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PubMed1978

Rotavirus in travelers' diarrhea: study of an adult student population in Mexico.

The role of rotavirus in adult diarrhea was evaluated in 165 students attending a Mexican university. Students were divided into three groups: newly arrived summer students from the United Sttes, regular students from the United States, and Mexican and Venezuelan students. Ninety-one students with diarrhea and 74 corresponding, matched, asymptomatic control students were included in the study. The frequency of rotavirus in stools was determined by electron microscopy with use of the pseudoreplica technique. Twenty-five percent of those who were ill and 12% of the controls had rotavirus in their stools. A significantly (P less than 0.05) greater number of newly arrived United States summer students with diarrhea had rotavirus in their stool than did matched controls (26% vs. 3%). There was no significant difference in rate of recovery of bacterial pathogens from rotavirus-positive and rotavirus-negative stools (52% vs. 53%) from students with diarrhea. Although significantly more rotavirus was identified from ill American summer students than from controls, the role of rotavirus as a cause of diarrhea in these students could not be established in all cases since bacterial pathogens were also commonly found in stool.

Diarrhea↗
PubMed2005

Preservice teachers' predictions, perceptions, and actual assessment of students with special needs in secondary general music.

The purpose of the current study was to examine preservice teachers' predictions and perceptions of students with special needs' level of mastery of specific music education concepts and actual grades achieved by these students using alternative assessments and testing accommodations within two subpopulations: students with emotional and/or behavior disorders, and students with acute cognitive delays. The preservice teachers predicted students within the EDBD class would achieve a significantly higher level of mastery of the music concepts than students within the ACD classroom. After the field experience, however, the preservice teachers perceptions of all students' level of mastery increased from predictions scores overall. Additionally, pre-service teachers were able to execute testing accommodations and implement successful alternative assessments which gave empirical data on the students' level of mastery of the music education concepts within the curriculum. Finally, there was no correlation between how the preservice teachers thought students would perform, how they thought the students performed, and how the students actually performed based on assessment data.

Adolescent↗
PubMed1998

The effect of professional education on the knowledge and attitudes of physical therapist and occupational therapist students about acquired immunodeficiency syndrome.

BACKGROUND AND PURPOSE: Anxiety and fear about caring for people with acquired immunodeficiency syndrome (AIDS) are concerns expressed by students in health care professions. This study was designed to evaluate the influence of education offered to physical therapist (PT) and occupational therapist (OT) students on their knowledge, attitudes, and willingness to provide services to people with AIDS. SUBJECTS AND METHODS: Twenty-six undergraduate PT students and 23 undergraduate OT students completed a questionnaire at the beginning of their professional education program, following a 5-hour AIDS education seminar, and shortly before their graduation. The questionnaire consisted of 3 subscales designed to evaluate the respondents' knowledge, attitudes, and willingness to treat people with AIDS. RESULTS: At the time of graduation, the students in both disciplines showed improvement in knowledge about AIDS (14.3% for PT students and 13.8% for OT students) and more positive attitudes toward people with AIDS (7.4% for PT students and 5% for OT students). In both disciplines, the students' willingness to provide services for people with AIDS remained unchanged following the AIDS education seminar and at the end of the professional education program. CONCLUSION AND DISCUSSION: The professional education offered to the cohort of students in this study appeared to be beneficial in improving their knowledge and attitudes toward people with AIDS, but it did not affect their willingness to work with this patient group.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Effects of teaching first-year medical students skills to read medical literature.

A required first-year course at George Washington University School of Medicine and Health Sciences, entitled Studying a Study: Methods for Reading the Medical Literature, was evaluated by the author to determine the students' perception of the course's effectiveness, changes in the students' perception of their competence in reading medical literature, the students' knowledge of research study design and statistics, and the effect of the course on the students' journal reading. Students who took the course were questioned before and after the course and as fourth-year students and were compared with fourth-year students in a prior class that had not been offered the course. Students rated the course as effective. The students who took the course rated themselves as more competent and had greater knowledge than did the class that did not take the course. These students' ratings and scores declined, however, from the first to the fourth year. A required preclinical course in study design and statistics can be well received and can affect students' knowledge and perceptions of their competence. Reinforcement is necessary to maintain the results.

Clinical Competence↗
PubMed1988

Student evaluation of accelerated program at the University of Miami.

The University of Miami School of Medicine has an accelerated, six-year B.S.-M.D. program called the Honors Program in Medicine (HPM). In 1985 the HPM and traditional program students were surveyed at the end of their first year in medical school regarding their opinions about accelerated medical education. Eighty-seven percent of the traditional students felt that HPM students had ability equal to that of the average medical student (that is, neither more nor less ability), but 41 percent felt that the HPM students were less mature than the average class member. The traditional students felt the HPM students were required to follow a rigid collegiate curriculum (76 percent) and had an inadequate nonscience background (68 percent) and that the HPM would negatively affect both the future professional competence of HPM participants (59 percent) and the medical profession (34 percent). A larger percentage of the HPM than the traditional students (63 versus 48 percent) reported earning more than a minor in nonscience subjects, and fewer HPM than traditional students (9 versus 36 percent) felt that pressure to maintain a high grade-point average limited their selection of college courses. The HPM students felt that they were well prepared for medical school academically (82 percent) and emotionally (91 percent). The HPM students excelled academically in college and in the preclinical curriculum.

Attitude↗
PubMed1988

Medical student's access to information and resources for the residency selection process.

In the study reported here, the authors analyzed senior medical students' attitudes regarding the availability of information and resources pertaining to the residency selection process. Results of a nationwide survey of students showed that when the students had access to information from medical professionals (that is, faculty members, deans, house staff physicians), they felt they had greater access to information than did students who made greater use of other sources (official directories, classmates and the "grapevine"). Furthermore, the findings suggest that greater availability of information from medical professionals was related to higher levels of overall satisfaction with the residency match. While no evidence is presented that demonstrates that medical school faculty members and administrators were unwilling to devote attention to any particular group of students, the data suggest that these professionals provided information regarding the residency selection process more often to medical students at high-prestige schools, students who chose high-prestige specialties, and students who perceived themselves as having high class rank than to other students. Also, students in publicly supported schools felt the cost of travel for interviews to be more burdensome than did the students in private schools.

Attitude↗
PubMed1993

Effect of debt level on the residency preferences of graduating medical students.

BACKGROUND: The increased educational indebtedness of graduating medical students has led to speculation about the effects of students' debt levels on their choices of practice specialties as evidenced by their residency preferences. METHOD: Information was analyzed for 1,658 medical students who graduated from six private medical schools in 1988, 1989, and 1990; 1,431 of these students had educational debts. Chi-square analysis was used to compare the 1,431 students' average levels of indebtedness with their selections of residencies leading to specialties with higher or lower potential incomes. For this analysis, the students were grouped into four clusters based on the potential incomes of their specialty preferences. In addition, various subgroups, i.e., men, women, need-based scholarship recipients, and underrepresented-minority students, were also studied. RESULTS: For all the students, there was no relationship among their average levels of indebtedness and their specialty preferences. Similar results were obtained for all the subgroups--men, women, underrepresented-minority students, and scholarship recipients. However, the women students tended to have higher levels of indebtedness than the men. CONCLUSION: The results do not support the hypothesis that debt level is a determining factor among the variables that influence choices of residency by graduating medical students.

Career Choice↗
PubMed1993

A process for identifying marginal performers among students in a clerkship.

PURPOSE: To evaluate a review process for identifying marginal performers among students in a clerkship. METHOD: To better identify the marginal performers among the students participating in the medicine clerkship at the University of Minnesota Medical School--Minneapolis, the Medicine Clerkship Committee reviewed in 1990-91 and 1991-92 all students rated by faculty or housestaff as below expectations for any of nine areas of clinical performance (27 students of 890, 3%). (In the past, a student was considered to be a marginal performer only if he or she was assigned an unsatisfactory numerical grade, calculated from the nine ratings, or if written comments by housestaff and faculty and the opinions of the attending faculty and clerkship site coordinator indicated that the student should fail.) Chi-square analysis was used to compare the number of students judged to be marginal performers under the review process with the number of marginal performers in 1988-89 and 1989-90. The two groups were also compared based on their preclerkship performances on standardized examinations. RESULTS: Ten of those reviewed (37%) were judged to have performed marginally. Although the study group's performance on standardized examinations was not different from that of students during the previous two years, significantly fewer students were identified as marginal performers before the review process began than afterwards (2 of 867, 0.2%, versus 10 of 890, 1.1%, p < .05). CONCLUSION: Without changing the way in which faculty and housestaff evaluated students, the review process improved the medicine clerkship evaluation system by identifying significantly more students who were marginal performers.

Achievement↗
PubMed1993

Stability and change of interest in obstetrics-gynecology among medical students: eighteen years of longitudinal data.

PURPOSE: To compare the percentage of students who maintain interest in specializing in obstetrics-gynecology during medical school with the percentages of students maintaining interest in other selected specialties, and to examine changes of interest from obstetrics-gynecology to other specialties and from other specialties to obstetrics-gynecology. METHOD: A longitudinal cohort study comparing the stabilities of students' interests in obstetrics-gynecology and in other specialties was performed by using data on 3,889 graduates of 18 classes of Jefferson Medical College of Thomas Jefferson University between 1975 and 1992. RESULTS: The percentage of students who maintained interest in obstetrics-gynecology, as measured at the beginning and end of medical school, was 19%, compared with 40% for internal medicine and surgery, 39% for family medicine, and 22% for pediatrics. By the time they graduated, some students who had planned as freshman to pursue obstetrics-gynecology had changed their interests to internal medicine (19%), surgery (17%), family medicine (8%), or pediatrics (7%). In turn, obstetrics-gynecology attracted students who had initially expressed interest in other specialties: 17% from family medicine, 14% from surgery, 12% from internal medicine, and 8% from pediatrics. Despite the low percentage of students who maintained interest in obstetrics-gynecology, the overall percentage of students interested in obstetrics-gynecology at the time of graduation was somewhat greater than the percentage of students interested at the start of medical school. CONCLUSION: That only about one-fifth of the students initially interested in obstetrics-gynecology maintained their interest, and that many students' interests changed from one specialty to another, suggest that factors contributing to changes in interest need further investigation.

Career Choice↗
PubMed1996

Preclinical science course "preludes" taken by premedical students: do they provide a competitive advantage?

BACKGROUND: Premedical students often elect advanced science courses whose content will reappear during preclinical courses. Are such "preludes" useful? METHOD: The study participants were the 176 first-year students entering the University of Iowa College of Medicine in 1992. Their grades in medical school courses in biochemistry, gross anatomy, histology, physiology, and microbiology were compared with their grades in similar premedical courses. RESULTS: The students who had taken a premedical prelude in advanced science performed no better than their classmates except in biochemistry, where the 118 students (67%) with prior biochemistry exposure had a significantly higher mean score (96.3 vs 87.6, p < .0001 using Student's t-test). A biochemistry prelude appeared to benefit all students, especially those from minorities underrepresented in medicine. In addition, among the 13 students who failed biochemistry in medical school, a number of them had low grades in organic chemistry and had not taken a premedical course in biochemistry. To test the replicability of the findings, an analysis was undertaken of the biochemistry performances of the 162 students who had entered in 1991, and again a significant difference was found between the students who had and those who had not taken a biochemistry prelude. CONCLUSION: A premedical biochemistry course, required by only two schools in 1995-96, appears advantageous, especially for students with weak academic preparation. Lack of such benefit from other preludes suggests that premedical students might better choose electives in arts and humanities to enhance their educational breadth.

Education, Premedical↗
PubMed2000

Specialty choices of students who actually have choices: the influence of excellent clinical teachers.

PURPOSE: To determine the influence of the quality of attending physicians and residents on the specialty choices of excellent medical students, who actually have a broad choice of specialties. METHOD: In 1993-94 and 1994-95, 169 third-year students at the University of Kentucky College of Medicine were randomly assigned to two one-month rotations on general medicine inpatient wards. At the end of each rotation, the students confidentially evaluated the attending physician and the supervising resident (different for each rotation) with whom they had worked. Data were collected for 62 attending physicians and 89 residents. The authors analyzed the influences of the "best" and "worst" clinical instructors (those rated in the top and the bottom 20% by all students with whom they had worked over the two years) on "excellent" medical students (the 52 students whose USMLE I scores were in the top 30% of their class). RESULTS: Using regression approaches from the general linear model, the authors found that independent predictors of internal medicine residency choice for excellent medical students were exposure to highly rated internal medicine attendings (p = .02) and residents (p = .03). Nine of 29 (30%) of the excellent students who worked with a "best" medicine clinical instructor chose an internal medicine residency, while none of the 23 excellent medical students who did not work with a "best" medicine clinical instructor did so. The authors found no correlation in students' ratings of their pairs of attendings and residents, suggesting that rater bias did not explain the results. CONCLUSION: Better medical students who work with the best internal medicine attending physicians and residents in their internal medicine clerkship are more likely to choose an internal medicine residency.

Career Choice↗
PubMed2000

Are medical students comfortable with practicing physical examinations on each other?

PURPOSE: To assess medical student attitudes toward, and comfort with, taking turns practicing peer physical examinations (PPEs) on fellow classmates. METHOD: A questionnaire with 25 Likert-scaled questions was administered to 164 end-first-year medical students at the University of Minnesota, Minneapolis. Topics assessed included: (1) comfort with various aspects of PPEs; (2) attitudes regarding the professionalism, appropriateness, and perceived value of PPEs; (3) attitudes toward peer breast, genital, and rectal exams; and (4) the effects of age and gender on response. RESULTS: Of the 164 students surveyed, 124 (76%) responded. Almost all (98%) agreed that PPEs are appropriate, valuable, and a comfortable experience. Fewer students were comfortable with performing inguinal examinations and conducting PPEs with students of the opposite gender. Twelve percent of the students expressed difficulty in setting limits with peers, and 48% felt exposed when undressed as an examination model in front of a group of peers. The majority of students were opposed to peer breast, genital, and rectal examinations. Some statistically significant gender differences and age/gender interactions were observed. CONCLUSION: Results suggest that this sample of medical students was very comfortable with PPEs and willing to participate in PPEs, although a few students were uncomfortable with these examinations. No extensive curricular change appears warranted, though steps can be taken to maximize overall student comfort and to accommodate the few students who do not favor PPEs.

Adult↗
PubMed2000

The effects of patient characteristics and practice settings on students' participation in a primary care clerkship.

PURPOSE: To explore the effects of practice, patient, and encounter variables on students' participation in a third-year primary care clerkship. METHOD: In 1995-96, 154 students, randomly assigned to ambulatory teaching sites, completed for each patient encounter a scannable card indicating the patient's age range, gender, and insurance type, the setting of care, the type of visit, whether it was a repeat or first visit to the student, and the student's level of participation. Conventional measures of students' satisfaction (post-clerkship survey) and performance (preceptor ratings, USMLE Step 2, standardized-patient examination scores) were examined. RESULTS: The students reported significantly higher levels of participation for patient encounters taking place in clinic and emergency room settings than for those in private offices; for repeat rather than for first visits; for patients over 12 years old than for those 12 years old or younger; and for sick visits rather than for follow-ups or checkups. Students' participation had a modestly positive correlation with students' satisfaction and performance. CONCLUSION: Several practice and patient variables influence the level of students' participation in the care of ambulatory patients. The strongest predictor of active student participation is the clinical setting of the encounter. Monitoring students' self-reported levels of participation is an important tool for tracking the impact of practice variability on the quality of the learning environment in ambulatory clerkships.

Adolescent↗
PubMed2000

If students are not customers, what are they?

The answers to questions about the relationship between faculty and students-including medical students-depend on an understanding of the nature of teaching and the underlying ethical principles of our society. The authors maintain that teaching is purposive, rational, communal, and moral. They assert that Western society is based on the values of liberal democracy and that the key ethical principles for the professions that are derived from those values are autonomy, standard of care, and respect for democratic institutions. There are three candidates for ethical models on which to base the relationship between students and faculty. Two of them (clientism and paternalism) the authors reject. The one that they favor (the fiduciary model) is based on mutual trust and respect, which both students and faculty have responsibilities to maintain. Using that model, the authors conclude that students are, in some aspects, customers of faculty. This student-centered approach is balanced by treating society and other faculty as customers as well. Pathologies in medical education attributed to clientism (such as an obsession with marks and overemphasis on memorization) existed well before medical students were purportedly being treated as customers; perhaps it is not the student who is "broken" but the system in which the student is made to function. Whether students are called customers, clients, knowledge workers, or simply students, faculty must involve them more in shaping their education and in dealing with enduring problems that profoundly affect their learning.

Democracy↗
PubMed2001

Diversity in medical school: perceptions of first-year students at four southeastern U.S. medical schools.

PURPOSE: To assess students' perceptions of the extent of diversity in their classes, the role of diversity in their first-year curriculum, and their predictions of the amount of diversity in their future patient populations. METHOD: In 1998, students at four southeastern U.S. medical schools that had distinct demographics and differing institutional missions completed a questionnaire on diversity at the end of the first year. In the instrument, diversity was defined according to nine population characteristics: age, sex, race, ethnic background, physical disability, religious affiliation, sexual orientation, socioeconomic status, and rural background (growing up in a community of less than 5,000). Responses were compared according to students' institution, sex, and race. RESULTS: Questionnaires were returned by 349 of 474 students (74%). Students at the school with the most diverse first-year class placed the greatest value on the contributions of diversity to the learning environment. Women students placed more value on the inclusion of diversity issues in the curriculum than did men students, and they placed greater value on understanding diversity issues in their future medical practices than did men. Compared with Asian American, Hispanic, and white students, African American students were the least likely to think that the curriculum contained adequate information about diversity. CONCLUSIONS: The results indicate that perceptions of diversity were influenced by the students' own demographic characteristics and those of their medical school. The more diverse the class, the more comfortable the students were with diversity and the more they valued its contribution to their medical education.

Curriculum↗
PubMed2001

Effectiveness of a formal post-baccalaureate pre-medicine program for underrepresented minority students.

PURPOSE: To address the effectiveness of a formal postbaccalaureate (PB) experience for underrepresented minority (URM) students before medical school. The program provided an intense year-long experience of course work, research, and personal development. METHOD: There were 516 participants from one medical school: 15 URM medical students had completed the formal PB program, 58 students had done independent PB work before matriculation, and 443 students were traditional matriculants. Cognitive and academic indicators [college science and non-science grade-point averages (GPAs); biology, physics, and verbal MCAT scores; and percentage scores from first-year medical school courses] were compared for the three groups. RESULTS: Both groups of students with PB experience demonstrated competency in the first year of medical school consistent with traditional students even though the students who had completed the formal PB program had lower MCAT scores and lower college GPAs than did the traditional students. Traditional predictors of academic performance during the first year of medical school did not significantly contribute to actual academic performances of students from the formal PB program. CONCLUSION: The results support the use of a formal PB program to provide academic readiness and support for URM students prior to medical school. Such a program may also improve retention. Noncognitive variables, however, may be important to understanding the success of such students in medical school.

Adult↗
PubMed2002

Health professions students' perceptions of interprofessional relationships.

PURPOSE: To make a preliminary assessment of the perceptions of health professions students about interprofessional cooperation. METHOD: Health professions students (588 students from eight professions) at the Iowa Geriatric Education Center's partner institutions received a questionnaire of demographics questions and the Interdisciplinary Education Perception Scale (IEPS). The IEPS is an 18-item questionnaire that uses a six-point Likert-type scale to measure attitudes toward interprofessional cooperation on four factors: competence and autonomy, perceived need for cooperation, perception of actual cooperation, and understanding others' value. RESULTS: Total mean IEPS scores differed significantly among professional groups (p =.001), with physician assistant students scoring highest (most positive attitudes) and chiropractic students scoring lowest. The medical students' mean total score was significantly lower than was that of physician assistant students (p =.003) and higher than was that of chiropractic students (p =.000), but medical students' scores did not differ significantly at the alpha =.05 level from those of osteopathy, physical therapy, nursing, podiatry, or social work students. CONCLUSION: This study provides the first normative data for the IEPS for students from these eight health professions. This instrument may be valuable when designing an evaluation scheme for training programs that have interdisciplinary components, which may be increasingly prevalent in the future.

Adult↗
PubMed2002

A Web-based geriatrics portfolio to document medical students' learning outcomes.

OBJECTIVE: The University of Michigan Medical School is integrating into its curriculum the attitudes, knowledge, and skills that pertain to the care of older individuals using a defined set of core learning outcomes encompassing all four years. Students will demonstrate proficiency in these outcomes as a graduation requirement. We have developed an individualized, interactive, Web-based geriatrics portfolio to track the acquisition and mastery of these outcomes for students. DESCRIPTION: The required learning outcomes in geriatrics are presented to first-year students in their geriatrics portfolio Web page. The outcomes have been adapted from the recommendations published by the American Geriatrics Society's Education Committee.(1) The portfolio cross-references learning outcomes to specific activities in the curriculum. The activities include content given in lectures, multidisciplinary case discussions, standardized patient instructor (SPI) experiences involving older patients, and specific types of patient encounters during the clinical years. The portfolio allows documentation of completion dates of specific activities and the evaluations the student received. Certain activities such as the SPI experiences will include hyperlinks to their descriptions and the information that should be reviewed prior to each activity. The portfolio is integrated with existing administrative databases. Data entry occurs through links (e.g., exam scores), uploading comment forms from the SPI, and direct student input. One novel example of student input is the ability to upload information concerning encounters with older patients that students are recording in personal data assistant templates such that this information maps directly to the appropriate learning outcomes in their portfolios. The portfolio is designed to encourage students to take responsibility for their geriatrics education. Several types of evaluation data are provided, some that are specific to an activity (e.g., SPI feedback) and others that provide global assessments of learning outcomes (e.g., attitude surveys). The Web page can be displayed by the list of outcomes (categorized by attitudes, knowledge, and skills), by medical school year, and by date of completion. In this way, students can see at a glance how they are performing and whether they are up-to-date with completing the required outcomes. DISCUSSION: The geriatrics portfolio serves to identify and highlight geriatrics-related content across the four years. Its interactive features make it much more dynamic than a written transcript. Requiring proficiency in learning outcomes related to geriatrics for graduation will clearly convey to students that this information is critically important in their training to become physicians. The individualized evaluation summaries will prove useful to the student because self-directed learning opportunities can be targeted to address weak areas. Evaluation of performances will also aid program directors to appropriately modify the curriculum to address any deficiencies. This innovative Web-based approach to capture learning outcomes that are dispersed throughout a four-year curriculum may also find application in similar curricula (e.g., women's health and end-of-life care).

Education, Medical, Undergraduate↗