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Training physiotherapy students' abilities in scoring the motor assessment scale for stroke.

The purpose of this study was to test the ability of students in scoring an observational tool for measuring physical disability, the Motor Assessment Scale (MAS) for stroke, before and after training in order to establish whether current training and testing procedures for students are adequate. Sixteen students were tested using items 1-8 of the MAS before and after training. The students were required to observe the videotaped performance of four patients with stroke being assessed using the MAS and to score the performance of each patient. After training, the students were retested. The percent exact agreement between students' scores and criterion scores was calculated for each student and for each item. They were then compared before and after training using Student t test. When compared with criterion, the students achieved a mean of 79.6% (standard deviation, 10.8%) exact agreement before training and 83.9% (standard deviation, 6.7%) after training. While this increase in percent exact agreement was not statistically significant (p = 0.10), all students reached at least 75% exact agreement after training. Percent exact agreement on the items increased significantly (p = 0.03) so that seven of the eight items reached at least 75% exact agreement after training. The results of this study suggest that training is important to ensure that all students reach an acceptable standard.

Female↗

[OSCE improves medical student's BLS knowledge, but its long-term memory is not well maintained].

BACKGROUND: Objective structured clinical examination: OSCE is now widely used in educational scene in medical schools before medical students start their clinical training. However, the utility of OSCE on BLS education has not been confirmed yet. The effect of OSCE on BLS education was examined using questionnaires. METHODS: Questionnaires on knowledge of resuscitation were distributed to 166 medical school students (100 students in 1999 semester without OSCE, 66 in 2004 semester with OSCE). The questionnaire included 13 questions based on the 1992 or 2000 guidelines for cardiopulmonary resuscitation. Six out of 12 questions were defined as "skill related questions" and the student who correctly answered all these "skill related questions" were thought to be competent for providing adequate BLS. RESULTS: Competent student ratio was significantly higher in students with OSCE (48%, vs 20% without OSCE, P < 0.001). Thus OSCE was useful for medical student to establish BLS knowledge when compared with students without OSCE. However, this result also revealed that the acquired knowledge through OSCE did not last long. Although 98% of students actually passed OSCE, only half of them were competent on paper test during clinical training. CONCLUSIONS: OSCE improved medical students' knowledge of BLS, but did not contribute to prevent forgetting for a long time. Thus, reeducation in BLS is still necessary for students after passing OSCE.

Anesthesiology↗

Third-year medical student attitudes toward internal medicine.

BACKGROUND: Student attitudes offer insight into career decisions and may suggest causes of the diminished interest in internal medicine. Students entering a salaried managed health care environment may have different attitudes about careers and potential income. Additionally, we evaluate the effect of an ambulatory experience on student attitudes and career selection. METHODS: We surveyed 163 medical students from the Uniformed Services University of the Health Sciences, Bethesda, Md, at the successful completion of the third year to determine their attitudes regarding the work, lifestyle, prestige, patient type, and challenge of internal medicine, as well as primary care interest, and the importance of income in career selection. A subgroup of 107 volunteers was randomized to either the traditional internal medicine clerkship (n = 69), or to 6 weeks of ambulatory medicine and 6 weeks of ward medicine (n = 38). RESULTS: The selection rate was low for internal medicine (10%) and was high for family practice and transitional internships (37%). Although most students highly valued their internal medicine training, relatively few selected internal medicine as a career. Students saw chronic illness and type of work, but not lifestyle, as disincentives toward choosing an internal medicine career. Half of the students believed that income potential would be a major factor in attracting students into internal medicine, and that reimbursement should be shifted from procedural fields to primary care. The ambulatory clerkship did not affect student attitudes nor type of internship selected. CONCLUSIONS: Medicine clerkships, whether traditional or ambulatory, are highly valued educational experiences yet may be insufficient by themselves to attract students to an internal medicine career. Income potential remains an important concern in the setting of salaried managed care, even for students who lack financial debt.

Adult↗

Attitudes of medical and dental students to dissection.

Guy's, King's, and St. Thomas's School of Medicine encourages students to learn anatomy from human dissection. Today, there is a worldwide move of anatomy-based teaching away from dissection to prosection. This study investigates how attitudes toward dissection vary with gender and ethnicity. We assessed students' reactions and concerns regarding the dissecting room, any coping strategies they use to combat them, and analyzed effective methods of teaching anatomy to medical and dental students. Three questionnaires were distributed amongst 474 first-year medical and dental students before dissection and 1 week and 12 weeks after exposure to the dissecting room. Over the 3 months we found significant changes in the concerns of students about dissection. There were also significant differences (P < 0.05) between medical and dental students, males and females, and students of differing ethnic backgrounds, which persisted over 12 weeks. Both medical and dental students found tutorials and textbooks of most value in learning anatomy. Dental students found prosection more useful than medical students (P < 0.001) though neither group demonstrated a significant preference for prosection over dissection. Of concern, 7% reported recurring images of cadavers and 2% insomnia after commencing dissection. Interest in the subject matter and discussion were the commonest methods used to combat stress. This study contributes to the ongoing debate about the value of the dissecting room in the medical school curriculum.

Adaptation, Psychological↗

Tobacco use amongst nursing and physiotherapy students: a cross sectional questionnaire survey.

AIM: The aim of this research was to evaluate the prevalence, knowledge and attitudes of tobacco use in the students of the School of Health Sciences in the Campus of Ponferrada (University of León, Spain). Two-hundred and sixty-six (88.3% of respondents) students were assessed by a confidential questionnaire, which was distributed, completed by the students and collected in the same session. METHODS: This was a descriptive quantitative survey research design to examine the tobacco use among nursing and physiotherapy students. RESULTS: The global prevalence was 29.3%. In relation to academic courses we have observed statistical significance (p=0.006). Therefore students increased tobacco use while their training at the school. Seventy (89.7%) of students were smokers prior to commencing degree. Nursing students declared were unfamiliar with strategies and methods to help people to quit. The first academic course students (78.6%) significantly differed (p=0.009) from second and third course. We have found scores statistically significant (p=0.04) about the students opinion about health professionals social role function. CONCLUSION: Tobacco consumption in university health students in the third year was higher than people aged 16-24 years old reported from the National Health Survey. The findings showed a great need to improve the curricular content in the area of tobacco including information, prevention, and treatment.

Adolescent↗

A problem-based preclinical course for dental students.

In September 1994 the Turner Dental School, University of Manchester, introduced a new curriculum in which the first 2 years were problem-oriented. The 82 dental students share the first year and part of the second with 252 medical students, making this the largest cohort of students in a problem-based learning course in the world. It is one of two or three dental courses of its kind. In addition to the problem-oriented work, the course includes a substantial informatics component involving computer skills. The number of lectures has been reduced to a maximum of four per week in the first year and seven per week in the second. Most of the students' learning is achieved by group work in which they study clinical cases and search out the basic biological background to them. At the same time the students consider the social and psychological implications of the cases and develop their own communication skills. Thus far the course has resulted in students having a much broader but less detailed subject knowledge. Students are able to integrate their knowledge more effectively. In the new kinds of examination developed for the course the dental students achieve marks around 5% lower than their medical colleagues, as in more traditional combined courses. The first year of the course was designed for medical students and may not therefore be optimal for dental students but the second year has more specifically dental components.

Biology↗

A comparative study of the attitudes of nursing and medical students to aspects of patient care and the nurse's role in organizing that care.

The purpose of this study was a comparative analysis of the attitudes of nursing and medical students toward some issues relating to patient care and the role of the nurse in organizing that care. The data were collected from 11 medical students and 19 undergraduate nursing students in their fourth or final year of study. Findings suggested that there was a statistically significant difference in the attitudes of both groups of students to the areas under investigation. Medical students were rather more cure-oriented than nursing students who showed a care orientation. Further, the nursing students had a more positive attitude towards the need for a nursing assessment than their medical colleagues. Finally there was a marked difference in the way in which each group perceived the nurse's role, the nursing students emphasizing its independent scope while the medical students were less convinced on this issue. The conclusions suggest that both nursing and medical students need to develop a mutual understanding and respect for each other's roles if interprofessional relations are to improve.

Attitude of Health Personnel↗

Mistreatment of university students most common during medical studies.

BACKGROUND: This study concerns the occurrence of various forms of mistreatment by staff and fellow students experienced by students in the Faculty of Medicine and the other four faculties of the University of Oulu, Finland. METHODS: A questionnaire with 51 questions on various forms of physical and psychological mistreatment was distributed to 665 students (451 females) after lectures or examinations and filled in and returned. The results were analysed by gender and faculty. The differences between the males and females were assessed statistically using a test for the equality of two proportions. An exact two-sided P value was calculated using a mid-P approach to Fisher's exact test (the null hypothesis being that there is no difference between the two proportions). RESULTS: About half of the students answering the questionnaire had experienced some form of mistreatment by staff during their university studies, most commonly humiliation and contempt (40%), negative or disparaging remarks (34%), yelling and shouting (23%), sexual harassment and other forms of gender-based mistreatment (17%) and tasks assigned as punishment (13%). The students in the Faculty of Medicine reported every form of mistreatment more commonly than those in the Faculties of Humanities, Education, Science and Technology. Experiences of mistreatment varied, but clear messages regarding its patterns were to be found in each faculty. Female students reported more instances of mistreatment than males and were more disturbed by them. Professors, lecturers and other staff in particular mistreated female students more than they mistreated males. About half of the respondents reported some form of mistreatment by their fellow students. CONCLUSION: Students in the Faculty of Medicine reported the greatest amount of mistreatment. If a faculty mistreats its students, its success in the main tasks of universities, research, teaching and learning, will be threatened. The results challenge university teachers, especially in faculties of medicine, to evaluate their ability to create a safe environment conducive to learning.

Adult↗

Description and evaluation of an innovative course on learning and study skills for the first year medical students.

The purpose of this study is to share educational structure and evaluation results of an innovative course on effective learning and study skills for the first year medical students. In Turkey, undergraduate medical education takes six years and each year nearly 5,000 high school graduates start medical schools. However, many students experience frustration and failure because of their lack in the learning and studying strategies. At the Ege University Faculty of Medicine, preclinical curriculum consists of the body function systems-based teaching blocks. Year one has three blocks. We implemented an effective learning and study skills course at the first and third blocks of the 2003-2004 curriculum. We evaluated the course by students' feedbacks derived from block questionnaires and students' homework performance analysis. At the first block questionnaire, out of 297, 163 students (54.8%) clearly stated that the course positively influenced their learning process. Structured analysis of the first block's students' homework showed that an average of 206 students (69.3%) can sufficiently describe their learning and studying approach, while 218 (73.4%) can identify the strengths and weaknesses of the curriculum. The average student scores were 74 +/- 10 and 68 +/- 11 out of 100 for first and third blocks, respectively. We interpreted these results as students enjoyed the course and learned the content. In conclusion, a course on effective learning and study skills is likely to assist first year medical students in improving their learning and adaptation to the school.

Clinical Competence↗

College students' views of excessive drinking and the university's role.

Views of college students (N = 133) regarding excessive drinking were explored in terms of the amount of drinking which constitutes a drinking problem, the behaviors that indicate a student has been drinking excessively, and university alcohol policies that students would endorse. Students accepted levels of drinking by peers that markedly exceed definitions of excessive drinking by experts. A sizable minority of students refuse to label very dangerous behaviors associated with excessive drinking as indicating a drinking problem. The views of male and female students differed only marginally. Since students seem to define excessive drinking in ways that differ from professionals, it is suggested that student affairs personnel need to plan programs that recognize the students' views, otherwise students may continue to believe that while excessive drinking is bad, their level of drinking cannot lead to any problems.

Adolescent↗

Admission level and students' performance at a Norwegian dental school.

Data on students' performance at the Oslo Dental Faculty for 1977-86 were divided in two 5-year periods and analyzed in accordance with admission levels, largely on the basis of academic performance in junior college. During these years admission level decreased considerably, whereas the frequency of 'not passed', 'dropouts', and candidates using prolonged student time increased. The dental school grade average and the distribution of high- and low-performance candidates varied with the admission level. This trend was visible most clearly in the first 5-year period, when the admission point range included a considerable number of high admission level students. However, the admission level was not a good predictor of students' performance in the large middle or low admission level groups prominent in the second 5-year period. Poor preclinical results were not compensated for by clinical skills. All comparison of students' performance gave results in favor of the female students, but no sex-related differences were statistically significant. Most dropouts left dental school during the 1st year without visible examination difficulties. Students with several 'not passed' tended to repeat examinations, dropping out at a later stage or graduating after prolonged student time with poor results. With low interest in odontology, selection of students on the basis of minute differences in academic performance in the lower admission point scale is of limited value as a predictor of students' performance.

Achievement↗

The effects of family nursing and family medicine clinical rotations on nursing and medical students' self-efficacy for health promotion counseling.

The effects of community-based family nursing and medicine clinical rotations on students' confidence in their knowledge and ability to counsel clients in selected health promotion areas were examined from the perspective of Bandura's (1986) self-efficacy theory. Nursing students (n=66) enrolled in a community family nursing course and medical students (n=71) enrolled in a 6-week family practice clerkship rotation completed questionnaires at three points: prior to, at completion of, and 3 months following their clinical rotations. Nursing and medical students' self-efficacy levels at pretest were similar. At-posttest, nursing students' self-efficacy was significantly higher than that of the medical students. This difference was sustained at 3 months follow up. Students' conception of health (clinical vs. nonclinical) did not have an effect on posttest self-efficacy levels. Self-efficacy scores accounted for 63% of the variance in the nursing students' self-reported use of health promotion principles in their daily practice; but only 11% of the variance in medical students' daily practice. The results of this exploratory study provide information to guide theory-informed curricular decisions to design clinical learning activities that foster the development of health promotion counseling skills in both nursing and medical students.

Analysis of Variance↗

Health habits of nursing versus non-nursing students: a longitudinal study.

As our culture shifts from a sickness repair system to a health promotion and disease prevention system, nurses need to take more responsibility for practicing positive health behaviors. The problem addressed in this study was "Does exposure to nursing theory content and client interactions make any difference in the regular practice of positive health behaviors in nursing students when compared to non-nursing students?" The purpose of this study was to determine if nursing students practice healthy life styles that would help prepare them to be effective advocates for health promotion and disease prevention. The Health Habits Inventory (HHI) was used in this two-year longitudinal study to compare health habits between 71 nursing and 83 non-nursing students. There was a statistically significant difference between nursing and non-nursing students in time 1 (t = 4.91, p < .001) and time 2 (t = 3.59, p < .001) with nursing students scoring higher in health habits. Nursing students improved significantly from time 1 to time 2 (t = 2.05, p = .021) whereas nonnursing students did not improve (t = .94, p = .175). In specific behaviors, nursing students improved in eating breakfast regularly, performing monthly self breast and testicular exams, reading food labels, wearing seatbelts, and exercising at least three times a week. Implications include the importance of emphasizing self health care in nursing curricula to promote healthy life styles of nursing students who can subsequently become role models in their professional practice.

Adolescent↗

English nursing and medical students' attitudes towards organ donation.

The purpose of the study reported in this paper was to examine nursing and medical students' attitudes towards organ and corneal donation. A sample of 72 nursing and medical degree students from a British University, completed a 61-item self-administered quantitative questionnaire, adapted by Kent and Owens (1995) from an original tool devised by Parisi and Katz (1986). The findings revealed that all but one of the respondents had an overall positive attitude towards organ donation; a significant relationship was found to exist between the extent of this positive attitude held by each student and their personal willingness to donate organs. In total, 74% of the student nurses had already signed a donor card, compared to only 43% of the medical students, and the difference in the two groups' personal commitment towards donation was significant (P = 0.005). However, this disparity between the nursing and medical students was not evident when students were questioned about personally accepting organs, for survival. Most respondents agreed that they would take some form of transplanted organ or tissue into their body, if it was needed to maintain life. Overall, the study revealed that although this group of student nurses seem to be in favour of organ donation, with many willing to sign a donor card, doubts still exist in the medical student group. Further work is required to understand this phenomena. A comparison of the data with an earlier study completed by Kent and Owens (1995) indicate that student nurses may have a more positive orientation to donation than qualified staff.

Attitude of Health Personnel↗

Student retention practices in associate degree, entry-level dental hygiene programs.

PURPOSE: The main purpose of this study was to investigate student retention strategies and practices implemented in associate degree, entry-level dental hygiene programs. Included are student attrition issues, academic standards, re-entry policies, and clinical remediation strategies. METHODS: A survey consisting of forced choice and open-ended questions was mailed to 31 randomly selected associate degree, entry-level dental hygiene programs. Surveys were analyzed using descriptive statistics and frequency distributions. Open-ended questions were analyzed using the constant comparative qualitative method to identify recurring themes. RESULTS: There was an 80% (n=25) return response to the survey. The findings of this study determined that dental hygiene programs are graduating, on average, a higher percentage (83%) of students when compared to two-year, associate degree programs in general (46%). The primary reasons reported by respondents for student attrition included: academic difficulties (88%), dissatisfaction with career choice (76%), family/personal responsibilities (72%), and clinical skill difficulties (56%). A wide variety of retention strategies were reported. Those most often cited were academic remediation (92%), clinical skill development/remediation (84%), academic advising (84%), financial aid assistance (84%), and tutoring (80%). Participating programs also reported setting high academic and ethical standards. Specific criteria for student re-entry were discussed. CONCLUSION: The findings of this study suggest that associate degree, entry-level dental hygiene programs are committed to student retention and make considerable efforts to help students succeed. Student retention efforts could be enhanced for those student groups identified as possibly being at high risk for attrition. The findings and recommendations in this investigation may assist associate degree, entry-level dental hygiene programs in their efforts to retain a higher percentage of students.

Career Choice↗

The influence of inborn athletic potential on choice of profession and exercise habits of paramedical students.

Twenty physiotherapy and 15 pharmacology students from the 2nd-year paramedical class were studied to determine whether inborn athletic potential had influenced their choice of profession. Each subject completed a questionnaire and performed a graded treadmill test to exhaustion to determine maximum oxygen consumption (VO2max), peak treadmill running velocity and ventilation threshold (VT). No difference was found between physiotherapy and pharmacy students in body mass, VO2max or running speed at VT, but physiotherapy students reached a higher peak treadmill velocity (P less than 0.01). Fewer pharmacy students participated in sport at university. To determine factors influencing participation in sport, students from both groups who exercised were compared with non-exercisers. Students who exercised had significantly higher VO2max, peak treadmill running velocity and VT, but differences were less than could be explained purely on the basis of superior genetic endowment. It is concluded: (i) that physiotherapy students do not have greater inborn athletic potential than pharmacy students; (ii) that exercising students show physiological adaptations compatible with a higher level of 'fitness', and (iii) that whereas lack of inborn athletic potential is not the reason why some students do not exercise regularly at university, inborn athletic potential may determine those who will exercise competitively.

Attitude↗

Recruiting undergraduates to rural practice: what the students can tell us.

INTRODUCTION: There are still large gaps in the evidence base for the effectiveness of Australian undergraduate rural coursework and placements programs designed to increase the numbers of health graduates choosing rural practice. This article reports on an online survey conducted in 2004 of health science students at the University of Tasmania, Australia, designed as a part of a long-term study to test coursework interventions by tracking students' attitudes to, and experience of, rural practice from course entry to eventual practice. METHOD: All first and final year students in medicine, nursing and pharmacy in the Faculty of Health Science were invited to complete an online survey exploring the undergraduate experience of rural health. RESULTS: The survey was completed by 148 first year and 87 final year students, a response rate of 32.4% and 23.1% respectively. Over one-third (38.5%) of first years and 56.3% of final years indicated a general preference for rural life and practice and almost 90% expected to spend at least some of their career in rural practice. There was a statistically significant relationship between rural practice orientation and rural origin among first years, although this relationship was weaker among final years. Of first years, 82.4%, and 82.7% of final years appear to have made at least some commitment to a particular career path, and two-thirds to a particular practice environment. Rurally oriented first year students were significantly more committed to a career path than those without that orientation, although this did not hold for final years. When asked how much of their careers they expected to spend in capital city, rural, remote and/or overseas practice, both first and final year students' responses were notable for their spread. Few ruled rural or urban practice in or out entirely with most opting for middle range responses of 'most', 'about half' or 'part' of their career. Over half of both years expected to spend some time in remote practice and 75.1% of first years and 66.6% of final years some time in overseas practice. The factors rated most important in relation to career choice were those related directly to the realities of day-to-day professional practice--professional and peer support, work conditions and variety of work. Approximately three-quarters of those entering undergraduate education felt themselves to be at least 'somewhat informed' about rural practice but, apart from medical students, were little better informed by final year. The only perception of rural practice very widely shared (by more than 80% of respondents) was the possibility of developing better patient relations. Many of the other factors frequently identified as major issues in the rural practice literature--locality, flexibility, opportunities for further study, and spouse/partner and children's needs - while recognised by some, do not appear to loom large with undergraduates either in terms of career choice or perceptions of rural practice. Most final year students recalled receiving specific rural health training through rural placements and/or rural curriculum content. Overall recall of coursework was patchy, although placements were well-remembered and there was good support for increases in both. None of those who recalled undertaking rural coursework felt that it had influenced them towards a rural career and over two-thirds (n = 37, 69.8%) felt that this exposure had actually influenced them away from such a career. Three students reported that undertaking a rural placement influenced them towards, and 35 away from, a rural/remote career. CONCLUSION: The ultimate measure of the success of undergraduate interventions will be workforce changes over time. In the meantime more research is needed into undergraduate experience of rural health to provide the data needed for the careful design of coursework, detailed planning of the placement experience and long-term strategies to address those aspects of rural practice that are of most concern to these emerging health professionals.

Career Choice↗

Influences on medical student career choice: gender or generation?

HYPOTHESIS: We hypothesized that increased enrollment of female medical students and different priorities of the current generation of students would be important influences on the declining interest in surgical careers. DESIGN: Students scored statements on surgical careers on 5-point Likert scales regarding agreement and whether these statements encouraged them to pursue a career in surgery. Data were analyzed using the Mann-Whitney U test. Qualitative comments were iteratively coded using a constant comparative method. SETTING: Nine US medical schools. PARTICIPANTS: A Web-based survey on the Association for Surgical Education server was e-mailed to medical students. A total of 1300 of the 1365 respondents stated their sex. MAIN OUTCOME MEASURES: The survey asked questions pertaining to surgical life, surgical residency, surgeons as influence, equity, family, and other influences. RESULTS: A total of 680 (52%) of the 1300 respondents were male. Men and women disagreed about whether surgeons lead well-balanced lives (68% and 77%, respectively) and saw this as a deterrent. A total of 35% of women (3% men; P<.001) were discouraged by a lack of female role models. Compared with students unlikely to study surgery, lower percentages of male (74% vs 65%) and female students (85% vs 58%) likely to study surgery agreed that career choice was influenced by their decision to have a family (P=.01 for men, P<.001 for women). Of medical students who agreed that their skill sets were compatible with surgical careers, similar percentages were likely (30% men vs 24% women) and unlikely (49% men vs 54% women) to study surgery. All differences between men and women were less apparent when students likely to study surgery were compared with students unlikely to study surgery. CONCLUSIONS: The decision to have a family was a more significant influence for women than men, but family and lifestyle priorities were also important to male students, supporting our hypothesis that generation and gender are both important influences on career choices.

Adult↗