did not reach statistical significance. In general, the online students believed the online audio lectures were more effective than the traditional live lectures. CONCLUSION: Distance learning technology appears to be an effective mechanism for extending didactic paramedic education off-campus, and may be beneficial particularly to areas that lack paramedic training programs or adequate numbers of qualified instructors.

Adult↗
PubMed2000

A comparison of learning outcomes and attitudes in student- versus faculty-led problem-based learning: an experimental study.

OBJECTIVES: To compare learning outcomes and perceptions of facilitator behaviours and small-group process in problem-based learning (PBL) groups led by students and those led by faculty. DESIGN: A prospective, Latin-square cross-over design was employed. Second-year medical students participated in 11 PBL cases over the course of the academic year. For each case, half the student groups were led by faculty and the other half by a student group member selected randomly to serve in the facilitator role. Learning outcomes were assessed by performance on objective examinations covering factual materials pertinent to the case. Perceptions of facilitator behaviours and of group functioning were assessed with a questionnaire completed at the end of each individual case. Focus-group discussions were held to gain more in-depth information about student perceptions and experience. Student-led sessions were observed at random by the investigators. SETTING: A state-supported, US medical school with a hybrid lecture-based and problem-based curriculum. SUBJECTS: One hundred and twenty-seven second-year medical students and 30 basic science and clinical faculty. RESULTS: No differences were detected in student performance on the objective evaluation based on whether the facilitator was a faculty member or peer group member, nor were there any differences in the perceptions of group process. Students gave peer facilitators slightly higher ratings in the second semester of the experiment. In the focus-group discussions, students voiced a general preference for student-led groups because they felt they were more efficient. Observation and focus-group reports suggest that groups led by students sometimes took short cuts in the PBL process. CONCLUSION: In a hybrid lecture- and PBL-based curriculum, student performance on objective examinations covering PBL materials is unaffected by the status of the facilitator (student vs. faculty). However, in peer-facilitated groups, students sometimes took short cuts in the PBL process that may undermine some of the intended goals of PBL.

Attitude of Health Personnel↗
PubMed1993

Influence of tutors' subject-matter expertise on student effort and achievement in problem-based learning.

PURPOSE: To investigate the effects of tutors' subject-matter expertise on students' levels of academic achievement and study effort in a problem-based health sciences curriculum. Also, to study differences in tutors' behaviors and the influences of these differences on students' performances. METHOD: Data were analyzed from 336 staff-led tutorial groups involving student participants in seven four-year undergraduate programs at the University of Limburg Faculty of Health Sciences in 1989-90. Overall, 1,925 data records were studied, with each student participating in an average of 1.7 groups led by either content experts or non-experts. The basic analyses were of (1) students' achievement scores as a function of tutors' expertise levels and students' curriculum year; (2) students' estimates of self-study time as a function of tutors' expertise levels and students' curriculum year; and (3) the average ratings of the tutors' behaviors as a function of tutors' expertise levels. Statistical methods included analysis of variance and Pearson correlations. RESULTS: The students guided by subject-matter experts were shown to spend more time on self-directed study, and they achieved somewhat better than did the students guided by non-expert tutors. The effect of subject-matter expertise on achievement was strongest in the first curriculum year, suggesting that novice students are more dependent on their tutors' expertise than are more advanced students. Also, the content-expert tutors made more extensive use of their subject-matter knowledge to guide students. However, in addition to the tutors' knowledge-related behaviors, the tutors' process-facilitation skills affected student achievement. Moreover, these two sets of behaviors were correlated, indicating that both are necessary conditions for effective tutoring. CONCLUSION: The results indicate that, at least for the curriculum studied, the assumption in the literature that tutors do not necessarily need content knowledge so long as they are skilled in the tutoring process is not entirely justified: the students who were guided by content experts achieved somewhat better and spent more time on self-directed learning. More important, tutoring skill and content knowledge seemed to be necessary and closely related conditions for effective tutoring.

Achievement↗
PubMed1996

A state university's model program to increase the number of its disadvantaged students who matriculate into health professions schools.

Health professions schools often provide support for minority and disadvantaged students in high school or in a single college summer program. However, long-term support for students during their undergraduate years is also crucial. Since 1990, San Diego State University (SDSU), a large urban public university, has implemented the Health Careers Opportunity Program (HCOP) to increase the number of the university's disadvantaged students (most of whom are from minority groups) who matriculate into medical, dental, veterinary, and physician assistant schools. The program's 11 components, each dedicated to some form of educational intervention and support, emphasize developing students' collaborative learning skills, fostering their pride in accomplishment, and helping them achieve positive self-images and self-confidence; these goals are linked with building students' analytical and problem-solving skills. Weekly journals kept by students' mentors serve as an "early warning system" for "bad" feelings, attitudes, and behaviors that reflect students' personal problems and correlate with lower grades, and help the program staff work intensively with students immediately, before problems become severe. The SDSU's HCOP increased the number of disadvantaged (mostly minority) students staying in the prehealth career path (not counting those in the schools of nursing and public health) from 70 in 1989 to 360 in 1995. In 1992 through 1994, the students who had completed the HCOP's Summer Academic Program (to help them bridge into a science curriculum) had pass rates for entry-level math, writing competency, and math placement that were consistently higher than the rates for other SDSU students. The overall grade-point average of HCOP students in the spring of 1995 (3.05) was significantly higher than the overall GPA of all minority students in prehealth training before the HCOP began (2.59 in 1988). The number of SDSU's minority students accepted by health professions schools (primarily medical schools) rose significantly from six in 1990 to 23 in 1995. It is clear that the labor-intensive interventions of the HCOP throughout students' years at SDSU until they matriculate into health professions schools are working.

California↗
PubMed2002

Improving medical students' comfort with, and skill in handling, gender-related inquiries during the residency selection process.

OBJECTIVE: Previous work has identified that medical students experience instances of gender discrimination and sexual harassment during the residency selection process (i.e., "audition" elective rotations, residency interviews, and career counseling).(1,2) Examples of such instances include male students who report being counseled away from obstetrics-gynecology and a female student who reported being asked about her sexual orientation because of an expressed interest in breast disease. Students also report confusion about what constitutes an appropriate question or inappropriate gender-related comments. A common example is questioning about plans for child care during residency. We developed an education intervention focused on gender- and family-related issues that may arise during the residency selection process in an attempt to improve our students' ability to (1) recognize appropriate and inappropriate questions and situations and (2) handle such situations in a professional manner. DESCRIPTION: Our educational intervention is a voluntary, intense, active learning situation composed of four parts. First, data outlining the problem-including personal stories of students-are presented. Second, a faculty member with dual experience as a residency training director and dean for student affairs presents examples of appropriate and inappropriate questions (both types of questions can be uncomfortable if not contemplated in advance), potential ways to approach these questions, and a thoughtful approach for the student to take when integrating his or her experiences during the residency selection process with ultimate decisions about career and ranked programs. During the third part of the workshop, students draw two cases of 15 potential situations from a hat. They work in pairs, first to identify whether the case outlines an appropriate or inappropriate situation and second to develop and practice their responses. The session concludes with open discussion about the various scenarios and responses. DISCUSSION: This workshop has been well received by our medical students. In post-workshop surveys, students universally reported that the session was useful. Ninety percent of attendees felt better able to recognize appropriate and inappropriate questions and situations during the residency selection process. Seventy-seven percent of students reported that they felt better able to handle inappropriate situations during the residency selection process in a professional manner. Student comments reflected great satisfaction with the interactive nature of the exercise, interest in expanding the amount of time dedicated to the workshop, and a desire for clear rules about what can/cannot be said. Faculty offering the workshop reported satisfaction doing the workshop and noted that the greatest challenge in presenting the material is balancing the discussion about reasonable responses to inappropriate behaviors with the students' interest in performing well on all interviews in order to maximize their options. Interest in the program has resulted in the authors' being invited to share the workshop at an upcoming GME retreat for the institution's program directors. Based on these results we plan to continue the workshop in an expanded version. In addition, we plan to use this format of the workshop as a springboard for similar sessions for medical students interested in confronting issues of discrimination and harassment in the educational setting.

Female↗
PubMed2006

Prevalence of voice complaints, risk factors and impact of voice problems in female student teachers.

A cross-sectional questionnaire survey was done among 457 female student teachers and 144 females in the general population. The conclusions are based on the opinions of student teachers and the general population. The results of this study show that 39.6% of the student teachers and 32.6% of the general population reported voice complaints at the moment and/or over the past year (p=0.198). The association between various risk factors (vocal loading factors, physical factors, environmental factors and psycho-emotional factors) and voice complaints were examined. Vocal load was reported in both the student teachers and the general population (p=0.322). Among the subjects with voice complaints, the student teachers were significantly more of the opinion than the general population that environmental irritants in the classroom (p=0.001) and the composition of the group they communicate with (p=0.033) have a negative influence on their voice. In the groups with voice complaints, the student teachers reported significantly less than the general population that stress (p=0.004) and the deterioration of their general physical condition (p=0.003) have a negative influence on their voice. Remarkably, over a third of the student teachers and one fifth of the general population with voice complaints were of the opinion that decrease of hearing has a negative influence on their voices (p=0.113). There was no significant difference in Voice Handicap Index (VHI) scores (p=0.284) and impact of voice complaints among student teachers and the general population. Over 15% of the student teachers and the general population with voice complaints reported being or having been disabled due to the voice problem, probably reflecting the severity of the voice problem (p=0.838). The groups reporting voice complaints and disability in relation to their voice complaints have significantly higher VHI scores than those without voice complaints and disability, which indicates a higher psychosocial impact of voice complaints. Only around a third of the student teachers and the general population with voice complaints sought paramedical care (p=0.656)/treatment (p=0.361) for their voice complaint. Only a minority of student teachers (18.6%) and the general population (29.5%) with voice complaints were of the opinion that the number of people they communicate with has a negative influence on their voice (p=0.120). Only around a third of the student teachers and less than a tenth of the general population with voice complaints were of the view that they would develop a voice complaint due to their profession (p=0.003). Less than half of the student teachers and less than one fifth of the general population with voice complaints were aware of the potential risks of their profession on their voice (p=0.002). Voice complaints appear to have a multifactorial genesis. The student teachers are not sufficiently aware of the impact of the various risk factors on their voice. Furthermore, they are not aware of the potential risk that future teaching may have on their voice. This apparent lack of awareness in student teachers may be considered a risk factor for voice complaints.

Adolescent↗
PubMed2005

Curricular reform may improve students' performance on externally administered comprehensive examinations.

AIM: To determine whether changes in the format of teaching pathology and the introduction of active learning principles can improve medical students' performance on external examinations and enhance clinical skills. METHOD: The sophomore Pathology Course at Jefferson Medical College (JMC) in Philadelphia, Pennsylvania, USA, was completely restructured in 1986, with greater emphasis placed on independent study, small group teaching, and case study discussion. We used the scores of JMC medical students on the National Board of Medical Examiners (NBME) Part I Examination to compare the performance of JMC students who completed their medical education before curricular change (entering classes 1982-1984) with the performance of subsequent generations of students who were taught according to the reformed curriculum (entering classes 1985-1988). RESULTS: The two groups of students were comparable in terms of standard social and psychometric parameters, such as mean age at matriculation, female/male ratio, ratio of minority students in the class, premedical college grade point averages, and mean scores on the preadmission Medical College Admissions Test. JMC students who studied pathology prior to the curricular reform received on the pathology subsection of the NBME Part I Examination reform scores that were close to the national average. In contrast, mean scores for students who studied pathology after curricular changes were significantly higher than the national average (P<0.001). Based on their pathology subscores, the number of JMC students scoring below the cutoff line for passing (380 points) decreased significantly after the curricular reform, whereas the number of high-scoring students whose scores ranked them in the 90th percentile nationally increased. Curricular reform was also associated with an increase in overall student satisfaction. CONCLUSION: Curricular changes that include an emphasis on active learning can improve the performance of medical students on externally administered, objective examinations. We have shown that the means of the medical school class can be improved, the number of failing students reduced, and the number of high-scoring students increased. The improvement of students' scores was not limited to the first class after curricular reform, but persisted throughout the entire observation period of four years.

Curriculum↗