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PubMed1999

Can medical students contribute to quality assurance programmes in day surgery?

CONTEXT AND OBJECTIVES: Health care delivery has undertaken a major shift from inpatient management to ambulatory surgical care with increasing emphasis on quality assurance (QA) processes. Educational opportunities for medical undergraduate programmes are being sought in the day surgery environment. Our study was undertaken to explore ways in which senior medical students can actively contribute to QA processes as part of an undergraduate day surgery educational programme. SUBJECTS AND METHODS: Health care delivery has undertaken a major shift from inpatient management to ambulatory surgical care with increasing emphasis on quality assurance (QA) processes. Educational opportunities for medical undergraduate programmes are being sought in the day surgery environment. Our study was undertaken to explore ways in which senior medical students can actively contribute to the QA processes as part of an undergraduate day surgery educational programme. SUBJECTS AND METHODS: Fifty-nine final year medical students followed allocated patients with common surgical conditions through all phases of the day surgery process. Students kept records about each case in a log book and also presented their cases at weekly Problem Based Learning tutorials. An audit of student log books and review of tutorial records was conducted for the 1996 and 1997 academic years, in order to evaluate student contribution to QA. RESULTS: Students followed 621 cases, representing a sampling of 14. 1% day surgery cases. Categories of problems highlighted by students included inappropriate patient and procedure selection, inadequate pain management, discharge, communication and resource issues. Students made a number of recommendations including the development of multilingual videotapes and patient information sheets for non-English speaking patients, avoidance of bilateral surgical procedures and improved links with local medical officers. They also developed new guidelines and protocols. CONCLUSIONS: Our study confirms that students are able to identify QA issues and propose solutions. We recommend that students have a formally recognized place in day surgery QA programmes, to close the QA loop and to adequately prepare them for medical practice in the 21st century.

Ambulatory Surgical Procedures↗
PubMed2001

Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey.

OBJECTIVE: To assess psychological changes in medical students in Antalya, Turkey during their undergraduate education. The first-year follow-up outcomes are presented in this article. DESIGN: All first-year undergraduate students were given a detailed, self-report questionnaire and another in the second year. They were asked to complete the General Health Questionnaire (GHQ), the Spielberger State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI). SETTING: The Faculties of Medicine, Economics and Physical Education (PE) of the Akdeniz University, Antalya, Turkey. PARTICIPANTS: All first-year undergraduate students in the Faculties of Medicine, Economics and PE who were registered in 1996. RESULTS: The findings showed that psychological test scores on the GHQ, the STAI and the BDI rose significantly in medical students between the first and second years. Using the GHQ, with different cut-off scores, the percentage of students scoring above the thresholds was higher in medical students in year 2, compared with economics and PE students. In addition, the scores for some stressful life events of medical students showed a significant rise from year 1 to year 2. Multiple regression analyses indicated that some stressful life events related to social activities were associated with the psychological test scores for medical students. CONCLUSION: The results indicate that there is a decrease in the psychological health of first-year medical students. Some inadequacies in the social activities of the students might play a role in this type of disturbance.

Anxiety↗
PubMed2003

Meeting the challenge of prescribing and administering medicines safely: structured teaching and assessment for final year medical students.

OBJECTIVES: To promote safe prescribing and administration of medicines in the pre-registration house officer (PRHO) year through a programme of structured teaching and assessment for final year medical students. DESIGN: Forty final year medical students from two medical schools were randomly allocated either to participate in a pharmacist facilitated teaching session or to receive no additional teaching. Teaching comprised five practical exercises covering seven skills through which students rotated in small groups. One month later, a random sample of 16 taught and 16 non-taught students participated in a nine-station objective structured clinical examination (OSCE) to assess the impact of the teaching. SETTING: Manchester School of Medicine (MSM), and Kings College School of Medicine and Dentistry (KCSMD). PARTICIPANTS: Final year medical student volunteers. MAIN OUTCOME MEASURES: The need for teaching as indicated by student prior experience; questionnaire rating of student acceptability of teaching and assessment; self-rating of student confidence post-assessment, and student performance assessed by OSCE. RESULTS: The study demonstrated that the taught group achieved higher scores in eight OSCE stations. Four of these were statistically significant (P < or= 0.005). Taught students felt more confident performing the skills on five stations. From 0 to 47.5% students had prior experience of the skills taught. The post-teaching questionnaire evaluated exercises positively on several criteria, including provision of new information and relevance to future work. CONCLUSIONS: Structured teaching provided an effective and acceptable method of teaching the medicines management skills needed in the PRHO year. The structured approach complemented variable precourse clinical experience.

Analysis of Variance↗
PubMedDate not supplied

Prevalence of skin disease among school children and adolescents in a Student Health Service Center in Hong Kong.

We document the prevalence and the pattern of dermatologic diseases among primary and secondary school students visiting a Student Health Service Center in Hong Kong. In this study, the differences in prevalence of skin diseases between these two groups are pointed out. A total of 1006 students from both primary (n = 559) and secondary schools (n = 447) were seen in a regional, population-based screening center during the period from October 1996 to September 1997. Each student was asked to answer a simple questionnaire to identify any skin problems and to explore health-seeking behavior. Students were then examined for evidence of skin disease. A total of 314 students (31.3%) had one or more skin disorders, the most common of which were acne vulgaris (9.9%), eczema (6.8%), café au lait spots (4.4%), congenital melanocytic nevus (3.6%), superficial fungal infections (2.2%), keratosis pilaris (1.3%), and pityriasis alba (1.0%), which represented 93% of the skin disorders encountered. Acne vulgaris and tinea cruris were distinctly more common in secondary school students, while atopic eczema and congenital melanocytic nevi were more commonly found in primary school students. Among the 314 students with skin disease, 129 (41%) had symptoms while 185 (59%) did not. Ninety of the 129 students (70%) with symptomatic skin problems did not seek medical attention. The two predominant skin diseases, acne vulgaris and endogenous eczema, both chronic skin problems, incur not only morbidity in affected individuals and families, but also use considerable resources in the community. The lack of medical intervention reported by symptomatic students in this study was unexpectedly high. Therefore it is useful to monitor the epidemiology of skin problems in children so that relevant skin health education programs and preventive measures can be planned and implemented effectively.

Acne Vulgaris↗
PubMed1999

Educational and career outcomes of an internal medicine preceptorship for first-year medical students.

OBJECTIVE: Medical educators have attempted in recent years to provide quality clinical experiences for medical students early in their medical training. We questioned whether participating in a preceptorship in internal medicine (PIM) resulted in better performances on subsequent clinical rotations and increased interest in internal medicine. PARTICIPANTS: Fifty-four students have participated in the PIM to date, with control groups consisting of students who applied for it but were not selected (n = 36), students participating in a preceptorship in family medicine (n = 168), and the remaining students (n = 330). DESIGN: Prospective cohort study. SETTING: University medical center and community practices. INTERVENTION: A 2-month, clinical preceptorship following the first year of medical school. MEASUREMENTS AND MAIN RESULTS: The following outcomes were assessed: scores in the introduction to clinical medicine course; grades in the medical ethics course; scores from the internal medicine clerkship; and choosing a career in internal medicine. In their second year, PIM students scored higher in both semesters of the introduction to clinical medicine course (87% and 86% vs 84% and 84%, p's <.01) and were more likely to receive honors in ethics (50% vs 29%, p <.01) than non-PIM students. During the internal medicine clerkship, PIM students' scores were significantly higher on an objective structured clinical examination (79% vs 76%, p =.05), ambulatory clinical evaluations (80% vs 76%, p <.01), and overall clerkship scores (78% vs 75%, p =.03) but not on inpatient clinical evaluations or on the National Board of Medical Examiners Subject Examination. Preceptorship students were more likely to receive honors grades in the medicine clerkship (33% vs 10%, p <.01), and they were more likely to match into internal medicine residencies than control students (54% vs 27%, p <.01). CONCLUSIONS: The PIM course is an intervention, early in students' careers, which appears to benefit them academically and increase their interest in internal medicine as a career.

Career Choice↗
PubMed2003

Early clinical exposure to geriatric medicine in second-year medical school students--the McGill experience.

This study examined the effect of a curriculum change on early clinical exposure to geriatrics for second-year medical students at McGill University and its effects on learning and students' appreciation of geriatrics as a subspecialty. Second-year medical students (N = 200) were exposed to a change in the curriculum involving the integration of 10 weekly sessions into one integrated week in geriatric medicine. Students participating in 10 weekly sessions were Group 1 and students participating in one integrated week were Group 2. Students rated their rotation using two different scales. The students completed 12-item questionnaires during their feedback sessions at the end of the 10-week session experience or the integrated week. The first six items assessed the students' appreciation of their improvement of knowledge in the subject of geriatrics and aging. The second and third part of the survey (questions 7 and 8) included the students' opinions about the quality of the instruction (teaching feedback) and evaluation. Students in Group 2 found their rotation more effective as a learning experience and expressed greater satisfaction with interaction with the tutors, community settings, and multidisciplinary team sessions. Grades obtained on final examinations showed a better and more-effective acquisition of knowledge by Group 2. The integrated week is a more-effective learning tool in the early clinical experience for medical students in geriatric medicine than 10 weekly sessions as the first introductory experience to the field of geriatric medicine.

Aged↗
PubMed2002

Student nurse satisfaction levels with their courses: Part II--effects of academic variables.

The degree of student satisfaction with their educational experiences is an important dimension in the assessment of institutional effectiveness. All nursing education teams are currently working on ways to improve the quality of their educational provision and increase the satisfaction of their students. This is the second of a two-part article on the factors that influence student satisfaction with their courses. Part I examined how the four demographic features of gender, disability, ethnicity and age influenced student satisfaction and their performance on nursing modules. This paper complements Part I by examining the effects of three educational factors (academic level of the module, mode of study, and the qualification aim) on the accomplishment and satisfaction levels of 460 students attending multidisciplinary health care modules at the School of Health Care, Oxford Brookes University, 2000/2001. The study found that in contrast to Level 1 students, Level 3 participants felt the need for modules to stimulate more interest, that module teams be more skilled and knowledgeable and that library resources be more abundant. The findings also suggested that part-time students required significantly more attention than full-time participants in terms of the need for smaller seminar groups that would facilitate contributions and decrease inhibitions among students, and were more concerned with the utility and relevance of their learning in relation to their chosen professions. Diploma participants had the highest satisfaction followed by the BA and then the BSc students. The findings raise issues which are of interest to academic staff and nursing students, and the implications for nurse education and curriculum design are discussed within the context of student nurse satisfaction and quality issues of learning and teaching in higher education.

Adult↗
PubMed2005

Musculoskeletal disorders in left- and right-handed Turkish dental students.

The purpose of this study was two-fold: first, to find out the musculoskeletal disorders between left- and right-handed dentists and second, to describe the prevalence and distribution of symptoms of musculoskeletal disorders among Turkish students who are practicing general dentistry. The investigation was carried out on 221 dental students; group I consisted of 24 left-handed students (18 male, 6 female), aged 24.2+/-2.24 years; group II comprised 24 right-handed students (14 male, 10 female), aged 25.1+/-3.14 years; and group III included 173 right-handed students (102 male, 71 female), aged 24.3+/-1.45 years. The study consists of a questionnaire to identify work tasks and working conditions, and a field study to assess the pain of the neck, shoulders, and other disorders during the dental practice. Data were analyzed through tests for the difference between two population proportion, percentage, and Chi-square. Left- and right-handed students had headaches (34%, 22%), pins and needles (35%, 22%), weakness (42%, 40%), numbness (23%, 19%), neck pain (67%, 43%), back pain (56%, 47%), upper limp pain (46%, 43%) and shoulder pain (78%, 58%), respectively (Table 3). Female students were not significantly different from males in musculoskeletal symptoms (p>.05). The position adopted by the student was significantly related to the intensity of pain. Left-handed students especially suffered from neck and shoulder pain when compared with right-handed students (p<.06). The authors think that a modification of work practices appears to be effective in decreasing the prevalence of symptoms. The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, and further study is required to identify factors that will reduce the prevalence of symptoms among those practicing general dentistry.

Adult↗
PubMed1984

Schizophrenics' and college students' preference for and judgment of schizophrenic versus normal humorous captions.

The present study investigated schizophrenics' and college students' preference for and judgment of humor samples written by schizophrenics and normals. Twenty male hospitalized schizophrenics and 20 male undergraduate college students ranked from most to least funny two sets of captions that had been previously written by an independent group of 10 college students and 10 schizophrenics. In addition, all subjects identified which captions they thought were written by college students and which by schizophrenics. The schizophrenic judges ranked the schizophrenic captions significantly more humorous than the student judges did. Student judges found the student captions significantly more humorous than the schizophrenic judges found them. When presented with both schizophrenic and student captions, however, all 40 subjects found the student captions significantly more humorous than the schizophrenic captions. Schizophrenic judges were not significantly better than student judges in the identification of schizophrenic captions. Student judges, however, were significantly better judges of "normal" humor than schizophrenic judges were.

Adolescent↗
PubMed2006

Teaching styles of tutors in a problem-based curriculum: students' and tutors' perception.

This study compared the self-rated with student-rated teaching styles of PBL tutors. We also examined the relationship between teaching styles of tutors' and students' evaluation of tutor effectiveness in tutorials. The study included 48 tutors and 276 medical students. Tutors, and students' were given a teaching style inventory with a 5-point scale consisting of 21 items that comprise four domains of teaching styles (facilitative, collaborative, suggestive and assertive). In addition, quantitative and qualitative evaluations of tutor effectiveness by students were analyzed. Tutors perceived themselves in the facilitative-collaborative end of the spectrum of styles In contrast, students perceived tutors as less 'facilitative-collaborative' and more 'suggestive-assertive' than tutors self-ratings (p < 0.001). In addition, the difference in perception between students and tutors ratings in the facilitative-collaborative domains was more evident as students progressed in the PBL curriculum. The students' ratings of the effectiveness of tutors correlated more strongly with facilitative-collaborative than with suggestive-assertive domains of teaching styles. However, other tutor attributes such as establishing rapport with students, providing academic help for them and having content expertise were considered important criteria of an effective tutor. We conclude that there is a mismatch between students' and tutors' perceptions about teaching styles of tutor. Tutor attributes other than teaching styles are important determinants of an effective tutor.

Communication↗
PubMed1999

Teaching medical students to give bad news: does formal instruction help?

BACKGROUND: In 1994, the Oregon Health Sciences University instituted an integrated course (Principles of Clinical Medicine; PCM) of classroom and outpatient clinic experience designed to give first- and second-year medical students a head start in clinical skills. During their third year, the students have been periodically evaluated by objective structured clinical examinations (OSCEs). Part of the OSCE assesses the student's skills in giving bad news by means of role playing. Assessment criteria fall into those measuring knowledge and those evaluating humanistic skills. METHODS: To evaluate whether formal instruction in giving bad news leads to an improvement in a medical student's skills, the bad-news portions of the OSCE scores of third-year medical students taught by the old curriculum (OC) were compared with those of third-year students who had taken PCM. RESULTS: While bad news knowledge scores did not differ significantly between the two groups of students, the average bad-news humanistic score was significantly better for the PCM group (85% vs 79%; p = 0.05). There was no significant difference in average scores for either knowledge or humanistic skills between male and female students in the PCM group. The benefit of PCM regarding delivering bad news was also reflected by a survey of attending physicians who had taught students under both the old and the new curricula. The majority of those surveyed scored students' skills in related areas better after PCM. CONCLUSION: Formal instruction in the first two years of medical school improved students' humanistic skills as they relate to the delivery of bad news.

Attitude of Health Personnel↗
PubMedDate not supplied

Predicting prehospital care students' first-year academic performance.

OBJECTIVES: To answer two research questions: First, can previously identified factors relating to academic performance be used to predict first-year academic success for students undertaking a newly developed and vocationally oriented prehospital care course delivered in a rural setting? Second, can the study's findings be used to develop appropriate student selection criteria to assist in the admission of students into relevant tertiary studies or the prehospital care industry? METHODS: A retrospective review of all first-year, on-campus prehospital care students enrolled in a vocational course at a rural Australian university from 1998 to 2001 was conducted. Six predictors of academic performance were examined, namely: University Admission Index (UAI), postsecondary educational qualifications, student entry type (traditional or mature-aged), previous health-related experience, gender, and background (rural or urban). Three dependent variables assessed academic performance: grade point average (GPA) of students who completed all required first-year subjects, GPA of students who completed at least one subject in the first year, and the student's ability to successfully complete the first year. RESULTS: UAI > 50, previous health-related experience, postsecondary educational qualifications, background, student entry type, and gender were all found to be significant predictors of first-year academic performance in selective cohorts. In addition, a combination of predictors produced higher GPAs than did any single predictor. CONCLUSION: Academic performance of first-year students in the prehospital care discipline can be predicted given the appropriate selection variables. Admission selection can be assisted with the generated Student Selection 001.

Adult↗
PubMedDate not supplied

Impact of EMS education on emergency medicine ability and career choices of medical students.

OBJECTIVE: To determine whether a course in emergency medical services (EMS) impacts on the perceived ability of medical students to render care in emergencies such as choking and cardiac arrest, and affects their choice of emergency medicine as a career. METHODS: An eight-question pre- and postcourse survey was given to first- and second-year medical students. The elective course lasted a semester (four months) and dealt with prehospital emergency care, including ambulance rides and helicopter observation. Surveys were collected over a period of seven semesters. The eight-question survey assessed the student's experience, interest, and perceived competence. Precourse and postcourse results were compared using a chi-square with p<0.05 considered significant. RESULTS: Two hundred ten students enrolled in the EMS course. A total of 384 surveys were completed, 190 precourse and 194 postcourse surveys. Eighty-three students (44%) had a family member in the medical profession, five students (2.6%) had experience as an EMT or EMT-P, and 67 students (35%) had worked in any capacity in an ED. There was a statistically significant positive shift in the responses to both questions relating to self-perceived competency (p<0.01). Thirty-eight students (20%) precourse and 58 students (30%) postcourse were interested in emergency medicine as a career (p = 0.03). CONCLUSION: A course in EMS has significant impact on the perceived ability and career choice of medical students. Further study of an EMS curriculum design is needed to determine what information is critical to medical students' education and valuable in their career choice decisions.

Attitude of Health Personnel↗
PubMed2005

Gender-related differences in learning in student-led PBL tutorials.

CONTEXT: Male and female students behave differently in problem-based learning (PBL) tutorials. However, these differences could be partly attributed to faculty tutor behavior in male and female tutorials. OBJECTIVES: This study aims to examine the gender differences in learning outcomes between medical students when peer tutors facilitate PBL tutorials. METHODS: A questionnaire-based study conducted in single-gender student-led (SLT) and faculty-led (FLT) tutorials. The study involved third year medical students (n = 91) divided into ten groups (five groups each). The SLT groups consisted of 16 male and 28 female students, while the FLT group consisted of 20 male and 27 female students. Students evaluated their individual and group performance in tutorials and also skills of tutors. Student performance in end-unit examinations and their perceptions about peer tutoring were also analyzed. RESULTS: A total of 290 questionnaires (response rate = 63.7%) were collected over the five-week period of the study. Although individual performance in tutorials and achievement in examinations were comparable in both groups, there was significantly higher group performance in female compared with male student-led tutorials (p < 0.01). This difference between male and female groups was not attributed to improvement in the performance of female groups, but rather to a decline in performance of the male SLT groups. In addition, both male and female students expressed facing difficulties in discussion and analysis of the problem in the first tutorial session. CONCLUSIONS: Understanding the gender differences in the group behavior in student-led tutorials is important for PBL programs adopting this approach.

Bahrain↗
PubMed2006

Development and implementation of a nutrition education program for medical students: a new challenge.

CONTEXT: Teaching nutrition to medical students is constrained by limitations in curricular time and competition with other topics. OBJECTIVES: To identify time slots and teaching methods for incorporating nutrition into the medical school curriculum, determine students' nutritional knowledge following the program, and their perception of the effectiveness of the program. METHODS: A nutritional workshop was added to the clinical experience weeks of second-year medical students. The first class included 66 students and the second class included 56 students. In order to fully acquaint the students with nutrition, four topics were included: nutritional policy, dietary assessment, nutritional recommendations, and obesity. Students were encouraged to actively participate in the program which included dietary intake interviews, debates regarding nutritional treatments, and actual practice in class. The main outcome measures were nutritional knowledge and evaluation of the program by the students. FINDINGS: Over 90% of the students answered the knowledge questions correctly. The effectiveness of the training was graded (on a scale of 1-7) between 3.7-5.4 in the first year and 3.4-5.7 in the second year. CONCLUSIONS: The ten-hour nutritional workshops within the clinical weeks were well-received by second-year medical students. Using cases relevant to the students' age seems to enhance their interest in the program.

Adult↗
PubMedDate not supplied

International students of speech and language therapy in the UK: do we meet their needs?

BACKGROUND: Informal evidence suggests that many Speech and Language Therapy (SLT) students from outside of the UK and/or Republic of Ireland who come to the UK either do not return to their home country on qualification or do not practise as SLTs in the public sector. Many factors may contribute to this situation. Concern that it may result in part from a poor match between UK SLT education and the demands of the role in other countries led the Royal College of Speech and Language Therapists (RCSLT) to fund a study of international SLT students' experiences of UK qualifying courses. AIMS: To discover and describe the experiences, views and expectations of current and past international students studying SLT in the UK and past international students' experiences, views and expectations of practising as SLTS, both inside and outside the UK. To consider the implications of the findings for (1) international students planning to work as SLTs; (2) UK SLT students planning to practise outside the UK; and (3) all those involved in SLT education: educational institutions; supervising SLTs; RCSLT. METHODS & PROCEDURES: The study involved distributing 166 postal questionnaires (some directly to (ex)students and some to their Higher Education Institutes, or HEIs) and carrying out 23 interviews, with both current students and those qualifying since May 1994. Quantitative analysis was carried out using SPSS using descriptive statistics. Qualitative analysis used content and thematic analyses. OUTCOMES & RESULTS: Seventy-one questionnaires were received from current and past students, representing a minimum response rate of 43%. (It was not possible to verify exactly how many questionnaires were distributed by HEIs.) The results describe the diverse range of respondents' experiences of studying and working in the UK, their views of working in their home countries and the UK, and their suggestions about strategies that might be adopted to support them further. The results revealed that students come from a wide diversity of countries, with resulting differences in their experiences. However, there were some commonalities in the perceived advantages and disadvantages of working at home and in the UK. CONCLUSIONS: The suggestions for change included practical ideas for change both before and after qualification as an SLT. These included courses about the organization of health, education and social services in the UK, adaptations of course delivery and course work to include cross-cultural/linguistic work and 'home-based' projects. Implications of the findings and strategies for home as well as international SLT students are discussed.

Consumer Behavior↗
PubMed2004

Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea.

BACKGROUND: Little is known about the prevalence of human papillomavirus (HPV) infection in young adults in Asia. METHODS: We invited female and male students in Busan, South Korea, to participate in a survey that included, for females, self-collection of vaginal cells and, for males, physician-performed collection of exfoliated genital cells. The prevalences of 25 HPV types were evaluated, by a polymerase chain reaction-based assay, in 672 female students (median age, 19 years) and in 381 male students (median age, 22 years). RESULTS: HPV DNA was detected more frequently in female students (15.2%) than in male students (8.7%); in both sexes, high-risk HPV types were predominant. Among sexually active students, HPV prevalence was 38.8% in females and 10.6% in males. In female students, currently smoking cigarettes and having multiple lifetime sex partners were the strongest risk factors for HPV infection; in male students, associations between HPV prevalence and sexual habits were similar to those in female students but never attained statistical significance. CONCLUSIONS: Young women in South Korea start having penetrative sexual intercourse relatively late (median age, 18 years), but, once they begin, HPV prevalence quickly rises to levels comparable with those found in university students in the United States and in northern Europe. The high rate of participation in our study suggests that trials of new vaccines against HPV may be feasible among university students in South Korea.

Adolescent↗
PubMed2006

Predictors of nutrition counseling behaviors and attitudes in US medical students.

BACKGROUND: Nutrition counseling by physicians can improve patients' dietary behaviors and is affected by physicians' nutrition practices and attitudes, such as the perceived relevance of nutrition counseling. OBJECTIVE: The objective was to provide data on medical students' perceived relevance of nutrition counseling, reported frequency of nutrition counseling, and frequency of fruit and vegetable intakes. DESIGN: Students (n = 2316) at 16 US medical schools were surveyed and tracked at freshmen orientation, at the time of orientation to wards, and in their senior year. RESULTS: Freshmen students were more likely (72%) to find nutrition counseling highly relevant than were students at the time of ward orientation (61%) or during their senior year (46%; P for trend = 0.0003). Those intending to subspecialize had lower and declining perceptions of counseling relevance (P for trend = 0.0009), whereas the perceived relevance of counseling by primary care specialists remained high (P for trend = 0.5). Students were significantly more likely to find nutrition counseling highly relevant if they were female, consumed more fruit and vegetables, believed in primary prevention, had personal physicians who encouraged disease prevention, or intended to specialize in primary care. Only 19% of students believed that they had been extensively trained in nutrition counseling, and 17% of seniors reported that they frequently counseled their patients about nutrition. Students who consumed more fruit and vegetables, believed that they would be more credible if they ate a healthy diet, were not Asian or white, or intended to specialize in primary care counseled patients about nutrition more frequently. Medical students consumed an average of 3.0 fruit and vegetable servings/d, which declined over time. CONCLUSIONS: The perceived relevance of nutrition counseling by US medical students declined throughout medical school, and students infrequently counseled their patients about nutrition. Interventions may be warranted to improve the professional nutritional practices of medical students.

Adolescent↗