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PubMed2004

Effects of four supplemental instruction programs on students' learning of gross anatomy.

Many researchers have reported that supplemental instruction programs improve medical students' performance in various basic sciences. This study was conducted to evaluate the summative effects of four supplemental instruction programs (i.e., second-year medical student teaching assistant program; directed study program; weekly instructor laboratory reviews; and a web-based anatomy program) on medical students' gross anatomy laboratory practical performance. First-year medical students from the graduating class of 2006 (n = 223) received the four supplemental instruction programs (Experimental Group). The Control Group consisted of first-year medical students from the graduating class of 2005 (n = 254) who did not receive the four supplemental learning methods. Mann-Whitney rank sum tests were used to compare the two groups' median percentages for the back-upper limb (B-UL) and the lower limb (LL) parts of a gross anatomy laboratory practical. The Experimental Group's median percentages for both the B-UL (77.78%) and LL (83.33%) were significantly greater than that of the Control Group (B-UL = 69.00%; LL = 81.00%; P < 0.05). Results from a post-hoc student survey showed that more students both rated and ranked the weekly instructor laboratory reviews as extremely useful and most beneficial, respectively. A greater number of students rated and ranked the web-based anatomy program as not useful and least beneficial, respectively. The results from this study suggest that the four supplemental instruction programs improved students' learning of gross anatomy as measured by laboratory practical performance. In addition, students most valued the additional time in the gross anatomy laboratory with the instructors.

Anatomy↗
PubMed1995

Human gross anatomy: a crucial time to encourage respect and compassion in students.

We suggest four ways in which human gross anatomy instructors can reinforce respect and compassion in students. First, encourage respectful language in the laboratory. The term "donor" should be used instead of "cadaver" or "corpse" in referring to the donated body because this promotes appreciation for the students' first "patient." Second, provide the students with the actual name, age, history, and likely cause of death of the donor so that they more fully appreciate the donor as having once been a living human being. Third, prompt students to explore feelings and discuss topics stimulated by the intense experience of human dissection. Suggested topics include the students' feelings about dissecting a human being, the difficulty in deciding to donate one's body, the central importance of anatomy to a medical practitioner's role, and the historical development of the study of anatomy. Fourth, hold a memorial ceremony, in which both students and faculty participate, as a positive closure to an emotionally and intellectually intense course. Additionally, a ceremony reinforces salutary values in students, enhances social bonding among students, and encourages their appreciation of various cultural and religious beliefs. These methods introduce a new dimension of experience for anatomy students. We have developed these methods in response to what we view as a negative trend in the medical profession in which health care becomes technical and patients become objects. It is our role as faculty to reinforce respectful and compassionate attitudes in medical students from the very beginning.

Anatomy↗
PubMed2002

Project placements for undergraduate occupational therapy students: design, implementation and evaluation.

This study aimed to document the process undertaken to incorporate project placements as an effective fieldwork option for second- and third-year occupational therapy students, by evaluating the experience of both students and supervisors and identifying areas for improvement. Project placements are full- or part-time placements where a project is completed by a student under the supervision of an occupational therapist. The study is primarily descriptive, and includes a pre-post design using qualitative and quantitative data. The results indicate that the objectives of the study were achieved. Both supervisors and students expressed positive views about the placements. Students also identified changes that could improve the placements. Second- and third-year students gave similar ratings about aspects of the learning experiences during the project placements. The small cohort of third-year students and the low response rate from supervisors limited results. These project placements have shown an applicable model for students in earlier years of the course instead of the usual practice of non-traditional fieldwork being focused on final-year students. The project placements described are presented as one more potential fieldwork model in the range currently offered by curricula worldwide. Future research needs to concentrate on the longitudinal impact of these placements on the developing practice and attitudes of occupational therapy students.

Curriculum↗
PubMed2002

A focused breast skills workshop improves the clinical skills of medical students.

PURPOSE: The aim of this study was to determine the effectiveness of a focused breast skills workshop for teaching clinical skills to third-year medical students. METHODOLOGY: One hundred twenty-four third-year medical students involved in the surgical core clerkship were randomly assigned to two groups. Group 1 (n = 67) participated in a 2-h focused breast skills workshop. Group 2 (n = 57) received "traditional" ambulatory teaching for a period of 4 h in the breast clinic. The focused workshop consisted of a series of encounters concentrating on mammogram and ultrasound interpretation, physical examination skills, lump detection, and workup of a breast mass. Both groups received a didactic core curriculum lecture from surgical faculty. All students completed a satisfaction rating scale and a subset of students completed a pre- and postencounter self-efficacy rating scale on several aspects of breast skills. Student's t test was used to compare the groups in the areas of clinical skills as evidenced by performance on the breast-specific items on the end of the clerkship Objective Structure Clinical Examination and student satisfaction as evidenced by their response on a satisfaction rating scale. ANCOVA (controlling for preencounter self-efficacy rating) was used to compare the change scores between pre- and postencounter self-efficacy ratings. RESULTS: Students in Group 1 performed significantly higher than the students in Group 2 in the areas of clinical examination skills (t = -2.99, P < 0.05); in sensitivity (t = -5.82, P < 0.05) and specificity (t = -7.27, P < 0.05) in the examination of breast models; and with their satisfaction with the encounter (t = 10.72, P < 0.05). Students in Group 1 also demonstrated a higher level of confidence in their breast skills at the end of the clerkship than students in Group 2 (F = 6.22, P < 0.05). CONCLUSIONS: The focused breast skills workshop is more effective than the traditional ambulatory setting for teaching clinical breast examination skills. This setting also demonstrated the development of higher confidence in breast skills than the traditional ambulatory setting.

Ambulatory Care↗
PubMed2002

Tobacco smoking habits, beliefs, and attitudes among medical students in Tirana, Albania.

BACKGROUND: Many surveys throughout the world have evaluated the smoking behaviors, beliefs, and attitudes of medical students, but no information is available from Albania. METHOD: A cross-sectional survey in classroom settings using a self-administered questionnaire was performed at the University of Tirana during October 2000. RESULTS: In the first and fifth years of medical school, 149 (68.5% women) and 185 (55% women) students, respectively, completed the questionnaire, with overall response rates of 82 and 92%. Tobacco smoking prevailed among males. The smoking rates among first-year medical students were 34% among men and 5% among women. Among fifth-year students, 55% of the men and 34% of the women smoked. The percentages of occasional smokers were 29 and 49%, respectively, among the first- and fifth-year students who smoked. Most medical students reported knowing the health hazards of tobacco. Most students in both groups believed that smoking should be restricted in hospitals. Slightly more than half of the students stated that they will regularly advise smokers against smoking in their future jobs. CONCLUSION: Tobacco smoking is common among medical students in Albania. Targeted antismoking training should be mandatory for medical students in Albania.

Adult↗
PubMed1995

Teacher and parent perceptions of behavior problems among a sample of African American, Hispanic, and non-Hispanic white students.

A multiracial/multiethnic sample of middle school adolescents and their teachers was used to assess whether teacher ratings of student behavior problems varied according to teacher-student racial/ethnic differences and students' perception of teachers' attitudes toward them. No significant mean score differences were found for Hispanic or non-Hispanic white students according to the race/ethnicity of the teachers doing the ratings. However, African American students rated by Hispanic and non-Hispanic white teachers had significantly higher mean total behavior problem scores than African American students rated by African American teachers. Teacher ratings were also compared to those made by parents. The percentage of students rated as cases by teachers but not by parents differed significantly by race/ethnicity of student. Other findings indicated highly significant relationships between student-perceived teacher disparagement and the assignment of high behavior problem scores to students by teachers.

Adolescent↗
PubMed1994

A controlled trial of a seminar to improve medical student attitudes toward, knowledge about, and use of the medical literature.

OBJECTIVE: To determine whether an interactive seminar could affect medical student knowledge of research design, basic critical appraisal skills, and attitudes toward and clinical use of the medical literature. DESIGN: Controlled, nonrandomized clinical trial. PARTICIPANTS: Third-year clinical clerks (n = 146) during their core medicine clerkship. INTERVENTIONS: Two 90-minute interactive seminars. MEASUREMENTS AND MAIN RESULTS: Pre- and postquestionnaires were used to assess knowledge and attitudes regarding the use of the medical literature among 65 study and 81 control students. Blinded review of write-ups assessed actual use of the medical literature. Overall, 80% of the students subscribed to one or more journals and reported reading three or more journal articles per month. After the intervention, the study students were more likely than the control students to consider: 1) study design important in article selection and 2) use of medical literature critical to patient care decisions. Knowledge scores were significantly improved in the study group (p = 0.0001). The intervention yielded no increase in the actual use of medical literature in patient write-ups over that encouraged by usual clerkship goals. 51% of the study and 48% of the control students cited literature at baseline, and 53% of all the students did so after the intervention. Of these citations, 50% were for journal articles and the remainder were for textbooks. The students infrequently mentioned the quality of the cited literature. CONCLUSIONS: An interactive seminar designed to introduce medical students to critical appraisal improved student knowledge and attitudes but did not increase the actual use of literature in patient write-ups.

Adult↗
PubMed2003

Are dyspeptic symptoms linked to Helicobacter pylori? A prospective cohort study among medical students.

OBJECTIVE AND DESIGN: In Austria, the prevalence of Helicobacter pylori (Hp) infection in healthy people with or without symptoms of dyspepsia has not yet been assessed systematically. We conducted a prospective cohort study among medical students during their rotation in internal medicine to determine whether or not dyspeptic symptoms are linked to Hp infection. Symptoms were assessed before testing for Hp so that knowledge of Hp status could not influence symptom-reporting behavior. METHODS: From February 2000 to February 2001 we invited 242 medical students to participate in this trial. Abdominal symptoms were assessed by a questionnaire. Dyspeptic symptoms were defined according to the Rome II criteria: heartburn was not considered a dyspeptic symptom. Severity of symptoms was assessed using the Glasgow dyspepsia severity score (GDSS). After determination of symptoms, students underwent a 13C-urea breath test for Hp. RESULTS: Of 242 students (103 male, 139 female, mean age 26 years, range 21-39 years), 23 tested positive for Hp (10%). Of 34 participants reporting dyspeptic symptoms (14%, GDSS-range 1-11), four were Hp positive (12%). Of the 208 asymptomatic students, 19 were Hp positive (9%). Statistical analysis did not show a significant difference in the frequency of Hp infection between asymptomatic students and students reporting dyspeptic symptoms. CONCLUSION: Hp prevalence in Austrian medical students is similar to that in other western countries. There was no significant difference in Hp prevalence between dyspeptic students and asymptomatic students.

Adult↗
PubMed2006

Medical students' attitudes toward underserved patients: a longitudinal comparison of problem-based and traditional medical curricula.

Medical education has been shown to negatively influence student attitudes toward certain types of patient populations. Past research does not inform current educational practice because today's medical school environment is different from when most of the published research was conducted. There are more female students, curricular innovations such as problem-based learning have changed the framework for educational delivery, and longitudinal studies, which could inform when interventions may be needed, are uncommon. The purposes of this longitudinal, prospective cohort study were to compare the attitudes of Problem-based learning and Traditional curriculum students toward providing care for medically indigent patients as they progressed through the four-year undergraduate medical education curriculum, and to determine if gender differences were apparent and persisted over time. Attitudes of one cohort of students enrolled in separate curricula were studied. The outcome measure was the Medical Student Attitudes Toward the Underserved questionnaire, which was administered three times. A linear mixed effects regression analysis was performed to examine changes in factor scores over time and whether these changes differed between Problem-based and Traditional students, and males and females. Longitudinal findings revealed that commitment to caring for the medically underserved was greater when students entered medical school than when they graduated. Students in both curricula, as well as male and female students, experienced increasingly negative attitudes over the four year period. Decline in attitudes toward medically underserved patients was similar to previous research results. This study showed that attitudes of students were not influenced by the preclinical curriculum they experienced.

Adult↗
PubMed1996

Training of medical students in resuscitation at the University of Ljubljana.

The Faculty of Medicine in Ljubljana has been offering formal training in cardiopulmonary resuscitation (CPR) to its students since 1988. The CPR courses are taught mostly by anaesthesiologists. To determine whether our training programme provides the students with adequate skills and knowledge in CPR we analyzed the results of the examinations, tests, questionnaires and interviews of all students who had received CPR training at our Faculty of Medicine in 1994. We found that all the 1st year students passed the skill test immediately after the basic life support (BLS) course and that the majority of these students showed good knowledge in the written exam at the end of the year. These students were generally satisfied with the first-aid lecture course and BLS course. The 4th year lecture courses, however, were less effective because only a few of the students were present at each lecture. The 6th year students ended the advanced cardiac life support (ACLS) courses and practice in the operating theatre with both satisfactory basic theoretical knowledge and also practical skills in CPR. Thus in the oral examination at the end of the 6th year the success rate at first attempt was high, and the interviews with these students showed that they had been given the opportunities to practice airway management, breathing support and venous cannulation. These findings suggest that the education programme provides our students with both a sound basic knowledge and adequate practical skills in CPR for postgraduate training in emergency medicine.

Adult↗
PubMed1996

Student attitudes toward school-based health centers.

PURPOSE: Little is known about student attitudes toward school-based health centers (SBHCs) or about factors that influence SBHC enrollment. METHODS: Students in 9 Baltimore schools with SBHCs and 4 schools without health centers were surveyed in May 1991, using an anonymous classroom questionnaire. SBHC enrollees, nonenrollees from health center schools, and students in schools without health centers were compared using bi-variate analyses. Logistic regression analyses identified predictors of enrollment. RESULTS: A total of 91% of enrollees supported having a SBHC compared with 89% of nonenrollees and 77% of students from non-health center schools (p < .001). Support for a variety of services (including contraceptive services) was significantly higher among enrollees and nonenrollees compared with students in non-SBHC schools. A total of 86% of enrollees rated the quality of care "satisfactory" to "excellent" and 79% rated privacy in the school health center as "satisfactory" to "excellent." The most common reason given for not enrolling was satisfaction with current provider. Independent predictors of student confidence in the privacy of SBHCs included prior SBHC use and enrollment of close peers. Predictors of enrollment included: one or more self-reported health problems; having medical assistance; attending one or more special education classes; enrollment of close peers; membership in a school club, sports team, or church organization; and being African-American. CONCLUSIONS: Students overwhelmingly supported school-based health centers. Personal experience and peer influences were important in shaping student attitudes. We found evidence of a "learning curve" gradient in student attitudes such that students with the greatest exposure to SBHCs (as measured by attending a SBHC school, enrolling in the SBHC, and using the health center) had the most favorable attitudes.

Adolescent↗
PubMed2006

Redefining radiology education for first-year medical students: shifting from a passive to an active case-based approach.

RATIONALE AND OBJECTIVES: The aim of the study is to design and implement an elective course in which first-year medical students learn about radiology by actively integrating imaging with hospital records and radiology reports, rather than passively observing radiologists or images. MATERIALS AND METHODS: Twenty students enrolled in an elective entitled "Introduction to Clinical Radiology." Students were divided into groups of two or three and given a case file describing the hospital visit of a patient with a common computed tomographic (CT) diagnosis. Files contained a PowerPoint presentation with all images from the patient's CT examination (allowing students to scroll through the images as if viewed on a picture archive and communication system workstation), as well as emergency department records, admission and discharge summaries, surgical notes, pathology reports, and radiology reports. Group discussion was facilitated by radiology staff acting as consultants, rather than instructors. As a final project, each group presented its case to the students and faculty. RESULTS: Compared with before the course, students' understanding of the role of radiologists in the clinical management of patients significantly increased, but interest in radiology as a specialty was unchanged. Students significantly preferred scrolling through images on their own, rather than being shown static images in a didactic format. Students significantly agreed that they would recommend the course to a classmate. CONCLUSION: Case-based instruction in radiology, in which first-year medical students are actively engaged in the integration of clinical and imaging information, can affect students' views on the role of radiologists and their clinical management of patients.

Case-Control Studies↗
PubMed2005

Students' perceptions on the use of portfolios in pre-registration nursing education: a questionnaire survey.

BACKGROUND: Portfolios encourage both personal and professional development through the process of reflective practice and critical analysis. In clinical placements portfolios are used both as a learning tool and as an assessment tool. OBJECTIVES: To determine nursing students' perceptions on the use and effectiveness of portfolios in their education as well as their perceptions on the use of the portfolio as both an assessment and learning tool in clinical placement. DESIGN: Postal questionnaire survey. SETTINGS: Higher Education Institute in the UK. PARTICIPANTS: 90 first and 84 third year pre-registration diploma of nursing students. METHODS: Postal questionnaires were sent to 131 first year and 122 third year students, with a reminder 3 weeks later. The total response rate was 69% (174/253), with a response rate of 69% (90/131) for first year students and a response rate of 69% (84/122) for third year students. RESULTS: Students felt that portfolios were very time-consuming, causing them a great deal of anxiety, and were not very effective in developing and assessing their learning and competence. Using portfolios for both assessment and learning creates a conflict. Any assessment reduces the honesty and learning value of reflective writing and of the portfolio. Additionally, students become increasingly demoralized with portfolio use over time with experience. The study suggested three main linked reasons for this, namely the conflict between using portfolios for both assessment and learning, the design of the portfolio and the amount of support and guidance students feel they receive with their portfolio use. CONCLUSIONS: Portfolios can be very effective as an assessment and learning tool, but it is essential that both students and mentors receive clear guidelines on and comprehensive support with their use. They should be designed in such as way that they are relevant, clear and user-friendly for both students and mentors.

Adult↗
PubMed2006

Measuring peer caring behaviors of nursing students: scale development.

BACKGROUND: Caring is one of the most important domains of nursing research, peer caring among student nurses, and its potential effects on nurse caring behaviors remains largely unexplored. Few tools in the literature target peer caring interactions, and which were either irrelevant to our research purpose or culturally inappropriate for nursing student population in Taiwan. OBJECTIVES: The purpose of this study was to develop a culturally sensitive instrument to measure peer caring behavior from the student perspective and to offer a descriptive answer to "what is peer caring in Taiwan." DESIGN: The study uses both qualitative and quantitative methods in developing the "Peer Caring Measurement (PCM)" questionnaire. SETTINGS: Students from a 5-year associate degree nursing program in a university of technology in southern Taiwan were recruited into this study. PARTICIPANTS: Thirteen first- through fourth-year student volunteers between the ages of 16 and 20 were interviewed to explore caring behavior in student peer-to-peer interactions. Two classes from each of the first, second, third, and fourth year students, a total of 360 students were randomly selected to assess the internal consistency of "PCM", and 47 first-year students were conveniently selected to examine the stability of the tool. METHODS: Interviews were conducted in an unstructured manner. Qualitative data were analyzed by a constant comparative method. The questionnaire survey was used to assess the validity and reliability of "PCM". RESULTS: A 17-item "PCM" was developed; the content validity, construct validity, and reliability of the tool were ensured by expert review, factor analysis, and internal consistency. Three factors, labeled assistant caring, academic caring, and affective caring, accounted for 63.197% of the variance. CONCLUSIONS: The "PCM" addressed the multidimensional construct of peer caring. It was validated in a Chinese language version and can be used in college settings to evaluate student interactions and their peer caring behaviors.

Adolescent↗
PubMed2006

Vitamin and mineral supplement use among US medical students: A longitudinal study.

OBJECTIVE: To provide data on medical students' multivitamin and calcium supplement use during medical school. DESIGN: Medical students were anonymously surveyed at three time points: freshman orientation, orientation to wards, and during senior year. SUBJECTS: Medical students (n = 2,316) at 16 US medical schools (response rate = 80.3%). OUTCOME MEASURES: Prevalence and correlates of multivitamin and calcium supplement use throughout medical school. STATISTICAL ANALYSES: Chi2 tests with associated P values, and logistic regression with associated odds ratios and confidence intervals. RESULTS: Half of medical students surveyed used multivitamins, and 19% used calcium supplements, at least once per week as freshmen. Consumption of calcium, but not multivitamin, supplements increased during subsequent years (P = 0.0001) and both supplements were more commonly used by women (P < 0.0003). Of 970 students tracked across all three time points, 14% of women, compared with only 2% of men (P < 0.0001), took calcium at all three time points. Using multivariate models, we found that medical students were more likely to use multivitamins if they exercised regularly, had children, were underweight, or were women who were not heavy users of alcohol (P < 0.0001 to P < 0.05). Similarly, students who were women, underweight, exercised regularly, or had a personal or family history of osteoporosis were more likely to consume supplemental calcium (P < 0.0001 to P = 0.04). CONCLUSIONS: Medical students of all types used supplements at moderate rates, and women used supplements more commonly and consistently than did men. Medical students, especially nonunderweight and nonexercising students, may be particularly important targets for messages regarding appropriate and adequate vitamin/mineral use.

Adult↗
PubMed2004

Why do students choose careers in surgery?

BACKGROUND: Recent changes in medical education have emphasized primary care careers. This could have a negative impact on the number of applicants to surgical residencies. We hypothesized that experiences during the third year surgical clerkship are influential for students' subsequent residency choice. MATERIALS AND METHODS: Third year medical students who completed their surgical clerkship in the 2001-02 academic year were surveyed pre- and post-surgical clerkship. Responses were analyzed and correlated to the 2003 match results. RESULTS: The response rate of students surveyed was 98% (82 surveys/83 match results). Pre-clerkship, 6/82 students (7%) expressed an interest in surgery or surgical subspecialty careers. Post-clerkship, 34/84 students (40%) expressed an increased interest a surgical career; 13/84 (15%) expressed a decreased interest, and 37% of students expressed no change in career interest. Of those students expressing an increased interest in surgery, the clerkship experiences most noted to be influential were (1) number of cases participated/scrubbed (95%), (2) resident interaction (85%), (3) faculty interaction (80%), and (4) number of cases observed (65%). The number of hours spent on rotation (call, rounds) was the leading experience associated with a decreased interest in a surgical career. 12/83 students surveyed (14%) ultimately matched into a surgical program (NRMP 2003 match results). CONCLUSIONS: These data suggest that operative exposure and interaction with residents and faculty have a positive influence in students' choice of a surgical career. Although only 6% of students expressed an interest in surgery pre-clerkship, a 2-fold increase in this number was noted in choice of residency (14%). Work hours were the primary negative indicator for surgery residency. As medical curriculum is restructured and surgical exposure decreased, these data underscore the importance of quality exposure to both procedures and role models during the 3rd year surgical clerkship.

Career Choice↗
PubMed2005

An exploratory study of the concerns of mature access to nursing students and the coping strategies used to manage these adverse experiences.

The inter-connections between educational, family and social spheres of life are integral to the experiences and outcomes of mature student participation in education. This relationship highlights the need to understand the educational experience in the context of the life of the mature student. Mature nursing students have been shown to experience many difficulties during their course. These problems include childcare, relationship and financial difficulties. What is not well documented are the problems and coping strategies of future nursing students who are undertaking Access to Nursing courses and whether these mirror those found in mature nursing students. This small scale exploratory study investigated the course-related problems and coping strategies of mature students undertaking an access to nursing in a Further Education College. This study is one part of a larger programme of research investigating mature students in nursing. In-depth interviews were conducted on mature students and data were analysed using content analysis methods. Content analysis revealed particular concerns regarding the obstacles faced by mature nursing students. In particular the findings suggested that financial difficulties and re-entry into tertiary education were the prominent concerns for these individuals. The coping mechanisms identified to overcome these problems included; support networks, prioritizing and organising, and positive expectations and attitudes for the future. Understanding how students cope with their difficulties will provide the building block for future intervention strategies designed to minimise problems and increase retention rates. Further longitudinal research is required on the long term and cumulative nature of stress and coping in this group from access to post-qualification.

Adaptation, Psychological↗
PubMed2006

The impact of active/cooperative instruction on beginning nursing student learning strategy preference.

Rapid changes in the nursing field and high demand for practicing nurses put pressure on nursing faculty to educate increasing numbers of nursing students, often without corresponding increases in resources. Although the use of active and cooperative instruction methods in the classroom has been associated with improved student learning, these practices require increased effort on the part of both faculty and students. In addition, little is known about whether these methods influence student nurses' use of these more elaborative processing strategies in their independent study. The purpose of this quasi-experimental investigation was to identify the impact of incorporating active and cooperative classroom instructional activities on student preference for teaching methods and use of learning strategies in independent study. A convenience sample of beginning baccalaureate nursing students at a large Mid-Atlantic University was randomly assigned by the registrar to two class sections. Students in one section received primarily active/cooperative instruction, while the other received primarily traditional lecture-based instruction. Results indicated that student nurses exposed to active/cooperative instructional methods had an increased preference for these methods after a semester of instruction, while those exposed to traditional instruction had a higher preference for traditional methods. In addition, students participating in active class instruction reported increased preference for more elaborative independent study strategies, although overall preference for both groups indicated a reliance on surface study strategies of memorization and recall. Implications for use of instruction and student testing methodologies are presented.

Consumer Behavior↗