Adam O Goldstein
Full Text Available Adam O Goldstein, Rachel Sobel BearmanDepartment of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USAIntroduction: This study examines the integration of community engagement and community-engaged scholarship at all accredited US and Canadian medical schools in order to better understand and assess their current state of engagement.Methods: A 32-question data abstraction instrument measured the role of community engagement and community-engaged scholarship as represented on the Web sites of all accredited US and Canadian medical schools. The instrument targeted a medical school's mission and vision statements, institutional structure, student and faculty awards and honors, and faculty tenure and promotion guidelines.Results: Medical school Web sites demonstrate little evidence that schools incorporate community engagement in their mission or vision statements or their promotion and tenure guidelines. The majority of medical schools do not include community service terms and/or descriptive language in their mission statements, and only 8.5% of medical schools incorporate community service and engagement as a primary or major criterion in promotion and tenure guidelines.Discussion: This research highlights significant gaps in the integration of community engagement or community-engaged scholarship into medical school mission and vision statements, promotion and tenure guidelines, and service administrative structures.Keywords: medical school, education, community service, mission, tenure, engagement
Huang, Grace; Reynolds, Robby; Candler, Chris
"Virtual patients" are computer-based simulations designed to complement clinical training. These applications possess numerous educational benefits but are costly to develop. Few medical schools can afford to create them. The purpose of this inventory was to gather information regarding in-house virtual patient development at U.S. and Canadian medical schools to promote the sharing of existing cases and future collaboration. From February to September 2005, the authors contacted 142 U.S. and Canadian medical schools and requested that they report on virtual patient simulation activities at their respective institutions. The inventory elicited information regarding the pedagogic and technical characteristics of each virtual patient application. The schools were also asked to report on their willingness to share virtual patients. Twenty-six out of 108 responding schools reported that they were producing virtual patients. Twelve schools provided additional data on 103 cases and 111 virtual patients. The vast majority of virtual patients were media rich and were associated with significant production costs and time. The reported virtual patient cases tended to focus on primary care disciplines and did not as a whole exhibit racial or ethnic diversity. Funding sources, production costs, and production duration influenced the extent of schools' willingness to share. Broader access to and cooperative development of these resources would allow medical schools to enhance their clinical curricula. Virtual patient development should include basic science objectives for more integrative learning, simulate the consequences of clinical decision making, and include additional cases in cultural competency. Together, these efforts can enhance medical education despite external constraints on clinical training.
Byszewski, Anna; Gill, Jeewanjit S; Lochnan, Heather
Accrediting bodies now recognize the importance of developing the professionalism competency, by setting standards that require medical schools to identify where professionalism is addressed and how it is evaluated within the formal curriculum. The objective of this study was to compare how professionalism competency is formally addressed in the curricula of Canadian medical schools, and to better understand the Canadian approach to reporting and remediation of lapses. A literature review was performed and with the input of the AFMC(Association of Faculties of Medicine of Canada) Professionalism group, questionnaires were generated. An electronic survey was circulated to key leaders across the country at all the medical schools. In-depth telephone interviews were used to further explore themes, and a subsequent focus group was held to discuss challenges, particularly related to reporting and remediation. The preponderance of formal professionalism teaching remains in the form of lectures and small group sessions in the preclinical years. Formal teaching declines significantly in the clerkship/clinical years. Evaluation is usually performed by a clinical supervisor, but OSCE, portfolio, and concern notes are increasingly used. Role modeling is heavily relied upon in clinical years, suggesting faculty training can help ensure clinical teachers recognize their influence on trainees. Formal remediation strategies are in place at most schools, and often involve essay writing, reflection exercises, or completion of learning modules about professionalism. Lack of clarity on what defines a lapse and fear of reprisal (for both trainees and faculty) limits reporting. This study provides an overview of how professional identity formation is supported in the Canadian context, guided by the standards set out by CanMEDS. Despite a rich literature that describes the definition, program design and evaluation methods for professionalism, in some areas of the curriculum there is
Lehmann, Lisa Soleymani; Kasoff, Willard S; Koch, Phoebe; Federman, Daniel D
To assess the format, content, method, and placement of medical ethics education in medical schools; the faculty and curricular resources and institutional structure and support of medical ethics; and the perceptions of ethics education among deans of medical education and medical ethics course directors at U.S. and Canadian medical schools. Two questionnaires were mailed to 125 U.S. medical schools and 16 Canadian schools: one to be completed by the deans of medical education and one to be completed by the medical ethics course director. Descriptive statistics were used to compare responses. In all, 123 (87%) deans and 91 (64%) course directors responded, providing information about 91 schools (six Canadian). All responding institutions offered some formal instruction in medical ethics, and among these, 71 (78%) incorporated ethics into required preclinical courses. The primary pedagogic course structure was small-group discussion and the primary pedagogic method was case discussions. One-fifth of schools provided no funding for ethics teaching, and 47 (52%) did not fund curricular development in ethics. Institutions with a dedicated ethics faculty member were twice as likely to have a mandatory introductory ethics course (64% versus 32%, p ethics education were thought to be a lack of time in the curriculum, a lack of qualified teachers, and a lack of time in faculty schedules. Within a few decades the number of U.S. and Canadian medical schools requiring medical ethics has increased. Nevertheless, significant variation in the content, method, and timing of ethics education suggests consensus about curricular content and pedagogic methods remains lacking. Further progress in ethics education may depend on institutions' willingness to devote more curricular time and funding to medical ethics.
Gustafson, Diana L; Reitmanova, Sylvia
Cultural diversity education is a required curriculum component at all accredited North American medical schools. Each medical school determines its own content and pedagogical approaches. This preliminary study maps the approaches to cultural diversity education in English Canadian medical schools. A review of 14 English Canadian medical school websites was undertaken to identify the theoretical approaches to cultural diversity education. A PubMed search was also completed to identify the recent literature on cultural diversity medical education in Canada. Data were analysed using 10 criteria that distinguish pedagogical approaches, curricular structure, course content and theoretical understandings of cultural diversity. Based on the information posted on English Canadian medical school websites, all schools offer cultural diversity education although how each 'does' cultural diversity differs widely. Two medical schools have adopted the cultural competency model; five have adopted a critical cultural approach to diversity; and the remaining seven have incorporated some aspects of both approaches. More comprehensive research is needed to map the theoretical approaches to cultural diversity at Canadian medical schools and to evaluate the long-term effectiveness of these approaches on improving physician-patient relationships, reducing health disparities, improving health outcomes and producing positive learning outcomes in physicians.
Results: Approximately half of the 13 responding medical schools had integrated bedside ultrasound teaching into their undergraduate curriculum. The most common trends in undergraduate ultrasound teaching related to duration (1-5 hours/year in 50% of schools, format (practical and theoretical in 67% of schools, and logistics (1:4 instructor to student ratio in 67% of schools. The majority of responding vice-deans indicated that bedside ultrasound education should be integrated into the medical school curriculum (77%, and cited a lack of ultrasound machines and infrastructure as barriers to integration. Conclusions: This study documents the current characteristics of undergraduate ultrasound education in Canada.
Thurston, Virginia Carol; Wales, Paula Sue; Bell, Mary Alice; Torbeck, Laura; Brokaw, James Joseph
Relatively little is known about how medical genetics is being taught in the undergraduate medical curriculum and whether educators concur regarding topical priority. This study sought to document the current state of medical genetics education in U.S. and Canadian accredited medical schools. In August 2004, surveys were sent from the Indiana University School of Medicine to 149 U.S. and Canadian medical genetics course directors or curricular deans. Returned surveys were collected through June 2005. Participants were asked about material covered, number of contact hours, year in which the course was offered, and what department sponsored the course. Data were collated according to instructional method and course content. The response rate was 75.2%. Most respondents (77%) taught medical genetics in the first year of medical school; only half (47%) reported that medical genetics was incorporated into the third and fourth years. About two thirds of respondents (62%) devoted 20 to 40 hours to medical genetics instruction, which was largely concerned with general concepts (86%) rather than practical application (11%). Forty-six percent of respondents reported teaching a stand-alone course versus 54% who integrated medical genetics into another course. Topics most commonly taught were cancer genetics (94.2%), multifactorial inheritance (91.3%), Mendelian disorders (90.3%), clinical cytogenetics (89.3%), and patterns of inheritance (87.4%). The findings provide important baseline data relative to guidelines recently established by the Association of American Medical Colleges. Ultimately, improved genetics curricula will help train physicians who are knowledgeable and comfortable discussing and answering questions about genetics with their patients.
Steinmetz, Peter; Dobrescu, Octavian; Oleskevich, Sharon; Lewis, John
This study was carried out to determine the extent and characteristics of bedside ultrasound teaching in medical schools across Canada. A cross-sectional, survey-based study was used to assess undergraduate bedside ultrasound education in the 17 accredited medical schools in Canada. The survey, consisting of 19 questions was pilot-tested, web-based, and completed over a period of seven months in 2014. Approximately half of the 13 responding medical schools had integrated bedside ultrasound teaching into their undergraduate curriculum. The most common trends in undergraduate ultrasound teaching related to duration (1-5 hours/year in 50% of schools), format (practical and theoretical in 67% of schools), and logistics (1:4 instructor to student ratio in 67% of schools). The majority of responding vice-deans indicated that bedside ultrasound education should be integrated into the medical school curriculum (77%), and cited a lack of ultrasound machines and infrastructure as barriers to integration. This study documents the current characteristics of undergraduate ultrasound education in Canada.
Full Text Available INTRODUCTION: The education of medical students should be based on the best clinical information available, rather than on commercial interests. Previous research looking at university-wide conflict of interest (COI policies used in Canadian medical schools has shown very poor regulation. An analysis of COI policies was undertaken to document the current policy environment in all 17 Canadian medical schools. METHODS: A web search was used to initially locate COI policies supplemented by additional information from the deans of each medical school. Strength of policies was rated on a scale of 0 to 2 in 12 categories and also on the presence of enforcement measures. For each school, we report scores for all 12 categories, enforcement measures, and summative scores. RESULTS: COI policies received summative scores that ranged from 0 to 19, with 0 the lowest possible score obtainable and 24 the maximum. The highest mean scores per category were for disclosure and ghostwriting (0.9 and for gifts and scholarships (0.8. DISCUSSION: This study provides the first comprehensive evaluation of all 17 Canadian medical school-specific COI policies. Our results suggest that the COI policy environment at Canadian medical schools is generally permissive. Policy development is a dynamic process. We therefore encourage all Canadian medical schools to develop restrictive COI policies to ensure that their medical students are educated based on the best clinical evidence available, free of industry biases and COI relationships that may influence the future medical thinking and prescribing practices of medical students in Canada once they graduate.
Shnier, Adrienne; Lexchin, Joel; Mintzes, Barbara; Jutel, Annemarie; Holloway, Kelly
Introduction The education of medical students should be based on the best clinical information available, rather than on commercial interests. Previous research looking at university-wide conflict of interest (COI) policies used in Canadian medical schools has shown very poor regulation. An analysis of COI policies was undertaken to document the current policy environment in all 17 Canadian medical schools. Methods A web search was used to initially locate COI policies supplemented by additional information from the deans of each medical school. Strength of policies was rated on a scale of 0 to 2 in 12 categories and also on the presence of enforcement measures. For each school, we report scores for all 12 categories, enforcement measures, and summative scores. Results COI policies received summative scores that ranged from 0 to 19, with 0 the lowest possible score obtainable and 24 the maximum. The highest mean scores per category were for disclosure and ghostwriting (0.9) and for gifts and scholarships (0.8). Discussion This study provides the first comprehensive evaluation of all 17 Canadian medical school-specific COI policies. Our results suggest that the COI policy environment at Canadian medical schools is generally permissive. Policy development is a dynamic process. We therefore encourage all Canadian medical schools to develop restrictive COI policies to ensure that their medical students are educated based on the best clinical evidence available, free of industry biases and COI relationships that may influence the future medical thinking and prescribing practices of medical students in Canada once they graduate. PMID:23861928
Blanco, Maria A; Capello, Carol F; Dorsch, Josephine L; Perry, Gerald; Zanetti, Mary L
The authors conducted a survey examining (1) the current state of evidence-based medicine (EBM) curricula in US and Canadian medical schools and corresponding learning objectives, (2) medical educators' and librarians' participation in EBM training, and (3) barriers to EBM training. A survey instrument with thirty-four closed and open-ended questions was sent to curricular deans at US and Canadian medical schools. The survey sought information on enrollment and class size; EBM learning objectives, curricular activities, and assessment approaches by year of training; EBM faculty; EBM tools; barriers to implementing EBM curricula and possible ways to overcome them; and innovative approaches to EBM education. Both qualitative and quantitative methods were used for data analysis. Measurable learning objectives were categorized using Bloom's taxonomy. One hundred fifteen medical schools (77.2%) responded. Over half (53%) of the 900 reported learning objectives were measurable. Knowledge application was the predominant category from Bloom's categories. Most schools integrated EBM into other curricular activities; activities and formal assessment decreased significantly with advanced training. EBM faculty consisted primarily of clinicians, followed by basic scientists and librarians. Various EBM tools were used, with PubMed and the Cochrane database most frequently cited. Lack of time in curricula was rated the most significant barrier. National agreement on required EBM competencies was an extremely helpful factor. Few schools shared innovative approaches. Schools need help in overcoming barriers related to EBM curriculum development, implementation, and assessment. Findings can provide a starting point for discussion to develop a standardized competency framework.
Full Text Available Abstract Background Canadian international medical graduates are Canadian-citizens who have graduated from a medical school outside of Canada or the United States. A growing number of Canadians enroll in medical school abroad, including at Caribbean offshore medical schools. Often, Canadians studying medicine abroad attempt to return to Canada for postgraduate residency training and ultimately to practice. Methods The authors conducted a qualitative media analysis to discern the dominant themes and ideologies that frame discussion of offshore medical schools, and the Canadian medical students they graduate, in the Canadian print news. We carried out structured searches on Canadian Newsstand Database for print media related to offshore medical schools. Results Canadian news articles used two frames to characterize offshore medical schools and the Canadian international medical graduates they train: (1 increased opportunity for medical education for Canadians; and (2 frustration returning to Canada to practice despite domestic physician shortages. Conclusion Frames deployed by the Canadian print media to discuss Caribbean offshore medical schools and Canadians studying abroad define two problems: (1 highly qualified Canadians are unable to access medical school in Canada; and (2 some Canadian international medical graduates are unable to return to Canada to practice medicine. Caribbean offshore medical schools are identified as a solution to the first problem while playing a central role in creating the second problem. These frames do not acknowledge that medical school admissions are a primary means to control the make-up of the Canadian physician workforce and they do not address the nature of Canadian physician shortages.
Kwan, Jennifer Y Y; Nyhof-Young, Joyce; Catton, Pamela; Giuliani, Meredith E
To evaluate (1) the quantity and quality of current undergraduate oncology teaching at a major Canadian medical school; and (2) curricular changes over the past decade, to enhance local oncology education and provide insight for other educators. Relevant 2011-2012 undergraduate curricular sessions were extracted from the University of Toronto curriculum mapping database using keywords and database identifiers. Educational sessions were analyzed according to Medical Council of Canada objectives, discussion topics, instructor qualifications, teaching format, program year, and course subject. Course-related oncology research projects performed by students during 2000 to 2012 were extracted from another internal database. Elective choices of clerks during 2008-2014 were retrieved from the institution. The 2011-2012 and 2000-2001 curricula were compared using common criteria. The 2011-2012 curriculum covers 5 major themes (public health, cancer biology, diagnosis, principles of care, and therapy), which highlight 286 oncology teaching topics within 80 sessions. Genitourinary (10, 12.5%), gynecologic (8, 10.0%), and gastrointestinal cancers (7.9, 9.8%) were the most commonly taught cancers. A minority of sessions were taught by surgical oncologists (6.5, 8.1%), medical oncologists (2.5, 3.1%), and radiation oncologists (1, 1.2%). During 2000-2012, 9.0% of students (233 of 2578) opted to complete an oncology research project. During 2008-2014, oncology electives constituted 2.2% of all clerkship elective choices (209 of 9596). Compared with pre-2001 curricula, the 2012 oncology curriculum shows notable expansion in the coverage of epidemiology (6:1 increase), prevention (4:1), screening (3:1), and molecular biology (6:1). The scope of the oncology curriculum has grown over the past decade. Nevertheless, further work is needed to improve medical student knowledge of cancers, particularly those relevant to public health needs. Defining minimum curricular content
Kwan, Jennifer Y.Y. [School of Medicine, Faculty of Health Sciences, Queen' s University, Kingston, Ontario (Canada); Nyhof-Young, Joyce [Department of Family and Community Medicine, University of Toronto, Toronto, Ontario (Canada); Catton, Pamela [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Giuliani, Meredith E., E-mail: Meredith.Giuliani@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)
Purpose: To evaluate (1) the quantity and quality of current undergraduate oncology teaching at a major Canadian medical school; and (2) curricular changes over the past decade, to enhance local oncology education and provide insight for other educators. Methods and Materials: Relevant 2011-2012 undergraduate curricular sessions were extracted from the University of Toronto curriculum mapping database using keywords and database identifiers. Educational sessions were analyzed according to Medical Council of Canada objectives, discussion topics, instructor qualifications, teaching format, program year, and course subject. Course-related oncology research projects performed by students during 2000 to 2012 were extracted from another internal database. Elective choices of clerks during 2008-2014 were retrieved from the institution. The 2011-2012 and 2000-2001 curricula were compared using common criteria. Results: The 2011-2012 curriculum covers 5 major themes (public health, cancer biology, diagnosis, principles of care, and therapy), which highlight 286 oncology teaching topics within 80 sessions. Genitourinary (10, 12.5%), gynecologic (8, 10.0%), and gastrointestinal cancers (7.9, 9.8%) were the most commonly taught cancers. A minority of sessions were taught by surgical oncologists (6.5, 8.1%), medical oncologists (2.5, 3.1%), and radiation oncologists (1, 1.2%). During 2000-2012, 9.0% of students (233 of 2578) opted to complete an oncology research project. During 2008-2014, oncology electives constituted 2.2% of all clerkship elective choices (209 of 9596). Compared with pre-2001 curricula, the 2012 oncology curriculum shows notable expansion in the coverage of epidemiology (6:1 increase), prevention (4:1), screening (3:1), and molecular biology (6:1). Conclusions: The scope of the oncology curriculum has grown over the past decade. Nevertheless, further work is needed to improve medical student knowledge of cancers, particularly those relevant to public health
Souza, Kevin H; Kamin, Carol; O'Sullivan, Patricia; Moses, Anna; Heestand, Diane
To examine the organizational structure of educational technology units within U.S. and Canadian medical schools in order to (1) identify organization models that support educational technology, (2) describe key attributes of these models, and (3) discuss the strengths and challenges associated with these models. The authors distributed a survey to 88 schools that had previously provided information on their educational technology services and infrastructure. The authors developed the survey through a series of pilots and, then, from the data for each respondent school, created concept maps, which were used to identify organizational models. The authors conducted analyses to determine differences among models. The authors coded the comments about organizational models and identified themes. The authors received adequate data for analysis from 61 schools (69%). Four models for educational technology organizations emerged: (1) centralized units located in the school of medicine, (2) centralized units located at the health science center, (3) centralized units at the comprehensive university, and (4) no centralized unit (Dispersed Model). The majority (75%) of schools relied on some type of centralized organization. Whereas few organization attributes proved to be statistically significant, the centralized models have more resources devoted to educational technology and a closer alignment with the academic mission than the Dispersed Model. Medical schools primarily use central models. The authors recommend that schools structuring their educational technology resources consider exploration of a central model because of its focused use of resources to improve teaching and learning.
Abu-Laban, Riyad B; Scott, Ian M; Gowans, Margot C
Canada has two independent routes of emergency medicine (EM) training and certification. This unique situation may encourage medical students with EM career aspirations to apply to family medicine (FM) residencies to subsequently acquire College of Family Physicians of Canada (CFPC) training and certification in EM. We sought answers to the following: 1) Are medical students who indicate EM as their top career choice on medical school entry, and then complete a FM residency, more likely to undertake subsequent CFPC-EM training than other FM residents who did not indicate EM as their top career choice; and 2) What are the characteristics of medical students in four predefined groups, based upon their early interest in EM as a career and ultimate postgraduate training disposition. Data were accessed from a survey of medical students in 11 medical school classes from eight Canadian universities and anonymously linked to information from the Canadian Residency Matching Service between 2006 and 2009. Of 1036 participants, 63 (6.1%) named EM as their top career choice on medical school entry. Of these, 10 ultimately matched to a Royal College of Physicians and Surgeons of Canada (RCPSC) EM residency program, and 24 matched to a FM residency program, nine of whom went on to do a one-year CFPC-EM residency program in contrast to 57 of the remaining 356 students matching to FM residency programs who did not indicate EM was their top career choice (37.5% vs 16.0%, p=0.007). Statistically significant attitudinal differences related to the presence or absence of EM career interest on medical school entry were found. Considering those who complete CFPC-EM training, a greater proportion indicate on admission to medical school that EM is their top career choice compared to those who do not. Moreover, students with an early career interest in EM are similar for several attitudinal factors independent of their ultimate postgraduate training disposition. Given the current issues and
Nensi, Alysha; Chande, Nilesh
The digital rectal examination (DRE) is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada. Clinical skills coordinators from the 14 English-speaking medical schools in Canada were invited to participate in the survey and to respond to questions regarding DRE teaching at their respective schools. Thirteen of the 14 schools (93%) responded to the survey. The DRE is taught in various ways: 69% of schools use anatomical rectal models, 62% use video tutorials and 62% involve physician instruction. Most schools (85%) offer one formal teaching session before clerkship. Generally, there is no formal DRE teaching session during clerkship. Preclerkship students in 62% of the schools perform competence in their students as well as provide more opportunities for students to obtain the necessary experience performing DREs during their clinical training.
Watterson, Rita; Matthews, David; Bach, Paxton; Kherani, Irfan; Halpine, Mary; Meili, Ryan
This study set out to explore the current state of global health concentrations in Canadian medical schools and to solicit feedback on the barriers and challenges to implementing rigorous global health concentration programs. A set of consensus guidelines for global health concentrations was drafted through consultation with student and faculty leaders across Canada between May 2011 and May 2012. Drawing on these guidelines, a formal survey was sent to prominent faculty at each of the 14 English-speaking Canadian medical schools. A thematic analysis of the results was then conducted. Overall, the guidelines were strongly endorsed. A majority of Canadian medical schools have programs in place to offer global health course work, extracurricular learning opportunities, local community service-learning, low-resource-setting clinical electives, predeparture training, and postreturn debriefing. Although student evaluation, global health mentorship, and knowledge translation projects were endorsed as important components, few schools had been successful in implementing them. Language training for global health remains contested. Other common critiques included a lack of time and resources, and difficulties in setting standards for student evaluation. The results suggest that these guidelines are appropriate and, at least for the major criteria, achievable. Although many Canadian schools offer individual components, the majority of schools have yet to develop formally structured concentration programs. By better articulating guidelines, a standardized framework can aid in the establishment and refinement of future programs.
Ziring, Deborah; Danoff, Deborah; Grosseman, Suely; Langer, Debra; Esposito, Amanda; Jan, Mian Kouresch; Rosenzweig, Steven; Novack, Dennis
Teaching and assessing professionalism is an essential element of medical education, mandated by accrediting bodies. Responding to a call for comprehensive research on remediation of student professionalism lapses, the authors explored current medical school policies and practices. In 2012-2013, key administrators at U.S. and Canadian medical schools accredited by the Liaison Committee on Medical Education were interviewed via telephone or e-mail. The structured interview questionnaire contained open-ended and closed questions about practices for monitoring student professionalism, strategies for remediating lapses, and strengths and limitations of current systems. The authors employed a mixed-methods approach, using descriptive statistics and qualitative analysis based on grounded theory. Ninety-three (60.8%) of 153 eligible schools participated. Most (74/93; 79.6%) had specific policies and processes regarding professionalism lapses. Student affairs deans and course/clerkship directors were typically responsible for remediation oversight. Approaches for identifying lapses included incident-based reporting and routine student evaluations. The most common remediation strategies reported by schools that had remediated lapses were mandated mental health evaluation (74/90; 82.2%), remediation assignments (66/90; 73.3%), and professionalism mentoring (66/90; 73.3%). System strengths included catching minor offenses early, emphasizing professionalism schoolwide, focusing on helping rather than punishing students, and assuring transparency and good communication. System weaknesses included reluctance to report (by students and faculty), lack of faculty training, unclear policies, and ineffective remediation. In addition, considerable variability in feedforward processes existed between schools. The identified strengths can be used in developing best practices until studies of the strategies' effectiveness are conducted.
To, Matthew J; MacLeod, Anna; Hwang, Stephen W
PHENOMENON: Homelessness is a major public health concern. Given that homeless individuals have high rates of mortality and morbidity, are more likely to be users of the healthcare system, and often report unmet health needs, it is important to examine how homelessness is addressed in medical education. We wanted to examine content and framing of issues related to homelessness in the case-based learning (CBL) curriculum and provide insights about whether medical students are being adequately trained to meet the health needs of homeless individuals through CBL. CBL content at a Canadian medical school that featured content related to homelessness was analyzed. Data were extracted from cases for the following variables: curriculum unit (e.g., professionalism/ethics curriculum or biomedical/clinical curriculum), patient characteristics (e.g., age, sex), and medical and social conditions. A thematic analysis was performed on cases related to homelessness. Discrepancies in analysis were resolved by consensus. Homelessness was mentioned in five (2.6%) of 191 CBL cases in the medical curriculum. Homelessness was significantly more likely to be featured in professionalism/ethics cases than in biomedical/clinical cases (p = .03). Homeless patients were portrayed as socially disadvantaged individuals, and medical learners were prompted to discuss ethical issues related to homeless patients in cases. However, homeless individuals were largely voiceless in cases. Homelessness was associated with serious physical and mental health concerns, but students were rarely prompted to address these concerns. Insights: The health and social needs of homeless individuals are often overlooked in CBL cases in the medical curriculum. Moreover, stereotypes of homelessness may be reinforced through medical training. There are opportunities for growth in addressing the needs of homeless individuals through medical education.
Cujec, B; Oancia, T; Bohm, C; Johnson, D.
BACKGROUND: Studies of career and parenting satisfaction have focused separately on medical students, residents and practising physicians. The objective of this study was to compare satisfaction across a spectrum of stages of medical career. METHODS: A survey of incoming medical students, current medical students, residents and physician teachers at the University of Saskatchewan was conducted in the spring of 1997. Response rates were 77% (43/56), 81% (177/218), 65% (134/206) and 39% (215/55...
Full Text Available BACKGROUND: The digital rectal examination (DRE is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.
Cujec, B; Oancia, T; Bohm, C; Johnson, D
Studies of career and parenting satisfaction have focused separately on medical students, residents and practising physicians. The objective of this study was to compare satisfaction across a spectrum of stages of medical career. A survey of incoming medical students, current medical students, residents and physician teachers at the University of Saskatchewan was conducted in the spring of 1997. Response rates were 77% (43/56), 81% (177/218), 65% (134/206) and 39% (215/554) respectively. Factors assessed in the stepwise regression analysis were the effect of sex, parenting and level of training on the likelihood of recommending parenting to medical students or residents, and on parenting dissatisfaction, job dissatisfaction, career dissatisfaction and the importance of flexibility within the college program to accommodate family obligations. More male than female physician teachers had partners (92% v. 81%, p teachers spent equal hours per week at work compared with their male counterparts (mean 52 and 58 hours respectively) and more than double the weekly time on family and household work (36 v. 14 hours, p teachers were the most likely respondents to recommend parenting to residents and their peers. Residents were the most dissatisfied with their parenting time. At all career stages women were less likely than men to recommend parenting, were more dissatisfied with the amount of time spent as parents and were more likely to regard flexibility within the college program as beneficial. There were no sex-related differences in job dissatisfaction and career dissatisfaction. However, married women were more dissatisfied with their jobs than were married men. Job dissatisfaction was greatest among medical students, and career dissatisfaction was greatest among residents. The optimal timing of parenthood appears to be upon completion of medical training. Women were less likely to recommend parenting, less satisfied with the time available for parenting and more likely
Association of Canadian Medical Colleges, Ottawa (Ontario).
Data for 1980-1981 pertaining to medical education in Canada are presented. Information about Canadian medical schools, population of Canada by province and distribution of medical school openings, tuition, payment scales for post-M.D. clinical trainees, clinical clerkship stipends, and numbers of Canadian medical schools offering instruction in…
Stiell, Ian G; Artz, Jennifer D; Lang, Eddy S; Sherbino, Jonathan; Morrison, Laurie J; Christenson, James; Perry, Jeffrey J; Topping, Claude; Woods, Robert; Green, Robert S; Lim, Rodrick; Magee, Kirk; Foote, John; Meckler, Garth; Mensour, Mark; Field, Simon; Chung, Brian; Kuuskne, Martin; Ducharme, James; Klein, Vera; McEwen, Jill
We sought to conduct a major objective of the CAEP Academic Section, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools. We developed an 84-question questionnaire, which was distributed to academic heads. The responses were validated by phone by the lead author to ensure that the questions were answered completely and consistently. Details of pediatric emergency medicine units were excluded from the scan. At eight of 17 universities, emergency medicine has full departmental status and at two it has no official academic status. Canadian academic emergency medicine is practiced at 46 major teaching hospitals and 13 specialized pediatric hospitals. Another 69 Canadian hospital EDs regularly take clinical clerks and emergency medicine residents. There are 31 full professors of emergency medicine in Canada. Teaching programs are strong with clerkships offered at 16/17 universities, CCFP(EM) programs at 17/17, and RCPSC residency programs at 14/17. Fourteen sites have at least one physician with a Master's degree in education. There are 55 clinical researchers with salary support at 13 universities. Sixteen sites have published peer-reviewed papers in the past five years, ranging from four to 235 per site. Annual budgets range from $200,000 to $5,900,000. This comprehensive review of academic activities in emergency medicine across Canada identifies areas of strengths as well as opportunities for improvement. CAEP and the Academic Section hope we can ultimately improve ED patient care by sharing best academic practices and becoming better teachers, educators, and researchers.
Robins, Jason A; McInnes, Matthew D F; Esmail, Kaisra
Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates' documentation, the heterogeneity therein, as well as its objective data. Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.
Singh, Barinder; Banwell, Emma; Groll, Dianne
Background The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. Methods The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Results Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. Conclusion While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine. PMID:29354194
Reitmanova, Sylvia; Carter-Pokras, Olivia
In this paper we present the current state of cultural diversity education for undergraduate medical students in three English-speaking countries: the United Kingdom (U.K.), United States (U.S.) and Canada. We review key documents that have shaped cultural diversity education in each country and compare and contrast current issues. It is beyond the scope of this paper to discuss the varied terminology that is immediately evident. Suffice it to say that there are many terms (e.g. cultural awareness, competence, sensitivity, sensibility, diversity and critical cultural diversity) used in different contexts with different meanings. The major issues that all three countries face include a lack of conceptual clarity, and fragmented and variable programs to teach cultural diversity. Faculty and staff support and development, and ambivalence from both staff and students continue to be a challenge. We suggest that greater international collaboration may help provide some solutions. PMID:20352513
Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol - the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts.
Dobni, Dawn; Dobni, Brooke
Using Porter's five-forces model (potential entrants, suppliers, buyers, rivalry, substitutes) to analyze competition in Canadian university business schools, the authors conclude that schools are becoming increasingly vulnerable to competitive pressures and that strategic reorientation is necessary. (SK)
Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, "Liberation therapy" for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other businesses market regional, cross
Full Text Available Abstract Background Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, “Liberation therapy” for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Methods Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1 where in Canada these businesses are located; 2 the destination countries and health care facilities that they market; 3 the medical procedures they promote; 4 core marketing messages; and 5 whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Results Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism
Background Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, “Liberation therapy” for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel. Methods Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures. Results Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other
Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol ? the principal psychoactive...
Kudlow, Paul A; Naylor, Karline Treurnicht; Xie, Bin; McIntyre, Roger S
Cognitive enhancing agents are substances that may augment functions such as memory, attention, concentration, wakefulness, and intelligence. An anonymous, online survey containing a series of questions on the actual and hypothetical use of cognitive enhancers was sent via email to 647 medical students across all four years in one Canadian MD program. The response rate was 50% (326/647). Overall, 49 (15%, 95% CI: 11% to 19%) students admitted to non-medical and/or off-label use of one or more pharmaceutical stimulants, of whom 14 (4%, 95% CI: 2% to 6%) had used stimulants within the last year. Senior medical students reported recent use more often than junior students (8% vs. 2%, P = 0.04). Class seniority and male gender were both associated with positive attitudes towards use of these agents; favorable attitudes were associated with recent use of pharmaceutical stimulant and high-caffeine products. A substantial proportion of Canadian medical students have engaged at some point in non-medical and/or off-label use of stimulants for purposes of cognitive enhancement. Male students and those in upper years of the MD program were more likely to have used pharmaceutical stimulants in the last year, and have favorable attitudes concerning use of cognitive-enhancing agents.
Maggio, Lauren A; ten Cate, Olle; Chen, H Carrie; Irby, David M; O'Brien, Bridget C
Evidence-based medicine (EBM) is a fixture in many medical school curricula. Yet, little is known about the challenges medical students face in learning EBM or the educational approaches that medical schools use to overcome these challenges. A qualitative multi-institutional case study was conducted between December 2013 and July 2014. On the basis of the Association of American Medical Colleges 2012 Medical School Graduation Questionnaire data, the authors selected 22 U.S. and Canadian Liaison Committee on Medical Education-accredited medical schools with graduates reporting confidence in their EBM skills. Participants were interviewed and asked to submit EBM curricular materials. Interviews were audio-recorded, transcribed, and analyzed using an inductive approach. Thirty-one EBM instructors (17 clinicians, 11 librarians, 2 educationalists, and 1 epidemiologist) were interviewed from 17 medical schools (13 in the United States, 4 in Canada). Four common EBM learning challenges were identified: suboptimal role models, students' lack of willingness to admit uncertainty, a lack of clinical context, and students' difficulty mastering EBM skills. Five educational approaches to these challenges that were common across the participating institutions were identified: integrating EBM with other courses and content, incorporating clinical content into EBM training, EBM faculty development, EBM whole-task exercises, and longitudinal integration of EBM. The identification of these four learner-centered EBM challenges expands on the literature on challenges in teaching and practicing EBM, and the identification of these five educational approaches provides medical educators with potential strategies to inform the design of EBM curricula.
McAlpine, Kristen; Steele, Stephen
The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students' anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported. This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination. A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over one-third of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years. To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students' exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.
This article summarizes some of the findings and recommendations of a research project focusing on the nature and needs of refugee students in Canadian schools. The school performance of refugee students is examined under the following headings: immigration regulations; initial identification, assessment, placement and monitoring; unaccompanied youngsters; "at risk" students; academic needs; the conflict of cultures. In particular, the article discusses the changing role of the school in the light of recent immigration trends. Many of the findings are applicable to other national settings.
Vitoroulis, Irene; Brittain, Heather; Vaillancourt, Tracy
Bullying in ethnically diverse schools varies as a function of the ethnic composition and degree of diversity in schools. Although Canada is highly multicultural, few researchers have focused on the role of context on ethnic majority and minority youths' bullying involvement. In the present study, 11,649 European-Canadian/ethnic majority (77%) and…
Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M
Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts. PMID:27757048
Browning, H Frances; Laxer, Rachel E; Janssen, Ian
This national study was conducted to examine healthy eating programs, healthy eating education, and the food retail environments of schools. A total of 436 Canadian schools were studied. Administrators completed a questionnaire designed to assess school healthy eating programs, healthy eating education, and food retail environment. The number of chain fast food restaurants, chain cafés/coffee shops, and convenience stores within 1 km of schools was measured using geographic information systems food retailer measures from DMTI Spatial Inc. and the Yellow Pages. During the preceding year, 67% of schools had initiated healthy eating lunch programs while 18% had junk food-free days. The majority of schools offered cooking classes (59%) and healthy eating media literacy education (67%), while a minority offered gardening activities (15%) and field trips to farmers' markets (27%) and grocery stores (36%). Fifty-three percent had a school cafeteria, and most had a school tuck shop (75%) and pop/juice vending machines (76%). Fifty percent had a chain fast food restaurant, 33% had a chain café/coffee shop, and 41% had a convenience store within 1 km. An important aspect of addressing childhood obesity will be improving the food environments of schools and their surrounding neighbourhoods, and providing healthy eating education for all students.
Woodward, C A; Ferrier, B M
A study was undertaken of the career paths and decisions, and the factors influencing the decisions, of the first six graduating classes of McMaster University's medical school. Climate and geography, preference for urban or rural living and influence of spouse were the factors that most influenced the location of practice, although the graduates who moved to the United States considered economic factors important too. Nearly one third of the specialists were practising in the United States. Personal challenge and positive clinical experience in the field were the major influences on choice of medical field. Graduates entering a specialty were more likely than those entering primary care to consider encouragement of others, a positive example set by medical school faculty members, working hours and research experience in the field as important influences on their choice of medical field. Data are needed on the career decisions, and the factors affecting them, of the graduates of all Canadian medical schools if Canadian medical manpower planning is to be realistic.
Ly, Anh; Crowshoe, Lynden
Efforts are underway in many parts of the world to develop medical education curricula that address the health care issues of indigenous populations. The topic of stereotypes and their impact on such peoples' health, however, has received little attention. An examination of stereotypes will shed light on dominant cultural attitudes toward Aboriginal people that can affect quality of care and health outcomes in Aboriginal patients. This study examines the views of undergraduate medical students regarding Canadian Aboriginal stereotypes and how they potentially affect Aboriginal people's health. The goal of this study was to gain insight into how medical learners perceive issues related to racism, discrimination and social stereotypes and to draw attention to gaps in Aboriginal health curricula. This study involved a convenience sample of medical learners drawn from one undergraduate medical programme in western Canada. Using a semi-structured interview guide, we conducted a total of seven focus group interviews with 38 first- and second-year undergraduate medical students. Data were analysed using a thematic content analysis approach. Medical students recognise that stereotypes are closely related to processes of racism and discrimination. However, they generally feel that stereotypes of Aboriginal people are rooted in reality. Students also identified medical school as one of the environments in which they are commonly exposed to negative views of Aboriginal people. Student responses suggest they see the cultural gap between Aboriginal and non-Aboriginal people as being both a cause and a consequence of discrimination against Aboriginal people. The results of this study suggest that teaching medical students about the realities and impacts of stereotypes on Aboriginal peoples is a good starting point from which to address issues of racism and health inequities affecting the health of Aboriginal people. © 2015 John Wiley & Sons Ltd.
Kutsyuruba, Benjamin; Walker, Keith; Noonan, Brian
As a fundamental concept in human interactions, trust is important for understanding and mediating the social structures in schools. The instrumental work of cultivating, brokering, and maintaining trust in schools lies within the role of the school administrator. Our exploratory study examined the Canadian school principals' perceptions of their…
Newton, Paul; da Costa, Jose
Purpose: The purpose of this paper is to report on the policy and practice contexts for school autonomy and twenty-first century learning in Canadian provinces. Design/methodology/approach: This paper reports on an analysis of policies in Canadian provinces (particularly the provinces of Alberta and Saskatchewan). The authors review policies…
Internationalisation is no longer a well-recognised feature unique to higher education. It has permeated K-12 education. However, little research has been done on internationalisation at the K-12 level, particularly on offshore schools. This study examines how Canadian and Chinese policies regarding offshore schools have developed over the years,…
Callaghan, Tonya D.
Little is known about the experiences of non-heterosexual educators in Canadian Catholic schools. This article reveals previously unreported data from a qualitative study that compares the treatment of and attitudes towards lesbian, gay, bisexual, transgender, and queer (lgbtq) teachers in publicly-funded Catholic school systems in the Canadian…
Full Text Available Background: A growing population of Canadian students are travelling outside of Canada for medical training. The purpose of this study is to assess the opportunity for Canadians studying medicine abroad (CSAs to secure post-graduate medical residency positions as International medical graduates (IMGs in Canada. Methods: Current statistics on IMG applicants into the Canadian Residency Matching Service (CaRMS will be compared to the number of CSAs applying to return to Canada. Results: In 2010, 75% (1232 of IMG applicants were unmatched following application to CaRMS, despite a doubling in positions reserved for IMGs from 2003. An estimated 3750 CSAs are currently attending over 55 medical schools globally; a six-fold increase since first reports in 2006. Between 2012 and 2014, it is estimated that 72.8% of CSAs will graduate, with 90.4% hoping to return to Canada for post-graduate residency training. Discussion: The increasing population of CSAs poses a significant risk for future IMGs attempting to secure postgraduate training positions in Canada. From this perspective, we have coined the term ‘Canadian IMG Bottleneck’ – which describes the funnelling effect that has been created by the growing number of CSAs and the limited number of IMG residency positions available in Canada.
Wong, Janice C; Hong, Jonathan; Leung, Pearl; Yin, Penny; Stewart, Donna E
Human trafficking is a human rights violation prevalent globally. Current guidelines highlight healthcare professionals' key role in responding to human trafficking, emphasizing the importance of medical education in raising awareness of trafficking. To assess pre-clerkship medical students' awareness of human trafficking and attitudes towards learning about trafficking in the medical curriculum at Canada's largest medical school. An anonymous, classroom-based questionnaire was designed, piloted and administered to first- and second-year medical students at one large Canadian medical school with a diverse student population. The questionnaire sought demographic data and information on students' self-perceived awareness of human trafficking and interest in learning about trafficking and other community health issues. 262 medical students completed the questionnaire (70.0% response). Most participants reported that they were not knowledgeable (48.5%) or only somewhat knowledgeable (45.4%) about human trafficking. 88.9% of participants were not familiar with signs and symptoms of trafficked persons. While students' responses indicated that they prioritized other social issues, a majority of participants (76.0%) thought that trafficking was important to learn about in medical school, especially identifying trafficked persons and their health needs. These medical students of one Canadian medical school demonstrated limited familiarity with the issue of human trafficking but largely felt that they should be taught more about this issue during their medical education. This assessment of early medical students' awareness of human trafficking is relevant to medical educators and the organizations that could develop the required educational curricula and resources.
Snyder, Jeremy; Johnston, Rory; Crooks, Valorie A; Morgan, Jeff; Adams, Krystyna
Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: (1) Inbound medical tourism to Canada's public hospitals; (2) Inbound medical tourism to a First Nations reserve; (3) Canadian patients opting to go abroad for medical tourism; and (4) Canadian patients traveling abroad with a Canadian surgeon. These patterns of medical tourism affect preferential access to health care by Canadians by circumventing domestic regulation of care, creating jurisdictional tensions over the provision of health care, and undermining solidarity with the Canadian health system.
Brenneis Fraser R
Full Text Available Abstract Background Given the looming shortage of physicians in Canada, we wished to determine how closely the career preference of students entering Canadian medical schools was aligned with the current physician mix in Canada. Methods Career choice information was collected from a survey of 2,896 Canadian medical students upon their entry to medical school. The distribution of career choices of survey respondents was compared to the current physician speciality mix in Canada. Results We show that there is a clear mismatch between student career choice at medical school entry and the current specialty mix of physicians in Canada. This mismatch is greatest in Urban Family Medicine with far fewer students interested in this career at medical school entry compared to the current proportion of practicing physicians. There are also fewer students interested in Psychiatry than the current proportion of practicing physicians. Conclusion This mismatch between the student interest and the current proportion of practicing physicians in the various specialities in Canada is particularly disturbing in the face of the current sub-optimal distribution of physicians. If nothing is done to correct this mismatch of student interest in certain specialities, shortages and misdistributions of physicians will be further amplified. Studies such as this can give a window into the future health human resources challenges for a nation.
Ford, Jason; Pambrun, Chantale
Physicians in every medical and surgical field must be able to use pathology concepts and skills in their practice: for example, they must order and interpret the correct laboratory tests, they must use their understanding of pathogenesis to diagnose and treat, and they must work with the laboratory to care for their patients. These important concepts and skills may be ignored by medical schools and even national/international organizations setting graduation expectations for medical students. There is an evolving international consensus about the importance of exit competencies for medical school graduates, which define the measurable or observable behaviors each graduate must be able to demonstrate. The Canadian Association of Pathologists (CAP) Education Group set out to establish the basic competencies in pathology and laboratory medicine which should be expected of every medical graduate: not competencies for pathologists, but for medical graduates who intend to enter any residency program. We defined 4 targets for pathology and laboratory medicine exit competencies: that they represent only measurable behaviors, that they be clinically focused, that they be generalizable to every medical graduate, and that the final competency document be user-friendly. A set of competencies was developed iteratively and underwent final revision at the 2012 CAP annual meeting. These competencies were subsequently endorsed by the CAP executive and the Canadian Leadership Council on Laboratory Medicine. This clinically focused consensus document provides the first comprehensive list of exit competencies in pathology and laboratory medicine for undergraduate medical education. Copyright © 2015 Elsevier Inc. All rights reserved.
Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy
International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006. We examined 3 entry-to-practice milestones; obtaining a postgraduate position, passing the Medical Council of Canada Qualifying Examination Part II and obtaining a specialty designation. Of the 6925 eligible graduates in cohort 1, 2144 (31.0%) had obtained a postgraduate position. Of the 1214 eligible graduates in cohort 2, 1126 (92.8%) had passed the Qualifying Examination Part II, and 889 (73.2%) had obtained a specialty designation. In multivariate analyses, Canadian graduates of Western or Caribbean medical schools (odds ratio [OR] 4.69, 95% confidence interval [CI] 3.82-5.71) and Canadian graduates of other medical schools (OR 1.49, 95% CI 1.31-1.70) were more likely to obtain a postgraduate position than non-Canadian graduates of other (not Western or Caribbean) medical schools. There was no difference among the groups in passing the Qualifying Examination Part II or obtaining a specialty designation. Canadians who studied abroad were more likely than other international medical graduates to obtain a postgraduate position; there were no differences among the groups in realizing milestones once in a postgraduate program. These findings support policies that do not distinguish postgraduate applicants by citizenship or permanent residency status before medical school. Copyright 2017, Joule Inc. or its
Zhukovskyi, Vasyl; Kostiuk, Olha
The article deals with the issue of educational preconditions of gender education formation and development in Canadian secondary schools. On the basis of conducted scientific and pedagogical literature analysis it has been determined that gender education has undergone three main stages and is currently developing during its fourth, modern…
Bean, Glynis; Kidder, Louise H.
Research on the characteristics of women in non-traditional fields, e.g., medicine, has yielded complex information in terms of adherence to sex-role stereotypes. To determine whether students' attitudes toward helping and achieving followed sex-role typing and were different at various stages in medical school, 384 male and female oncology…
Wei, Yifeng; Kutcher, Stan; Szumilas, Magdalena
Adolescence is a critical period for the promotion of mental health and the treatment of mental disorders. Schools are well-positioned to address adolescent mental health. This paper describes a school mental health model, "School-Based Pathway to Care," for Canadian secondary schools that links schools with primary care providers and…
Kutcher, Stan; Bagnell, Alexa; Wei, Yifeng
"Mental health literacy is an integral component of health literacy and has been gaining increasing attention as an important focus globally for mental health interventions. In Canada, youth mental health is increasingly recognized as a key national health concern and has received more focused attention than ever before within our health system. This article outlines 2 unique homegrown initiatives to address youth mental health literacy within Canadian secondary schools." Copyright © 2015 Elsevier Inc. All rights reserved.
Tam, V C; Berry, S; Hsu, T; North, S; Neville, A; Chan, K; Verma, S
The oncology education framework currently in use in Canadian medical training programs is unknown, and the needs of learners have not been fully assessed to determine whether they are adequately prepared to manage patients with cancer. To assess the oncology education framework currently in use at Canadian medical schools and residency training programs for family (fm) and internal medicine (im), and to evaluate opinions about the content and utility of standard oncology education objectives, a Web survey was designed and sent to educators and learners. The survey recipients included undergraduate medical education curriculum committee members (umeccms), directors of fm and im programs, oncologists, medical students, and fm and im residents. Survey responses were received from 677 educators and learners. Oncology education was felt to be inadequate in their respective programs by 58% of umeccms, 57% of fm program directors, and 50% of im program directors. For learners, oncology education was thought to be inadequate by 67% of medical students, 86% of fm residents, and 63% of im residents. When comparing teaching of medical subspecialty-related diseases, all groups agreed that their trainees were least prepared to manage patients with cancer. A standard set of oncology objectives was thought to be possibly or definitely useful for undergraduate learners by 59% of respondents overall and by 61% of postgraduate learners. Oncology education in Canadian undergraduate and postgraduate fm and im training programs are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives might address the needs of learners.
Tam, V.C.; Berry, S.; Hsu, T.; North, S.; Neville, A.; Chan, K.; Verma, S.
Background The oncology education framework currently in use in Canadian medical training programs is unknown, and the needs of learners have not been fully assessed to determine whether they are adequately prepared to manage patients with cancer. Methods To assess the oncology education framework currently in use at Canadian medical schools and residency training programs for family (fm) and internal medicine (im), and to evaluate opinions about the content and utility of standard oncology education objectives, a Web survey was designed and sent to educators and learners. The survey recipients included undergraduate medical education curriculum committee members (umeccms), directors of fm and im programs, oncologists, medical students, and fm and im residents. Results Survey responses were received from 677 educators and learners. Oncology education was felt to be inadequate in their respective programs by 58% of umeccms, 57% of fm program directors, and 50% of im program directors. For learners, oncology education was thought to be inadequate by 67% of medical students, 86% of fm residents, and 63% of im residents. When comparing teaching of medical subspecialty–related diseases, all groups agreed that their trainees were least prepared to manage patients with cancer. A standard set of oncology objectives was thought to be possibly or definitely useful for undergraduate learners by 59% of respondents overall and by 61% of postgraduate learners. Conclusions Oncology education in Canadian undergraduate and postgraduate fm and im training programs are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives might address the needs of learners. PMID:24523624
Ng, Victor; Irwin, Jennifer D
Physical activity (PA) is powerful for preventing and treating many chronic diseases. Physicians' own PA behaviors are correlated with their likelihood to counsel patients regarding PA. Medical students' PA-related attitudes and behaviors reflect what can be expected from our future physicians. A 27-item online survey was used to determine the percentage of Canadian medical students meeting the Canadian physical activity recommendations, and their self-reported perception of relevance and frequency of exercise counseling during patient encounters. We generated cross-tabulations with the independent covariates and our statistical comparison was based on the generalized estimating equation (GEE) algorithm to adjust for schools (clusters). While 64% (969/1510) of medical students met the MVPA recommendation, only 25% discussed PA counseling with patients. Most (80% and 90%, respectfully) believed physicians should adhere to a healthy lifestyle to effectively encourage their patients to do so, and that their credibility increased if they stayed fit themselves. Medical students are interested in and receptive to the importance of PA. However, not only is there improvement needed for the more than one-third of medical students who are insufficiently active themselves, but substantial change is needed regarding the vast majority of students' current counseling behaviors.
Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Kingsbury, Paul
Medical tourism, the intentional pursuit of elective medical treatments in foreign countries, is a rapidly growing global industry. Canadians are among those crossing international borders to seek out privately purchased medical care. Given Canada's universally accessible, single-payer domestic health care system, important implications emerge from Canadians' private engagement in medical tourism. A scoping review was conducted of the popular, academic, and business literature to synthesize what is currently known about Canadian involvement in medical tourism. Of the 348 sources that were reviewed either partly or in full, 113 were ultimately included in the review. The review demonstrates that there is an extreme paucity of academic, empirical literature examining medical tourism in general or the Canadian context more specifically. Canadians are engaged with the medical tourism industry not just as patients but also as investors and business people. There have been a limited number of instances of Canadians having their medical tourism expenses reimbursed by the public medicare system. Wait times are by far the most heavily cited driver of Canadians' involvement in medical tourism. However, despite its treatment as fact, there is no empirical research to support or contradict this point. Although medical tourism is often discussed in the Canadian context, a paucity of data on this practice complicates our understanding of its scope and impact.
Bombi, Josep Antoni
Assesses the current situation of medical teaching, available healthcare facilities, and teaching staff employed at Spanish medical schools. Response rate was 100% from 27 schools surveyed. (Author/NB)
Peter Arcidiacono; Sean Nicholson
Using data on the universe of students who graduated from U.S. medical schools between 1996 and 1998, we examine whether the abilities and specialty preferences of a medical school class affect a student's academic achievement in medical school and his choice of specialty. We mitigate the selection problem by including school-specific fixed effects, and show that this method yields an upper bound on peer effects for our data. We estimate positive peer effects that disappear when school-specif...
Blissett, Sarah; Law, Christine; Morra, Dante; Ginsburg, Shiphra
Many medical students find choosing a residency challenging. There are several steps involved, including determining one's own priorities, arranging electives, choosing a training program and site, and preparing an in-depth application and a rank order list. Many resources are available to assist students, including the Canadian Resident Matching Service website, program websites, career counselors, career information sessions, mentors, peers, family/friends, and the Canadian Medical Residency Guide. Our study explored the relative impact of these resources on the career decision-making process. We invited medical students in their final year at 12 Canadian medical schools to complete an online survey. Questions included identifying the relative utility of resources in the context of each component of the decision-making process. Responses were analyzed using descriptive statistics. The response rate was 71% (1076 of 1518). Overall, mentors, family/friends, and peers had the most impact on students' decision making. Career counselors, websites, and the Canadian Medical Residency Guide had much less impact. Family/friends were most frequently cited as essential to the process; however, family/friends and peers were equal in having some impact. Our findings suggest that students are most influenced by family, friends, and peers, who are not involved in the formal residency selection effort. Appreciating the impact of these influences on students' decision making is important to understanding how they decide on their future careers. The study supports continuation of mentorship programs. Future work could focus on qualitative research to further characterize resource use.
Seibert, Warren F.; Kuenz, Marjorie A.
The analyses reported here on the growth and change of medical school libraries are based on the annual statistics of 67 U.S. and Canadian medical school libraries, 1975-89, and 4 primary statistics from "parent," main campus libraries, all of them members of the Association of Research Libraries. The results show that medical school…
Tam, Vincent C; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E
Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to
Full Text Available No abstract available. Article truncated at 150 words. I recently retired and have been encouraged to write about what has changed in medicine. However, the changes have been sufficiently extensive that one editorial would be too long. Therefore, this will be the first of several editorials examining medical school, residency, fellowship and practice.The beginning of my own medical career was 1972 when I entered medical school, graduating in 1976. My reasons for choosing the specific school I entered were several: 1. A scholarship was provided that paid tuition; 2. It was a state school and otherwise relatively cheap; 3. The school would accept me after 3 years of college and without a college degree; 4. It was the medical school of my undergraduate school and I knew many of the entering students; and 5. I was told that it mattered less where you did your medical school training than where you did your residency. I saw no …
Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Kingsbury, Paul
Background Medical tourism, the intentional pursuit of elective medical treatments in foreign countries, is a rapidly growing global industry. Canadians are among those crossing international borders to seek out privately purchased medical care. Given Canada’s universally accessible, single-payer domestic health care system, important implications emerge from Canadians’ private engagement in medical tourism. Methods A scoping review was conducted of the popular, academic, and business literature to synthesize what is currently known about Canadian involvement in medical tourism. Of the 348 sources that were reviewed either partly or in full, 113 were ultimately included in the review. Results The review demonstrates that there is an extreme paucity of academic, empirical literature examining medical tourism in general or the Canadian context more specifically. Canadians are engaged with the medical tourism industry not just as patients but also as investors and business people. There have been a limited number of instances of Canadians having their medical tourism expenses reimbursed by the public medicare system. Wait times are by far the most heavily cited driver of Canadians’ involvement in medical tourism. However, despite its treatment as fact, there is no empirical research to support or contradict this point. Discussion Although medical tourism is often discussed in the Canadian context, a paucity of data on this practice complicates our understanding of its scope and impact. PMID:22046228
Matthew B. Schlenker
Full Text Available Objective. Compare glaucoma medication costs between the United States (USA and Canada. Methods. We modelled glaucoma brand name and generic medication annual costs in the USA and Canada based on October 2013 Costco prices and previously reported bottle overfill rates, drops per mL, and wastage adjustment. We also calculated real wholesale price changes from 2006 to 2013 based on the Average Wholesale Price (USA and the Ontario Drug Benefit Price (Canada. Results. US brand name medication costs were on average 4x more than Canadian medication costs (range: 1.9x–6.9x, averaging a cost difference of $859 annually. US generic costs were on average the same as Canadian costs, though variation exists. US brand name wholesale prices increased from 2006 to 2013 more than Canadian prices (US range: 29%–349%; Canadian range: 9%–16%. US generic wholesale prices increased modestly (US range: −23%–58%, and Canadian wholesale prices decreased (Canadian range: −38%–0%. Conclusions. US brand name glaucoma medications are more expensive than Canadian medications, though generic costs are similar (with some variation. The real prices of brand name medications increased more in the USA than in Canada. Generic price changes were more modest, with real prices actually decreasing in Canada.
Patricia A. Duff
Full Text Available Abstract Bilingualism and multiculturalism have for four decades been official ideologies and policies in Canada but, as is often the case, the implementation and outcomes of such government policies nationally are less impressive than the rhetoric would suggest. This article reviews the political, theoretical and demographic contexts justifying support for the learning and use of additional languages in contemporary Canadian society and schools, and summarizes research demonstrating that bilingualism and multilingualism are indeed cognitively, socially, and linguistically advantageous for children (and adults, as well as for society. The five studies in this special issue are then previewed with respect to the following themes that run across them: (1 the potential for bilingual synergies and transformations in language awareness activities and crosslinguistic knowledge construction; (2 the role of multiliteracies and multimodality in mediated learning; and (3 the interplay of positioning, identity, and agency in language learning by immigrant youth. The article concludes that more Canadian schools and educators must, like the researchers in this volume, find ways to embrace and build upon students’ prior knowledge, their creativity, their collaborative problem-solving skills, their potential for mastering and manipulating multiple, multilingual semiotic tools, and their desire for inclusion and integration in productive, engaging learning communities.
Matthew Hughes, J D; Azzi, Elise; Rose, Gregory Walter; Ramnanan, Christopher J; Khamisa, Karima
To prepare for careers in medicine, medical trainees must develop clinical teaching skills. It is unclear if Canadian medical students need or want to develop such skills. We sought to assess Canadian students' perceptions of clinical teaching, and their desire to pursue clinical teaching skills development via a clinical teaching elective (CTE) in their final year of medical school. We designed a descriptive cross-sectional study of Canadian senior medical students, using an online survey to gauge teaching experience, career goals, perceived areas of confidence, and interest in a CTE. Students at 13 of 17 Canadian medical schools were invited to participate in the survey (4154 students). We collected 321 responses (7.8%). Most (75%) respondents expressed confidence in giving presentations, but fewer were confident providing bedside teaching (47%), teaching sensitive issues (42%), and presenting at journal clubs (42%). A total of 240 respondents (75%) expressed interest in participating in a CTE. The majority (61%) favored a two week elective, and preferred topics included bedside teaching (85%), teaching physical examination skills (71%), moderation of small group learning (63%), and mentorship in medicine (60%). Our study demonstrates that a large number of Canadian medical students are interested in teaching in a clinical setting, but lack confidence in skills specific to clinical teaching. Our respondents signaled interest in participating in an elective in clinical teaching, particularly if it is offered in a two-week format.
Shariff, Salimah Z; Bejaimal, Shayna A D; Sontrop, Jessica M; Iansavichus, Arthur V; Weir, Matthew A; Haynes, R Brian; Speechley, Mark R; Thind, Amardeep; Garg, Amit X
Physicians often search for information to improve patient care. We evaluated how nephrologists use online information sources for this purpose. In this cross-sectional study (2008 to 2010), a random sample of Canadian nephrologists completed a survey of their online search practices. We queried respondents on their searching preferences, practices and use of 9 online information sources. Respondents (n=115; 75% response rate) comprised both academic (59%) and community-based (41%) nephrologists. Respondents were an average of 48 years old and were in practice for an average of 15 years. Nephrologists used a variety of online sources to retrieve information on patient treatment including UpToDate (92%), PubMed (89%), Google (76%) and Ovid MEDLINE (55%). Community-based nephrologists were more likely to consult UpToDate first (91%), while academic nephrologists were divided between UpToDate (58%) and PubMed (41%). When searching bibliographic resources such as PubMed, 80% of nephrologists scan a maximum of 40 citations (the equivalent of 2 search pages in PubMed). Searching practices did not differ by age, sex or years in practice. Nephrologists routinely use a variety of online resources to search for information for patient care. These include bibliographic databases, general search engines and specialized medical resources.
Nagji, Alim; Leslie, Karen; Wong, Eric; Myhre, Doug; Young, Meredith; Chan, Ming-Ka
Current theory in medical education emphasizes engaging learners as educators while tailoring teaching to their learning needs. However, little is known about learners' perceptions of their proposed roles as teachers and educators. Canadian medical students were invited to complete an English language online questionnaire structured to include: teaching experience, participation and/or awareness of teacher development at their school and awareness and/or interest in further training in medical education. The survey was developed by the Canadian Association for Medical Education (CAME) Membership Subcommittee, and distributed via the Canadian Federation of Medical Students (CFMS) email list and the CAME twitter account in March 2014. Of the 169 undergraduate medical student respondents, 36% (n=61) reported a lack of prior teaching experience and 45% (n=73) were unsure if their school provided teaching instruction. Overall, 91% (n=150) indicated that they planned to incorporate teaching or medical education into their future careers. While the majority of medical student respondents are expecting or planning to teach, most report not having access to adequate training through medical school. Further effort is necessary to support medical students as teachers to prepare them for increased teaching responsibilities as residents and to expose them to potential careers in medical education.
Gilbert, Jo-Anne; Miller, Doris; Olson, Shannon; St-Pierre, Sylvie
The article describes the after-school (AS) snacking pattern of young Canadians and its relationship with the amount of energy consumed daily and at dinner. We analyzed cross-sectional dietary data, measured by 24h recall, from 9,131 children and adolescents aged 4 to 18 years from the Canadian Community Health Survey, cycle 2.2 (2004). We evaluated AS snack intake; i.e., foods consumed Monday to Friday between 3:00 and 6:00 pm, excluding lunch and dinner. We also assessed the consumption frequency of AS snack items, the energy provided by AS snacks and total daily energy intake (TDEI) by age group and sex. Approximately 63% of respondents consumed AS snacks. AS snacks provided on average 1212[95%CI,1157-1268] kJ (290[95%CI,276-303] kcal), representing 13[95%CI,12-13]% of TDEI. Youth who consumed AS snacks contributing 1-418 kJ (1-99 kcal) reported lower TDEI than those who consumed no snack. Among AS snack consumers, TDEI was higher in groups consuming the highest amount of energy from AS snacks. Fruits were among the most frequently consumed food categories. However, the largest energy contributors were mostly foods that may be energy-dense and nutrient-poor, such as cookies, sugar-sweetened beverages and sweets. Considering that the majority of children and adolescents consumed AS snacks, that these snacks provided about 13% of their TDEI, and that the majority of the most frequently consumed snacks were generally energy-dense, nutrient-poor foods, the AS time period presents an opportunity to promote healthy eating in order to improve diet quality and potentially influence TDEI among Canadian children and adolescents.
Being aware of academic dishonesty in the Medical School made it. 86.3% likely that a student would participate. Having ... Key words: Academic Dishonesty, Medical Training,. Medical Students. Ann Afr Surg. 2017;14(1): 19-21. .... on Plagiarism and Cheating, in Perspectives on Plagiarism and Intellectual Property in the.
Full Text Available Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients
Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad
Johnston, Rory; Crooks, Valorie A; Adams, Krystyna; Snyder, Jeremy; Kingsbury, Paul
The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public
Professionalism is a critically important competency that must be evaluated in medical trainees but is a complex construct that is hard to assess. A systematic review was undertaken to give insight into the current best practices for assessment of professionalism in medical trainees and to identify new research priorities in the field. A search was conducted on PubMed for behavioral assessments of medical students and residents among the United States and Canadian allopathic schools in the last 15 years. An initial search yielded 594 results, 28 of which met our inclusion criteria. Our analysis indicated that there are robust generic definitions of the major attributes of medical professionalism. The most commonly used assessment tools are survey instruments that use Likert scales tied to attributes of professionalism. While significant progress has been made in this field in recent years, several opportunities for system-wide improvement were identified that require further research. These include a paucity of information about assessment reliability, the need for rater training, a need to better define competency in professionalism according to learner level (preclinical, clerkship, resident etc.) and ways to remediate lapses in professionalism. Student acceptance of assessment of professionalism may be increased if assessment tools are shifted to better incorporate feedback. Tackling the impact of the hidden curriculum in which students may observe lapses in professionalism by faculty and other health care providers is another priority for further study. PMID:28652951
Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy
Are Canadians who study abroad (CSAs) more likely to stay in Canada than other international medical graduates (IMGs)? We looked at retention patterns of CSAs and immigrant IMGs who completed post-graduate medical education (PGME) training in Canada to describe the proportion and predictors of those working in Canada and in rural communities in Canada in 2015. We linked the National IMG Database to Scott's Medical Database to track the work locations of CSAs and immigrant IMGs in 2015. Of the 1,214 IMGs who entered PGME training in Canada between 2005 and 2011, most were working in Canada in 2015 (88.0%). Relatively few IMGs worked in rural communities (9.1%). There were no differences in work location patterns of CSAs and immigrant IMGs. Contrary to what CSA advocates suggest, CSAs have the same retention patterns as immigrant IMGs. PGME admission policies should treat all IMGs in the same manner, regardless of their citizenship or residency before medical school. Copyright © 2017 Longwoods Publishing.
Istl, Alexandra C; McAlister, Vivian C
The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.
Drefs, Michelle A.; Schroeder, Meadow; Hiebert, Bryan; Panayotidis, E. Lisa; Winters, Katherine; Kerr, Jamie
This article presents a brief historical review and survey of the current landscape of online graduate psychology programs within the Canadian context. Specific focus is given to outlining the establishment and evolution of the first Canadian online professional specialization program in school psychology. The article argues that given the virtual…
Scott, Ian M; Matejcek, Adela N; Gowans, Margot C; Wright, Bruce J; Brenneis, Fraser R
Interest in both general surgery and surgical subspecialties has been declining among Canadian medical students. Studies have shown that a student's desire to practise surgery is largely determined before entry into medical school. As part of a larger study of students' career preferences throughout medical school, we sought to identify the level of interest in surgical careers and the factors that influence a student's interest in pursuing a surgical career. We surveyed students from 18 different classes at Canadian medical schools at the commencement of their studies between 2001 and 2004. We asked the students to list their top career choices and the degree to which a series of variables influenced their choices. We also collected demographic data. We performed a factor analysis on the variables. Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 21.0% of respondents named a surgical specialty as their first choice of career. We found that male students were more likely to express interest in a surgical specialty than female students, who were more likely to express interest in either family medicine or a medical specialty. Compared with students interested in a career in family medicine, those interested in a surgical or medical specialty were younger, more likely to be single and more likely to be influenced by prestige when making their career choices. Students interested in a career in surgery were less influenced by medical lifestyle and a varied scope of practice, less likely to demonstrate a social orientation and more likely to be hospital-oriented than students interested in either family medicine or a medical specialty. Male students interested in a career in surgery were more hospital-oriented and less likely to demonstrate a social orientation than female students interested in surgical careers. We identified 5 factors and a number of demographic variables associated with a student's interest in a surgical career.
Full Text Available Gordon D Ko,1,2 Sara L Bober,1 Sean Mindra,3 Jason M Moreau1 1Apollo Applied Research Inc., 2Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, 3University of Ottawa Medical School, Ottawa, ON, Canada Abstract: Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges. This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts. Keywords: randomized controlled trials
Describes a Chinese Canadian immigrant family that is encountering difficulties with schooling, demonstrating the complex interrelationship between home literacy, culture, and politics of schooling. Findings suggest that cultural mismatch theory alone cannot explain minority school failure. Rather, multilevel interactions, including cultural…
and that funding is only spent on that will deliver more or better medical education. So staffing and other resources will be kept to the minimum required to deliver a high‑quality service. Secondly as in other walks of life, the profit motive should be a driver of innovation, and this should also be the case in medical education.
Hadjistavropoulos, Thomas; Malloy, David C; Douaud, Patrick; Smythe, William E
The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.
O'Neill, Lotte Dyhrberg; Hartvigsen, Jan; Wallstedt, Birgitta
INTRODUCTION Very few studies have reported on the effect of admission tests on medical school dropout.1 Recently Urlings-Strop et al. found the relative risk of dropout to be 2.6 times lower for ‘selected students’ than for ‘lottery admitted controls’.2 The main aim of our study was to evaluate...... the predictive validity of admission testing versus grade-based admission on dropout. METHOD This prospective cohort study followed 6 cohorts of medical students admitted to the medical school at University of Southern Denmark (USD) in 2002-2007 (N=1544). Half the students were admitted based on highest prior....... The outcome of interest was students’ dropout status 2 years after admission. Multivariate logistic regression analysis was used to model dropout. RESULTS Quota 2 (admission tested) students had a lower relative risk of dropping out of medical school within 2 years of admission compared to quota 1 students...
Full Text Available Abstract Background In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS. The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making. Methods Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test. Results In total, 339 of 819 (41.4% eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more. Conclusions Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors
Evren, Sevan; Chander, Pranay; Kim, Julia; Bi, Andrew; Fiddler, Dennis; Wayent, Emily; Teitelbaum, Howard S
The growth of osteopathic medicine in the United States has led to a vibrant expansion of the profession internationally. Canadian students represent the majority of international applicants and matriculants to US colleges of osteopathic medicine (COMs); however, to our knowledge, no studies have explored this population. To gain a better understanding of Canadian students attending US colleges of osteopathic medicine by examining their residency training preference, visa preference, intent to practice in the United States or Canada, receptiveness to incorporating osteopathic manipulative medicine into practice, specialty preference, estimated debt incurred, and effect of debt on specialty choice. A 10-question electronic survey was sent to Canadian osteopathic medical students in the 17 COMs and branch campuses that accept international applicants. The initial survey pool consisted of frst-, second-, third-, and fourth-year medical students (classes of 2014-2017) compiled from a database managed by the Canadian Osteopathic Medical Student Association. Of the 102 students contacted, 66 (65%) completed the survey. Respondents had a strong desire to practice in Canada (44 [67%]) but were considering an Accreditation Council on Graduate Medical Education (ACGME) or dually accredited residency program in the United States (46 [70%] and 15 [23%], respectively) that would sponsor an H1B visa. Respondents were receptive to incorporating osteopathic manipulative medicine into practice (44 [67%]). Most respondents chose non-primary care specialties (40 [61%]) and incurred a debt of more than $200,000 (44 of 65 [68%]); however, debt had a limited infuence on respondents' choice of specialty (χ23=1.911; P=.591). Most respondents planned to complete ACGME training, to return to Canada to practice medicine, and to practice in a non-primary care specialty. As a growing population that will play a large role in the expansion and reception of the profession internationally
Eskander, Antoine; Shandling, Maureen; Hanson, Mark D
In light of the structural and content changes to the Medical College Admission Test (MCAT) to be implemented in 2015 and the recent diversity- and social-accountability-based recommendations of the Future of Medical Education in Canada (FMEC) project, the authors review and reexamine the use of the MCAT exam in Canadian medical school admissions decisions.This Perspective article uses a point-counterpoint format to discuss three main advantages and disadvantages of using the MCAT exam in the medical school admissions process, from a Canadian perspective. The authors examine three questions regarding the FMEC recommendations and the revised MCAT exam: (1) Is the MCAT exam equal and useful in Canadian admissions? (2) Does the MCAT exam affect matriculant diversity? and (3) Is the MCAT exam a strong predictor of future performance? They present the most recent arguments and evidence for and against use of the MCAT exam, with the purpose of summarizing these different perspectives for readers.
Conclusions: Medical students are neither more resilient nor better equipped with coping skills than peers in the population. Greater emphasis on self-care among medical trainees is recommended. Emphasizing the importance of self-care during medical training, whether by formal incorporation into the curriculum or informal mentorship, deserves further study.
Liboro, Renato M.; Travers, Robb; St. John, Alex
In 2012, Canadian media coverage on Bill 13--an Ontario legislative proposal to require all publicly funded schools to support Gay-Straight Alliances as a means of addressing issues concerning bullied lesbian, gay, bisexual, and transgender (LGBT) students--instigated a divisive exchange among representatives of the Ontario Catholic school sector.…
This study investigates children's multimodal perspectives on their school experiences in two diverse, international contexts. The research shares data from 45 Canadian and Tanzanian children, and focused on the children's use of multimodal methods to share what mattered to them at school. The children's significant interest in their outdoor…
Canadian data from the 1998 Cross-National Survey on Health Behaviors in School-Aged Children were analyzed to examine the effects of school experiences on personal health (physical health, mental health, self-esteem, helplessness, and body image) and interpersonal relationships (number of close friends and making friends) among adolescents.…
The practice of veiling has made Muslim women subject to dual oppressions--racism and Islamophobia--in society at large and patriarchal oppression and sexism from within their communities. Based on a narrative analysis of the politics of veiling in schools and society, the voices of young Muslim women attending a Canadian Islamic school speak to…
Dyrbye, Liselotte N; Thomas, Matthew R; Shanafelt, Tait D
To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.
Blouin, Danielle; Tekian, Ara; Kamin, Carol; Harris, Ilene B
Increased emphasis is being placed worldwide on accreditation of undergraduate medical education programmes, and costs of participation in accreditation continue to rise. The primary purposes of accreditation are to ensure the quality of medical education and to promote quality improvement. Student performance data as indicators of the impact of accreditation have important limitations. The purpose of this study was to evaluate the impact of accreditation using an innovative marker: the processes implemented at medical schools as a result of accreditation. This conceptual model suggests that accreditation drives medical schools to implement and strengthen processes that support quality in medical education. In this qualitative study, conducted in 2015-2016, interviews and focus group discussions with deans, undergraduate medical education deans and faculty leaders at 13 of the 17 Canadian medical schools were used to elicit perspectives about processes influenced by accreditation; the method of constant comparative analysis associated with grounded theory was used to generate themes of processes. Perceived negative consequences of accreditation on medical education programmes were also explored. Nine themes representing processes reported as resulting from accreditation were identified. These processes related to: (i) governance, (ii) data collection and analysis, (iii) monitoring, (iv) documentation, (v) creation and revision of policies and procedures, (vi) continuous quality improvement, (vii) faculty members' engagement, (viii) academic accountability and (ix) curriculum reforms. Themes representing negative consequences of accreditation included (i) costs, (ii) staff and faculty members' morale and feelings, (iii) school reputation and (iv) standards. The identified processes, given their nature, appear likely to be associated with improvement of quality in medical education. These results help justify the costs associated with accreditation. This study
Full Text Available This paper considers the influence of academic restructuring associated with neo-liberal postsecondary policies on the culture of law schools and legal scholarship in Canada. It offers empirical data from a case study of the Faculty of Law at the University of British Columbia. This paper examines the impact of the changing Canadian political economy on the scholarship and culture at the law school and explores the implications for professional autonomy and academic freedom. The findings suggest that, at the time of data collection (2002-2004, the changing political economy had not (yet affected the law school at the University of British Columbia in the same manner as other jurisdictions and disciplines described in the literature. The data shows that law professors who participated in the study experienced increasing pressures associated with corporatization, commodification and marketization in the larger university, however they consistently described high levels of academic freedom and professional autonomy over their work and scholarship. While there is some evidence of the transformation of academic culture associated with economic restructuring there is also evidence that law professors at this school have maintained control over the direction of their intellectual scholarship. Cet article se penche sur l’influence de la restructuration académique associée aux politiques postsecondaires néo-libérales sur la culture au sein des écoles de droit et sur les études juridiques au Canada. Il présente des données empiriques à partir d’une étude de cas de la Faculté de droit à l’Université de Colombie- Britannique. L’article examine l’impact de l’économie politique canadienne changeante sur l’érudition et la culture à l’école de droit et explore ce que cela implique pour l’autonomie professionnelle et la liberté de l’enseignement. Les résultats suggèrent qu’au moment de la collecte des données (2002
The introverted medical school - time to rethink medical education. A. B. Zwi, M. Zwarenstein, S. Tollman, D. Sanders. Curricular reform in the education of medical students is highlighted within the context of changing patterns of provision of health care. A number of industrialised countries' medical schools have accepted ...
Full Text Available Findings that detail the social organization of day-to-day practices associated with the Canadian government policy of mandatory HIV testing of permanent residence applicants to Canada are reported. Institutional ethnography was used to investigate interactions between HIV-positive applicants and immigration physicians during the immigration medical examination. A composite narrative recounts details of a woman applicant's discovery through immigration testing that she was living with HIV. Mandatory HIV testing gives rise to serious difficulties for applicants to Canada living with HIV. Applicant, physician and federal state employee work practices associated with mandatory HIV testing are analysed. These practices contribute to the ideological work of the Canadian state, where interest bounds up in the examination serve the state and not the applicant. Findings should be useful for Canadian immigration policy makers who wish to develop constructive and functional strategies to address issues that matter in people's lives
Reitmanova, Sylvia; Gustafson, Diana L
Drawing on critical discourse analysis of Canadian press coverage of the immigrant tuberculosis problem, we expose the complex relationship between press-constructed discourses of immigrant health and current tuberculosis control policies in Canada. The focus of these policies is on screening and surveillance of immigrants rather than addressing social inequalities underlying the problem of immigrant tuberculosis. The biomedical focus and racializing character of current policies were reinforced in the Canadian press by depicting tuberculosis as a biomedical (rather than a social) disease imported to Canada by immigrants. The status of the immigrant body as health threat was produced by and through preexisting and mutually constitutive racializing and medicalizing discourses materialized in press coverage and tuberculosis control policies. Deracialization and demedicalization of health information disseminated in the press are potentially important factors to be considered when revising health policies that would address the socioeconomic and political factors that determine the health status of Canadian immigrants.
Amram, Ofer; Abernethy, Rebecca; Brauer, Michael; Davies, Hugh; Allen, Ryan W
Epidemiologic studies have linked exposure to traffic-generated air and noise pollution with a wide range of adverse health effects in children. Children spend a large portion of time at school, and both air pollution and noise are elevated in close proximity to roads, so school location may be an important determinant of exposure. No studies have yet examined the proximity of schools to major roads in Canadian cities. Data on public elementary schools in Canada's 10 most populous cities were obtained from online databases. School addresses were geocoded and proximity to the nearest major road, defined using a standardized national road classification scheme, was calculated for each school. Based on measurements of nitrogen oxide concentrations, ultrafine particle counts, and noise levels in three Canadian cities we conservatively defined distances school proximity to major roads, urban density, and indicators of socioeconomic status. Addresses were obtained for 1,556 public elementary schools, 95% of which were successfully geocoded. Across all 10 cities, 16.3% of schools were located within 75 m of a major road, with wide variability between cities. Schools in neighborhoods with higher median income were less likely to be near major roads (OR per $20,000 increase: 0.81; 95% CI: 0.65, 1.00), while schools in densely populated neighborhoods were more frequently close to major roads (OR per 1,000 dwellings/km²: 1.07; 95% CI: 1.00, 1.16). Over 22% of schools in the lowest neighborhood income quintile were close to major roads, compared to 13% of schools in the highest income quintile. A substantial fraction of students at public elementary schools in Canada, particularly students attending schools in low income neighborhoods, may be exposed to elevated levels of air pollution and noise while at school. As a result, the locations of schools may negatively impact the healthy development and academic performance of a large number of Canadian children.
Smith, B H
Despite many relevant benefits, the study of literature has been rejected by medical schools this century. However, the role of literature and the arts is coming to the fore again in many branches of medicine, including education, leading to a broader approach to medical practice than the purely scientific approach. This is likely to enrich the profession and individuals therein. As well giving as a wider general education, areas of medical training and practice that a literary education will benefit directly include critical reading and appraisal, communication skills, history taking, 'surrogate experience', understanding the role of the physician, ethics, and self-expression. Many of these are central to our understanding of good medical practice. PMID:9747554
This article reviews Canadian administrative law regarding homophobic bullying and school board decision making. Depending on the provincial legislation, school boards either have a mandatory or a discretionary duty to provide queer students with a safe learning environment. However, Canadian case law has arguably limited that discretion. Recent…
The state of ESL in Canada has been a looming, mishandled entity. Canadians espouse the benefits of diversity and have politically correct policies concerning racism and equity for the linguistically disadvantaged, but in reality something has gone terribly wrong. This article outlines specific myths and delusions that plague educational…
Full Text Available Abstract Background Epidemiologic studies have linked exposure to traffic-generated air and noise pollution with a wide range of adverse health effects in children. Children spend a large portion of time at school, and both air pollution and noise are elevated in close proximity to roads, so school location may be an important determinant of exposure. No studies have yet examined the proximity of schools to major roads in Canadian cities. Methods Data on public elementary schools in Canada's 10 most populous cities were obtained from online databases. School addresses were geocoded and proximity to the nearest major road, defined using a standardized national road classification scheme, was calculated for each school. Based on measurements of nitrogen oxide concentrations, ultrafine particle counts, and noise levels in three Canadian cities we conservatively defined distances Results Addresses were obtained for 1,556 public elementary schools, 95% of which were successfully geocoded. Across all 10 cities, 16.3% of schools were located within 75 m of a major road, with wide variability between cities. Schools in neighborhoods with higher median income were less likely to be near major roads (OR per $20,000 increase: 0.81; 95% CI: 0.65, 1.00, while schools in densely populated neighborhoods were more frequently close to major roads (OR per 1,000 dwellings/km2: 1.07; 95% CI: 1.00, 1.16. Over 22% of schools in the lowest neighborhood income quintile were close to major roads, compared to 13% of schools in the highest income quintile. Conclusions A substantial fraction of students at public elementary schools in Canada, particularly students attending schools in low income neighborhoods, may be exposed to elevated levels of air pollution and noise while at school. As a result, the locations of schools may negatively impact the healthy development and academic performance of a large number of Canadian children.
Taras, Howard; Haste, Nina M.; Berry, Angela T.; Tran, Jennifer; Singh, Renu F.
Background: This project quantified and categorized medications left unclaimed by students at the end of the school year. It determined the feasibility of a model medication disposal program and assessed school nurses' perceptions of environmentally responsible medication disposal. Methods: At a large urban school district all unclaimed…
The aim of this study was to explore the curricula of medical schools in Europe in order to establish a formal representation of physics in the study of medicine. Information on the curricular representation of physics was gathered from the Internet presentations of medical schools. It was intended to explore at least 25% of medical schools in…
Monkman, Helen; Kushniruk, Andre W
Prescription medication use is prevalent. When a new prescription medication is dispensed, Consumer Medication Information (CMI) is provided to communicate various important aspects of the medication (e.g., benefits, administration instructions, potential side effects). However, CMI is not regulated and differs from pharmacy to pharmacy. This study explores the similarities and differences between the CMI from three pharmacies (two paper print outs and one online source) for a single medication. The three CMI were assessed in terms of readability and utility. This evaluation revealed drastic differences in the length of the CMI (Range = 453 to 2 337 words). The online CMI was longer, described more topics and provided more detail than the print versions. Although online CMI has the advantage of interactivity to expedite navigation to specific topics of interest (e.g., heading links) and searching for key words, this CMI was not layered but rather presented as one long continuous page. Consumers with lower eHealth literacy skills may be deterred by the length of the document. As CMI makes the shift to online presentation an improved understanding of optimal information organization and media presentation will be needed.
Palmer, Heather M.; Dobson, Keith S.
Investigated predictive value of three aspects of memory potentially related to success or failure in self-medication program. Results showed that combination of memory measures successfully discriminated between those subjects who advanced in program and those who did not. Results provide information that will aid in improving selection process…
Nagji, Alim; Leslie, Karen; Wong, Eric; Myhre, Doug; Young, Meredith; Chan, Ming-Ka
Background Current theory in medical education emphasizes engaging learners as educators while tailoring teaching to their learning needs. However, little is known about learners’ perceptions of their proposed roles as teachers and educators. Methods Canadian medical students were invited to complete an English language online questionnaire structured to include: teaching experience, participation and/or awareness of teacher development at their school and awareness and/or interest in further training in medical education. The survey was developed by the Canadian Association for Medical Education (CAME) Membership Subcommittee, and distributed via the Canadian Federation of Medical Students (CFMS) email list and the CAME twitter account in March 2014. Results Of the 169 undergraduate medical student respondents, 36% (n=61) reported a lack of prior teaching experience and 45% (n=73) were unsure if their school provided teaching instruction. Overall, 91% (n=150) indicated that they planned to incorporate teaching or medical education into their future careers. Conclusion While the majority of medical student respondents are expecting or planning to teach, most report not having access to adequate training through medical school. Further effort is necessary to support medical students as teachers to prepare them for increased teaching responsibilities as residents and to expose them to potential careers in medical education. PMID:29098045
The present study, which stems from a critical approach to common perceptions about ESL learners in the TESOL community, examines the perspectives of Japanese-speaking staff in Canadian ESL institutions on their students' school performance. From September 2003 to April 2004, qualitative data were gathered from 11 staff members through mail…
This paper offers an examination of gay-straight alliance (GSA) members' engagement with sex education, sexual health, and prejudice and discrimination in Canadian public high schools. It explores how five students' (four straight and one gay-identifying) participation in GSAs served as a springboard for learning about and challenging stereotypes;…
Clarke, Paul T.
In most Canadian jurisdictions, high school athletics are still governed by outdated and sexist views about participation. The author argues that the current approach is discriminatory and violates human rights laws. In addition, a careful analysis of the jurisprudence reveals a host of specious arguments that keeps athletically talented female…
This article reports on a survey with 170 school-age children growing up with two or more languages in the Canadian province of Ontario where English is the majority language, French is a minority language, and numerous other minority languages may be spoken by immigrant or Indigenous residents. Within this context the study focuses on minority…
This publication offers some insight into the problem of violence in Canadian schools and provides examples of ways to reduce it. The forms of violent activities examined include youth/youth-gang violence, violence against teachers, bullying, sexual harassment, and sexual assault. Each chapter presents research findings and examples of programs…
Findings that detail the social organization of day-to-day practices associated with the Canadian government policy of mandatory HIV testing of permanent residence applicants to Canada are reported. Institutional ethnography was used to investigate interactions between HIV-positive applicants and immigration physicians during the immigration medical examination. A composite narrative recounts details of a woman applicant's discovery through immigration testing that she was living with HIV. Ma...
Fitzpatrick, C; Datta, G D; Henderson, M; Gray-Donald, K; Kestens, Y; Barnett, T A
Targeting obesogenic features of children's environment that are amenable to change represents a promising strategy for health promotion. The school food environment, defined as the services and policies regarding nutrition and the availability of food in the school and surrounding neighborhood, is particularly important given that students travel through the school neighborhood almost daily and that they consume a substantial proportion of their calories at school. As part of the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) cohort study, we assessed features of school indoor dietary environment and the surrounding school neighborhoods, when children were aged 8-10 years (2005-2008). School principals reported on food practices and policies within the schools. The density of convenience stores and fast-food outlets surrounding the school was computed using a Geographical Information System. Indicators of school neighborhood deprivation were derived from census data. Adiposity outcomes were measured in a clinical setting 2 years later, when participants were aged 10-12 years (2008-2011). We conducted cluster analyses to identify school food environment types. Associations between school types and adiposity were estimated in linear regression models. Cluster analysis identified three school types with distinct food environments. Schools were characterized as: overall healthful (45%); a healthful food environment in the surrounding neighborhood, but an unhealthful indoor food environment (22%); or overall unhealthful (33%). Less healthful schools were located in more deprived neighborhoods and were associated with greater child adiposity. Despite regulatory efforts to improve school food environments, there is substantial inequity in dietary environments across schools. Ensuring healthful indoor and outdoor food environments across schools should be included in comprehensive efforts to reduce obesity-related health disparities.
Keegan, David A; Scott, Ian; Sylvester, Michael; Tan, Amy; Horrey, Kathleen; Weston, W Wayne
In 2006, leaders of undergraduate family medicine education programs faced a series of increasing curriculum mandates in the context of limited time and financial resources. Additionally, it became apparent that a hidden curriculum against family medicine as a career choice was active in medical schools. The Shared Canadian Curriculum in Family Medicine was developed by the Canadian Undergraduate Family Medicine Education Directors and supported by the College of Family Physicians of Canada as a national collaborative project to support medical student training in family medicine clerkship. Its key objective is to enable education leaders to meet their educational mandates, while at the same time countering the hidden curriculum and providing a route to scholarship. The Shared Canadian Curriculum in Family Medicine is an open-access, shared, national curriculum ( www.sharcfm.ca ). It contains 23 core clinical topics (determined through a modified Delphi process) with demonstrable objectives for each. It also includes low- and medium-fidelity virtual patient cases, point-of-care learning resources (clinical cards), and assessment tools, all aligned with the core topics. French translation of the resources is ongoing. The core topics, objectives, and educational resources have been adopted by medical schools across Canada, according to their needs. The lessons learned from mounting this multi-institutional collaborative project will help others develop their own collaborative curricula. Copyright© the College of Family Physicians of Canada.
Key words:Schools, First Aid Boxes, Medical Emergencies. ABSTRACT. Introduction: The school system aims at ... the school system, it is not completely devoid of health challenges to the enrolee if adequate measures .... example, the Health and Safety (First-Aid) Regulations for schools since 1981 set out that schools must ...
In light of a growing obesity crisis among children and concern about junk food in schools, this article investigates the attempt by food and beverage companies to gain entry into Canadian schools. Focusing in particular on the introduction of fast-food franchises in cafeterias and on school boards' secret exclusivity deals with soft drink manufacturers in the 1990s, it examines how and why this process occurred, public reactions to it, and government responses. Placing this phenomenon within a larger pattern of commercialization in North American schools, it argues that long-lasting reforms require government intervention and enforcement.
Roper, Fred W.
This paper reviews the current situation in library school education for medical librarianship in the United States and Canada based on information from a questionnaire sent to teachers of courses in medical librarianship in accredited library schools. Since 1939, when the first course devoted entirely to medical librarianship was offered at Columbia University, courses have been introduced into the curricula of at least forty-seven of the ALA-accredited library schools. In 1978 there were seventy courses available through forty-seven library schools. Possibilities for specialization in medical librarianship are examined. Course content is reviewed. Implications of the MLA certification examination for library school courses are explored. PMID:385086
Dunham, Lisette; Dekhtyar, Michael; Gruener, Gregory; CichoskiKelly, Eileen; Deitz, Jennifer; Elliott, Donna; Stuber, Margaret L; Skochelak, Susan E
Phenomenon: The learning environment is the physical, social, and psychological context in which a student learns. A supportive learning environment contributes to student well-being and enhances student empathy, professionalism, and academic success, whereas an unsupportive learning environment may lead to burnout, exhaustion, and cynicism. Student perceptions of the medical school learning environment may change over time and be associated with students' year of training and may differ significantly depending on the student's gender or race/ethnicity. Understanding the changes in perceptions of the learning environment related to student characteristics and year of training could inform interventions that facilitate positive experiences in undergraduate medical education. The Medical School Learning Environment Survey (MSLES) was administered to 4,262 students who matriculated at one of 23 U.S. and Canadian medical schools in 2010 and 2011. Students completed the survey at the end of each year of medical school as part of a battery of surveys in the Learning Environment Study. A mixed-effects longitudinal model, t tests, Cohen's d effect size, and analysis of variance assessed the relationship between MSLES score, year of training, and demographic variables. After controlling for gender, race/ethnicity, and school, students reported worsening perceptions toward the medical school learning environment, with the worst perceptions in the 3rd year of medical school as students begin their clinical experiences, and some recovery in the 4th year after Match Day. The drop in MSLES scores associated with the transition to the clinical learning environment (-0.26 point drop in addition to yearly change, effect size = 0.52, p medical school learning environment in the 4th year. Insights: Perceptions of the medical school learning environment worsen as students continue through medical school, with a stronger decline in perception scores as students' transition to the
Skochelak, Susan E; Stack, Steven J
Despite wide consensus on needed changes in medical education, experts agree that the gap continues to widen between how physicians are trained and the future needs of our health care system. A new model for medical education is needed to create the medical school of the future. The American Medical Association (AMA) is working to support innovative models through partnerships with medical schools, educators, professional organizations, and accreditors. In 2013, the AMA designed an initiative to support rapid innovation among medical schools and disseminate the ideas being tested to additional medical schools. Awards of $1 million were made to 11 medical schools to redesign curricula for flexible, individualized learning pathways, measure achievement of competencies, develop new assessment tools to test readiness for residency, and implement new models for clinical experiences within health care systems. The medical schools have partnered with the AMA to create the AMA Accelerating Change in Medical Education Consortium, working together to share prototypes and participate in a national evaluation plan. Most of the schools have embarked on major curriculum revisions, replacing as much as 25% of the curriculum with new content in health care delivery and health system science in all four years of training. Schools are developing new certification in quality and patient safety and population management. In 2015, the AMA invited 21 additional schools to join the 11 founding schools in testing and disseminating innovation through the consortium and beyond.
Full Text Available The Medical Council of Canada has set new eligibility criteria for examinations that are required in order to apply to postgraduate training. This is to facilitate the establishment of the National Assessment Collaboration Objective Structured Clinical Examination. These changes result in increased hardships on Canadians studying abroad who are wishing to apply for postgraduate training in Canada. While these exams are crucial to protect medical standards and the quality of healthcare in Canada, slight modifications of the examination timelines may alleviate some of the burdens caused by these exams.
Hamilton, Douglas R.; Thirsk, Robert; Gray, Gary; Lange, marv; Comtois, Jean Marc
In 2008, Dr. Thirsk was assigned to the crew of Expedition 20/21. This Expedition represented a milestone for the Canadian Space Program since it was the first time that a Canadian would take part in a long-duration mission. Robert Thirsk had the privilege of expanding the boundaries of space exploration by living and working on board the International Space Station for six months. The launch took place on May 27, 2009 aboard a Soyuz rocket from the Cosmodrome in Baikonur, Kazakhstan. This abstract was written before Dr. Thirsk returned to Kazakhstan. Objective: To gather all medically relevant data needed to support the first Canadian long-duration mission in space, and process it to derive lessons learned for presentation and for public disclosure. Methods: Sources of data used for analysis for Expedition 20 on International Space Station included flight selection data, maintenance annual physicals, Flight Medicine Clinic visits, parabolic flight experiments, preflight exams and baseline data collections, daily in-flight exercise countermeasure and science payloads, weekly periodic fitness, nutrition, radiation and payload assessments, postflight medical exams, rehabilitation, and science activities.
Wong, Anne K
Globalisation initiatives in medical education are premised on a universal model of medical education. This study was conducted to challenge this premise by empirically examining the impact of culture on the practice of medical education in anaesthesia residency training programmes in Thailand and Canada. Using a mixed-methods comparative case study research approach, one Thai and one Canadian anaesthesia residency training programme were examined with respect to curriculum, educational practices and teacher beliefs. Data sources included observations of academic and clinical teaching, programme document analysis, surveys and faculty interviews. Recruitment resulted in a 76% survey response rate and 13 interview participants at the Thai site and a 61% survey response rate and 16 interview participants at the Canadian site. Multiple linear regression analysis was used to compare survey responses between the two programmes. The qualitative analysis consisted of primary coding, clustering into pattern codes, and identifying themes and sub-themes. The integration of quantitative and qualitative data for each case was followed by a cross-case analysis. The two programmes were similarly organised and had similar curricular content. However, important differences emerged in curricular emphasis, educational practices, and teacher beliefs and values. Thai faculty staff emphasised knowledge and scholarship, described the faculty-resident relationship as 'familial' and focused on 'teaching methods'. Canadian faculty members emphasised clinical abilities, described the faculty-resident relationship as 'collegial' and focused on 'learning environments'. These findings were related to broader cultural differences that influenced how the curriculum was interpreted and enacted at each site. This study shows that although the scientific and knowledge base of medical education is universal, its enactment may be influenced by culture and context. Globalisation initiatives in medical
Gariépy, Geneviève; Janssen, Ian; Sentenac, Mariane; Elgar, Frank J
Insufficient sleep is a serious problem in adolescents and school start time is thought to be a key contributor. This study provided the first comprehensive assessment of school start times across Canada and examined whether school start times were associated with sleep duration and tiredness among adolescents. We collected information on school start times from 362 schools that participated in the 2013/2014 Health Behaviour in School-aged Children study. We calculated sleep duration from weekday bedtime and wake time reported by 29 635 students (aged 10-18 years). We classified weekday sleep as sufficient if it met national recommendations, and used data on self-reported tiredness at school in the morning. Random-effects regression models estimated the association of school start time with sleep duration, sleep sufficiency and tiredness. On average, schools started at 08:43 hours. Students slept an average of 8:36 h on weekdays and 69% met sleep duration recommendations, but 60% reported feeling tired in the morning. Every 10-min delay in school start time corresponded with 3.2 [95% confidence interval (CI): 2.0, 4.5] additional minutes of sleep, a 1.6% (95% CI: 0.5, 2.8) greater probability of sufficient sleep and a 2.1% (95% CI: 1.0, 3.2) smaller probability of feeling tired at school in the morning. Students from schools that started later slept longer, were more likely to meet sleep recommendations and were less likely to report feeling tired in the morning. The study adds weight to the mounting evidence that delaying school start time benefits adolescent sleep. © 2016 European Sleep Research Society.
Kind, Terry; Genrich, Gillian; Sodhi, Avneet; Chretien, Katherine C
Today's medical students are learning in a social media era in which patient confidentiality is at risk yet schools' social media policies have not been elucidated. The purpose of this study is to describe the presence of medical schools on top social media sites and to identify whether student policies for these schools explicitly address social media use. Websites of all 132 accredited US medical schools were independently assessed by two investigators for their presence (as of March 31, 2010) on the most common social networking and microblogging sites (Facebook and Twitter) and their publicly available policies addressing online social networking. Key features from these policies are described. 100% (n=132) of US medical schools had websites and 95.45% (126/132) had any Facebook presence. 25.76% (34/132) had official medical school pages, 71.21% (94/132) had student groups, and 54.55% (72/132) had alumni groups on Facebook. 10.6% of medical schools (14/132) had Twitter accounts. 128 of 132 medical schools (96.97%) had student guidelines or policies publicly available online. 13 of these 128 schools (10.16%) had guidelines/policies explicitly mentioning social media. 38.46% (5/13) of these guidelines included statements that defined what is forbidden, inappropriate, or impermissible under any circumstances, or mentioned strongly discouraged online behaviors. 53.85% (7/13) encouraged thoughtful and responsible social media use. Medical schools and their students are using social media. Almost all US medical schools have a Facebook presence, yet most do not have policies addressing student online social networking behavior. While social media use rises, policy informing appropriate conduct in medical schools lags behind. Established policies at some medical schools can provide a blueprint for others to adopt and adapt.
McNamara, Lauren; Colley, Paige; Franklin, Nicole
Children need opportunities to establish positive social connections at school, yet many school playgrounds are challenged by social conflict that can undermine these connections. When children's social needs go unmet, the resultant feelings of loneliness, isolation and self-doubt can cumulatively lead to mental and physical illness. Because recess is typically the only time during the school day that children are free to socialize and play, we propose a more thoughtful way of thinking about it: from the lens of belongingness. Schools are, historically, designed for instruction. We argue, however, that we need to attend to children's social needs at school. We highlight current research from social neuroscience, belonging and social connectedness in order to delineate the pathways between daily school recess and developmental health trajectories. We then consolidate an array of research on play, social interaction and school change to suggest four areas that could benefit from consideration in research, practice and policy: (i) the culture of recess, (ii) the importance of healthy role models on the playground, (iii) the necessity of activities, options and variety during recess and (iv) the significance of space and spatial layout (indoor and outdoor). We bridge our discussion with the conception of health as described in the Ottawa Charter and emphasize the need to build alliances across sectors to assist schools in their efforts to support children's overall health needs. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Elharram, Malik; Dinh, Trish; Lalande, Annie; Ge, Susan; Gao, Sophie; Noël, Geoffroy
As health care delivery increasingly requires providers to cross international borders, medical students at McGill University, Canada, developed a multidirectional exchange program with Haiti and Rwanda. The program integrates surgery, pathology, anatomy, research methodology, and medical education. The aim of the present study was to explore the global health value of this international training program to improve medical education within the environment of developing countries, such as Haiti and Rwanda, while improving sociocultural learning of Canadian students. Students from the University of Kigali, Rwanda and Université Quisqueya, Haiti, participated in a 3-week program at McGill University. The students spanned from the first to sixth year of their respective medical training. The program consisted of anatomy dissections, surgical simulations, clinical pathology shadowing, and interactive sessions in research methodology and medical education. To evaluate the program, a survey was administered to students using a mixed methodology approach. Common benefits pointed out by the participants included personal and professional growth. The exchange improved career development, sense of responsibility toward one's own community, teaching skills, and sociocultural awareness. The participants all agreed that the anatomy dissections improved their knowledge of anatomy and would make them more comfortable teaching the material when the returned to their university. The clinical simulation activities and shadowing experiences allowed them to integrate the different disciplines. However, the students all felt the research component had too little time devoted to it and that the knowledge presented was beyond their educational level. The development of an integrated international program in surgery, pathology, anatomy, research methodology, and medical education provided medical students with an opportunity to learn about differences in health care and medical education
Masić, Izet; Novo, Ahmed; Kudumović, Mensura; Masić, Zlatan
Standardization of education process and almost every aspect of life in EU moved the authors of this paper to evaluate medical informatics education at medical schools in Bosnia and Herzegovina. A very complex political structure and existence of two entities, one district and ten cantons in the Federation of Bosnia and Herzegovina caused great differences in the curricula, teaching methods and quality of acquired knowledge among medical schools in the country. Also, on the example of the teaching process at the Medical School, University of Sarajevo, the authors propose a future united and integrated system in the area. Method of the study is descriptive, comparing education in medical informatics at five B&H medical schools. Over 500 students answered questionnaires designed at medical schools in Sarajevo and Tuzla. The questions tackled the contents of the subject of medical informatics, the possibility of acquiring knowledge from both practical and theoretic lessons, "good" and "bad" sides of the curricula as well as students' computer literacy. The subject of medical informatics is being taught in at least 3-4 different ways. Medical schools in Banja Luka and Foca/Srbinje are under a strong influence of the University of Belgrade, Serbia and Montenegro; the teaching staff in Mostar are from Croatia; the University of Tuzla has its own way; and Medical School in Sarajevo maintains high quality values and principles. Things and events that distinguish the Medical School, University of Sarajevo is the fact that it is the only medical school in Bosnia and Herzegovina which has a web site of of the Department of Medical Informatics, organized a number of events including a distance learning course, and has a highly competent teaching staff. Medical School in Sarajevo is the oldest medical school in Bosnia and Herzegovina established in 1944. As a required subject, medical informatics was introduced in the academic year 1992/1993, and it is the only medical school
Murray, Richard B; Larkins, Sarah; Russell, Heather; Ewen, Shaun; Prideaux, David
Medical education reform can make an important contribution to the future health care of populations. Social accountability in medical education was defined by the World Health Organization in 1995, and an international movement for change is gathering momentum. While change can be enabled with policy levers, such as funding tied to achieving equity outcomes and systems of accreditation, medical schools and students themselves can lead the transformation agenda. An international movement for change and coalitions of medical schools with an interest in socially accountable medical education provide a "community of practice" that can drive change from within.
Shemie, Sam D; Simpson, Christy; Blackmer, Jeff; MacDonald, Shavaun; Dhanani, Sonny; Torrance, Sylvia; Byrne, Paul
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services. In anticipation of actual, potential or perceived ethical challenges with the role, Canadian Blood Services in partnership with the Canadian Medical Association organized the development of an evidence-informed consensus process of donation experts and bioethicists to produce an ethics guide. This guide includes overarching principles and benefits of the DP role, and recommendations in regard to communication with families, role disclosure, consent discussions, interprofessional conflicts, conscientious objection, death determination, donation specific clinical practices in neurological determination of death and donation after circulatory death, end-of-life care, performance metrics, resources and remuneration. Although this report is intended to inform donation physician practices, it is recognized that the recommendations may have applicability to other professionals (eg, physicians in intensive care, emergency medicine, neurology, neurosurgery, pulmonology) who may also participate in the end-of-life care of potential donors in various clinical settings. It is hoped that this guidance will assist practitioners and their sponsoring organizations in preserving their duty of care, protecting the interests of dying patients, and fulfilling best practices for organ and tissue donation.
Chu, Jennifer L; Snider, Carolyn E
The use of advertising on Facebook for medical research is not widely utilized, and we sought to describe the effectiveness of this tool in medical research recruitment. A survey study was designed to evaluate the prevalence of post-traumatic stress disorder (PTSD) in Canadian youth who were affected by violence. Participants were recruited from an advertisement on Facebook that targeted Canadian users aged 15 to 24 years and linked them to an online survey. This secondary analysis is a descriptive study of the effectiveness of the Facebook campaign. Over the course of the study, the advertisement was displayed 17.5 million times resulting in 3,440 clicks on the link to the survey (.020%). The overall cost worked out to $15.35 per final subject, totaling $1351.17. Facebook advertising is a cost-effective method of recruiting youth from a wide population. There are many potential uses for social networking in medical research. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available The current investigation was an exploration of the first year of a multi-year project designed to provide every Grade 3 to Grade 11 student throughout an English school board in Quebec with a laptop computer. Data were collected from 403 elementary and 270 secondary students from the experimental school board and also from 330 students in the control school board. In addition, questionnaire data were collected from 60 elementary school teachers and 51 secondary school teachers. Finally, interviews were conducted with 72 students and 20 teachers. Potentially the most interesting finding was the difference in achievement scores between the experimental and control boards. Secondary students from the experimental board had higher scores on the CAT-3 reading test and indicated making six times more frequent use of computer technology in their English classes, suggesting a possible treatment effect. In contrast, math scores were higher at the control board where neither board indicated high levels of computer use. Nevertheless, these findings must be interpreted with some caution until the threats to validity of selection bias are more clearly overcome.
Conclusions: Barriers to engagement in teaching primarily focused on differences in job structure in the community, administrative barriers both at the hospital and through the medical school, and lack of knowledge on how to teach. As medical schools look to expand the capacity of distributed campuses, misperceptions should be addressed and opportunities to improve engagement should be further explored.
In The End of Education, Neil Postman (1995) proposes several new narratives to animate the debate about the purposes of schooling. Narratives are needed, he says, that attend to students' social and emotional development. They must be capable of guiding and supporting young peoples' experience of participation and ...
Tugault-Lafleur, C N; Black, J L; Barr, S I
There is limited research on the dietary behaviours of Canadian children at school, including where students obtain food from during school hours or whether lunch-time food source influences diet quality. Nationally representative cross-sectional data from 24-h dietary recalls were analysed from the 2004 Canadian Community Health Survey (n = 4589). Dietary outcomes included school hour and school day dietary intakes and School Healthy Eating Index (S-HEI) scores. Survey-weighted covariate-adjusted linear regression models examined differences in dietary outcomes across lunch-time food source groups. The majority of children (72.8%) reported bringing lunch from home, whereas fewer students obtained lunch from off-campus locations (11.6%), schools (9.6%) or skipped lunch (5.9%). Compared to off-campus lunches, home-packed lunches were significantly higher in fibre, vitamins A, D and C, thiamin, magnesium, iron, grains, vegetables and fruit, but lower in total calories, fat and calories from minimally nutritious foods. Average school hour diet quality required improvement for all age groups, although S-HEI scores did not differ significantly by lunch-time food source among 6-8-year-old children. However, for children age 9-17 years, bringing a home-packed lunch was associated with significantly higher S-HEI scores compared to students obtaining lunch from off-campus locations. After adjusting for age and sex, lunch-time food source was also significantly associated with whole day dietary quality. Although the nutritional quality of off-campus lunches was lower than home-packed lunches, the quality of foods was suboptimal, regardless of food source. Strategies are needed to enhance access to nutritious foods on campus and improve the nutritional quality of packed lunches, which supply the majority of lunch-time foods consumed by Canadian children. © 2017 The British Dietetic Association Ltd.
Gupta, Aakriti; Chong, Alvin H; Scarff, Catherine E; Huilgol, Shyamala C
Although skin disease and skin cancers cause significant morbidity and mortality in Australia, limited time is dedicated to dermatology teaching in most medical courses. The aim of this study was to define the current state of dermatology teaching in Australian medical schools with a view to developing a national core curriculum for dermatology. An electronic questionnaire was circulated to the dermatology teaching leads and relevant medical program coordinators of the 18 medical schools in Australia. Replies were received from 17 medical schools. Dermatology was included as part of the core curriculum in 15 schools. Time set aside for dermatology teaching varied, as reflected by the number of lectures delivered (0-21, mean 5, median 3) and minimum clinics attended (0-10, mean 1.2, median 0). Only four medical schools had a compulsory clinical attachment in dermatology. Furthermore, satisfying requirements in dermatology was mentioned in the university examination regulations in only six schools. Certain core learning outcomes were addressed in most schools, including the structure and function of the skin, common conditions such as atopic dermatitis and psoriasis and cutaneous malignancies. However, there were important omissions, ranging from common problems like dermatophyte infections and drug reactions to the recognition of dermatological emergencies. These results are a compelling impetus to improve current standards of dermatology teaching, learning and assessment. The introduction of a national core curriculum would provide guidelines for dermatology teaching in medical schools, enabling the more effective utilisation of available time for key learning outcomes. © 2016 The Australasian College of Dermatologists.
Libbrecht, Nele; Lievens, Filip; Carette, Bernd; Côté, Stéphane
Accumulating evidence suggests that effective communication and interpersonal sensitivity during interactions between doctors and patients impact therapeutic outcomes. There is an important need to identify predictors of these behaviors, because traditional tests used in medical admissions offer limited predictions of "bedside manners" in medical practice. This study examined whether emotional intelligence would predict the performance of 367 medical students in medical school courses on communication and interpersonal sensitivity. One of the dimensions of emotional intelligence, the ability to regulate emotions, predicted performance in courses on communication and interpersonal sensitivity over the next 3 years of medical school, over and above cognitive ability and conscientiousness. Emotional intelligence did not predict performance on courses on medical subject domains. The results suggest that medical schools may better predict who will communicate effectively and show interpersonal sensitivity if they include measures of emotional intelligence in their admission systems. PsycINFO Database Record (c) 2014 APA, all rights reserved.
ALBashtawy, Mohammed; Batiha, Abdul-Monim; Tawalbeh, Loai; Tubaishat, Ahmad; AlAzzam, Manar
Self-medication, usually with over-the-counter (OTC) medication, is reported as a community health problem that affects many people worldwide. Most self-medication practice usually begins with the onset of adolescence. A school-based cross-sectional study was conducted in Mafraq Governorate, Jordan, using a simple random sampling method to select…
Enarson, Mark C; Ali, Samina; Vandermeer, Ben; Wright, Robert B; Klassen, Terry P; Spiers, Judith A
The purpose of this survey was to study the beliefs, expectations, and satisfaction of Canadian parents regarding fever and the treatment of their febrile children. A survey was developed exploring caregiver beliefs and treatment strategies, as well as expectations and satisfaction with medical care. Some items were modeled after previous studies to allow comparison. Caregivers with febrile children were recruited from 2005 to 2007 at 3 urgent care centers and emergency departments in Edmonton, Canada: a pediatric emergency department (n = 376), an urban urgent care center (n = 227), and a suburban urgent care clinic (n = 173). High and rapidly rising temperature, as well as physical symptoms associated with fever, caused concern in most parents surveyed. Seventy-four percent of parents felt that the elevated temperature from fever was dangerous and 90.3% always try to treat it. Forty degrees Celsius was the most commonly sited threshold for danger. Identifying the cause (80.6%) and seriousness (87.4%) of fever were the most com-mon stressors identified. Caregivers expected to receive information about the child's illness and appropriate treatment. The parents most often wanted information about febrile seizures and the potential dangers of febrile illness. Only 16.7% of caregivers expected anti-biotics. Nearly 92% of subjects were usually satisfied with medical care. Fever phobia continues to be a significant issue for Canadian parents. As a result, they treat fever aggressively and often seek medical attention. Good communication is important for medical staff caring for febrile children and typically leads to satisfied parents.
Full Text Available Abstract Background The aim was to explore the structures for managing student fitness to practise hearings in medical schools in the UK. We surveyed by email the named fitness to practise leads of all full members of the UK Medical Schools Council with a medical undergraduate programme. We asked whether student fitness to practise cases were considered by a committee/panel dedicated to medicine, or by one which also considered other undergraduate health and social care students. Findings All 31 medical schools responded. 19 medical schools had a fitness to practise committee dealing with medical students only. Three had a committee that dealt with students of medicine and dentistry. One had a committee that dealt with students of medicine and veterinary medicine. Eight had a committee that dealt with students of medicine and two or more other programmes, such as dentistry, nursing, midwifery, physiotherapy, dietetics, social work, pharmacy, psychology, audiology, speech therapy, operating department practice, veterinary medicine and education. Conclusion All 31 UK medical schools with undergraduate programmes have a fitness to practise committee to deal with students whose behaviour has given rise to concern about their fitness to practise. The variation in governance structures for student fitness to practise committees/panels can in part be explained by variations in University structures and the extent to which Universities co-manage undergraduate medicine with other courses.
Leggett, Carly; Irwin, Melinda; Griffith, Jane; Xue, Lin; Fradette, Katherine
Identifying multi-level factors affecting physical activity (PA) levels among adolescents is essential to increasing activity to promote health within this population. This study examines the associations between PA and 11 independent factors among Manitoba high school students. The sample included 31,202 grade 9-12 students who completed the Manitoba Youth Health Survey. Associations between PA and independent factors were examined separately and through multivariate regression. Analyses were stratified by gender. Perception of athletic ability, school location, parental encouragement and number of active friends were strong predictors of activity for moderately active and active males and females. Grade was a significant predictor of PA for females at both levels of activity but only significant for males when comparing active to inactive students. Perception of schoolwork and means of transport were minimally associated with PA. Results highlight the importance of targeting multiple levels of influence to increase PA among youth. Programs should focus on older students, females and those who are inactive or moderately active. In addition, social modeling of PA and increasing self-efficacy around activity should be encouraged.
Saito, R; Asano, M; Oshima, A; Minowa, M
The theme of the 6th WHO World Non-Smoking Day in 1993 was "Health services: our window to a tobacco-free world". A survey of the public health departments of all medical schools and universities was conducted in April, 1992 in order to investigate the state of smoking restrictions in those departments responsible for training in health services. Responses were received from 76 schools out of 80. The results were as follows: 1) In school cafeteria: Smoking prohibited (17.8%), Separate smoking/non-smoking areas (21.9%), Unrestricted smoking (60.3%), In student lounges: Smoking prohibited (2.9%), Separate Smoking/non-smoking areas (7.1%), Unrestricted smoking (90.0%), 2) The number of schools with tobacco vending machines: 59 schools (77.6%), 3) In medical faculty meetings: Smoking prohibited--32 schools (42.1%), Unrestricted smoking--22 schools (28.9%), No rules but no smokers--22 schools (28.9%), A total of 54 schools (71.0%) have established non-smoking meetings. 4) The number of school that give no attention to raking students aware of smoking risks: 6 schools As a result of this investigation, one national and one private medical school initiated prohibition of smoking at medical faculty meetings. In order to stimulate consciousness of the health hazards of smoking in future medical professionals, freshmen orientation should be utilized for teaching about the risks of both tobacco and "chug-a-lugging" of alcoholic beverages. In addition, the elimination of tobacco vending machines from all medical department area is strongly indicated.
Tsinuel, Girma; Tsedeke, Asaminew; Matthias, Siebeck; Fischer, Martin R; Jacobs, Fabian; Sebsibe, Desalegn; Yoseph, Mamo; Abraham, Haileamlak
One urgent goal of countries in sub-Saharan Africa is to dynamically scale up the education and work force of medical doctors in the training institutions and health facilities, respectively. These countries face challenges related to the rapid scale up which is mostly done without proper strategic planning, without the basic elements of infrastructure development, educational as well as academic and administrative human resources. Medical education done in the context of limited resources is thus compromising the quality of graduates. In the future, a collaborative and need-based approach involving major stakeholders such as medical educators concerned, ministries, planners and policy makers is needed. This article identifies the challenges of establishing medical schools and sustaining the quality of education through rapid scale-up in Sub-Saharan Africa in the settings of limited resources. It also outlines the minimum requirements for establishing medical schools. A consensus building workshop was conducted in Bishoftu, Ethiopia, from Nov 8-12, 2013. Participants were professionals from 13 Ethiopian medical schools, and representatives of medical schools from South Sudan, Somaliland, Somalia, and Mozambique. Participants are listed in Appendix 1. The governments and stakeholders should jointly develop strategic plans and a roadmaps for opening or expanding medical schools to scale up educational resources. It is advisable that medical schools have autonomy regarding the number of student-intake, student selection, curriculum ownership, resource allocation including for infrastructure and staff development. Health science and medical curricula should be integrated within and harmonized nationally. An educational evaluation framework needs to be embedded in the curricula, and all medical schools should have Health Science Education Development Centers.
Kusnoor, Anita V; Falik, Ruth
The reported prevalence of cheating among US medical students ranges from 0% to 58%. Cheating behaviors include copying from others, using unauthorized notes, sharing information about observed structured clinical encounters, and dishonesty about performing physical examinations on patients. Correlates of cheating in medical school include prior cheating behavior, burnout, and inadequate understanding about what constitutes cheating. Institutional responses include expulsion, reprimands, counseling, and peer review. Preventing cheating requires establishing standards for acceptable behavior, focusing on learning rather than assessment, involving medical students in peer review, and creating a culture of academic integrity. Cheating in medical school may have serious long-term consequences for future physicians. Institutions should develop environments that promote integrity.
Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9 businesses marketed health care
Background Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Methods Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. Results In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9
Full Text Available Abstract Background Medical tourism companies play an important role in promoting transnational medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, to date websites of medical tourism companies have received limited scrutiny. This article analyzes websites of Canadian medical tourism companies that advertised international healthcare but ultimately exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Methods Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1 where these businesses were based; 2 the destination countries and medical facilities that they promoted; 3 the health services they advertised; 4 core marketing messages; and 5 whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. Results In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a
McLuckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia
Background Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. Methods We cond...
Poole, Amanda; Catano, Victor M; Cunningham, D P
Using a sample of dental students (N=373) from four Canadian dental schools, this longitudinal study determined whether the new Canadian Dental Association (CDA) structured interview was a predictor of clinical and academic performance. The new interview predicted clinical performance in the third and fourth years of dental school, but not academic performance. The Canadian Dental Aptitude Test (DAT) continued to predict first- and second-year academic performance, but not clinical performance in the senior years. A personality factor, "Conscientiousness," predicted clinical and academic performance to various degrees across the four years of dental school. A second personality factor, "Openness to Experience," predicted third-year academic performance. The results suggest that a combination of scores from the DAT, a valid measure of personality, and a well-designed structured interview will provide the best prediction of those applicants who will do well in both the academic and clinical aspects of dental school.
Full Text Available Background: International medical electives (IMEs are unique learning opportunities; however, trainees can risk patient safety. Returning medical students often express concern about doing procedures beyond their level of training. The Canadian Federation of Medical Students has developed guidelines for pre-departure training (PDT, which do not address procedural skills. The purpose of this research is to determine which procedural skills to include in future PDT. Methods: Twenty-six medical students who returned from IMEs completed surveys to assess PDT. Using a Likert scale, we compared procedures performed by students before departing on IME to those performed while abroad. We used a similar scale to assess which procedures students feel ought to be included in future PDT. Results: There was no significant increase in number of procedures performed while on IME. Skills deemed most important to include in future PDT were intravenous line insertion, suturing of lacerations, surgical assisting and post-operative wound care. Conclusions: Pre-departure training is new and lacks instruction in procedural skills. Over half the students rated several procedural skills such as IV line insertion, suturing, assisting in surgery, post operative wound management and foley catheterization as important assets for future PDT.
Rigby, Perry G; Gururaja, Ramnarayan P
There is a worldwide shortage of doctors, which is true in most countries and on most continents. To enumerate the number of medical schools in the world at two different times, showing the trends and relating this to population is a beginning. The number is actually going up and has done so for some time; this has increased the supply of physicians and broadened healthcare delivery. The number to count for geographic and regional information about the medical schools relates directly to the supply of doctors. Regions were chosen from WHO and Foundation for the Advancement of International Medical Education and Research data to illustrate geographic distributions, physicians per patient and kinetics. The number of medical schools has consistently been rising around the world. However, world order is reverting to disorder, considering wars, disease and beleaguered stand-offs. None. Eight countries contain 40% of medical schools; however, several locations are rising faster than the rest. Some regions are stable, but sub-Saharan Africa, the Caribbean, South Asia and South America have increased the most in percentage recently, but not uniformly. Medical schools are related not only by geography, political boundaries and population but are concentrated in some regions. Graduate Medical Education positions appear to be short on a worldwide basis, as well as in some regions and countries. The number of medical schools is increasing worldwide and the identification of rapidly rising geographic areas is useful in exploring, planning and comparing regions. Controversy continues in a variety of locations, especially concerning Graduate Medical Education. In addition to funding, faculty candidates and accreditation, new schools are confronting a variety of choices in standards and quality, sizing and regional concerns.
Background Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. Methods An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Results Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across
Penney, Kali; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory
Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating the risks and benefits of undergoing surgery or other procedures abroad to their clientele. This raises important ethical concerns regarding processes such as informed consent and the liability of brokers in the event that complications arise from procedures. The purpose of this article is to examine the language, information, and online marketing of Canadian medical tourism brokers' websites in light of such ethical concerns. An exhaustive online search using multiple search engines and keywords was performed to compile a comprehensive directory of English-language Canadian medical tourism brokerage websites. These websites were examined using thematic content analysis, which included identifying informational themes, generating frequency counts of these themes, and comparing trends in these counts to the established literature. Seventeen websites were identified for inclusion in this study. It was found that Canadian medical tourism broker websites varied widely in scope, content, professionalism and depth of information. Three themes emerged from the thematic content analysis: training and accreditation, risk communication, and business dimensions. Third party accreditation bodies of debatable regulatory value were regularly mentioned on the reviewed websites, and discussion of surgical risk was absent on 47% of the websites reviewed, with limited discussion of risk on the remaining ones. Terminology describing brokers' roles was somewhat inconsistent across the websites. Finally
Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian
In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
Bator, Eli Xavier; Philpott, Bethany; Costa, Andrew Paul
In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying (MAiD). In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. This study assessed medical student views on MAiD, factors influencing these views, and opportunities for medical education. An exploratory cross-sectional survey was developed and distributed to medical students across all years of a three-year Canadian undergraduate medical program. The investigators administered the survey to participants during academic sessions from November to December, 2015. Analysis of the results included summary descriptive statistics, Pearson's chi-square test of independence to identify differences between participants by year of study, logistic regression to identify factors that influence students' stances on MAiD, and Wilcoxon signed rank test to measure changes in student support for MAiD and comfort discussing MAiD. There were 405 participants for a response rate of 87%. The majority of students (88%) supported the Supreme Court's decision, 61% would provide the means for a patient to end their life, and 38% would personally administer a lethal medication. Students who were more willing to provide the means for MAiD found medical education/clinical experience and patient autonomy to be important contributors to their stances on MAiD. Those students who were less willing to provide the means for MAiD found religious/spiritual beliefs and teachings, as well as concern about potential negative consequences, to be important contributors to their stances on MAiD. Educational training desired by participants included medicolegal (91%), communication skills (80%), technical skills (75%), and religious (49%). Medical students generally supported and would provide the means for MAiD to patients. They also indicated a
Introduction: The school system aims at developing pupils academically and socially. In the process of achieving this, pupils are prone to accidents and medical emergencies due to their vulnerabilities. The ability of the school system to respond to these challenges may depend on the availability of well equipped First Aid ...
When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.
Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results: The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.
Campbell, Amy T
Law is now routinely included in the medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework. There seems to lack, however, a systematic understanding of what works in terms of getting across an effective depth and breadth of legal knowledge for medical students - or what such would even look like. Moreover, and more critically, while some literature addresses these what, when, how, and who questions, a more fundamental question is left unanswered: why teach law in medical school? This article suggests a process to reveal a more consensual understanding of this latter question. The author highlights findings and recommendations of some of the leading literature to date related to teaching law in medical schools, and also recent U.K. projects addressing legal teaching in medical schools. Reflecting on these materials and activities, the author suggests that we take a "pause" before we argue for more or different legal topics within the medical curriculum. Before we alter the curricula for more and/or different "law," first, it is critical to have a meaningful, stakeholder-driven, consensus-seeking discussion of the goals of legal education: why do we think it matters that medical students learn about "the law"? © 2012 American Society of Law, Medicine & Ethics, Inc.
Ehn, S; Agardh, A; Holmer, H; Krantz, G; Hagander, L
Global health education is increasingly acknowledged as an opportunity for medical schools to prepare future practitioners for the broad health challenges of our time. The purpose of this study was to describe the evolution of global health education in Swedish medical schools and to assess students' perceived needs for such education. Data on global health education were collected from all medical faculties in Sweden for the years 2000-2013. In addition, 76% (439/577) of all Swedish medical students in their final semester answered a structured questionnaire. Global health education is offered at four of Sweden's seven medical schools, and most medical students have had no global health education. Medical students in their final semester consider themselves to lack knowledge and skills in areas such as the global burden of disease (51%), social determinants of health (52%), culture and health (60%), climate and health (62%), health promotion and disease prevention (66%), strategies for equal access to health care (69%) and global health care systems (72%). A significant association was found between self-assessed competence and the amount of global health education received (pmedical students (83%) wished to have more global health education added to the curriculum. Most Swedish medical students have had no global health education as part of their medical school curriculum. Expanded education in global health is sought after by medical students and could strengthen the professional development of future medical doctors in a wide range of topics important for practitioners in the global world of the twenty-first century. © 2015 the Nordic Societies of Public Health.
Sentenac, Mariane; Gariepy, Geneviève; McKinnon, Britt; Elgar, Frank J
The last decade saw a higher prevalence of overweight reported among food-insecure families in Canada, but no robust evidence exists on the covariate-adjusted association in children. In this study, we examined the association between hunger and overweight in Canadian students, using a propensity score matching analysis to reduce confounding. This research used data from the 2009/2010 Canadian Health Behaviour in School-aged Children study on a representative national sample of students in Grades 6 through 10. Students self-reported their height and weight and how often they have gone to school or to bed hungry due to a lack of food at home. Multivariate logistic regression modeling was conducted on the total sample (N = 17,694) and on the sample matched on propensity scores (n = 7,788). The overall prevalence of overweight among students was 20.2% with a significant difference between students who reported hunger (24.0%; 95% CI: 22.1-26.0) and students who did not (19.0%; 95% CI: 17.9-20.2). Analysis on the matched sample revealed a significant association between hunger and overweight in children (adjusted odds ratio: 1.30; 95% CI: 1.12-1.50). A substantial number of Canadian students have reported being hungry because of a lack of food at home. These students are at increased risk of overweight, regardless of their social class. Child hunger and household food insecurity exist in Canada and constitute a call for policy action at a national level.
Tran, Jennifer M; Li, Alan; Owino, Maureen; English, Ken; Mascarenhas, Lyndon; Tan, Darrell H S
HIV testing is mandatory for individuals wishing to immigrate to Canada. Since the Designated Medical Practitioners (DMPs) who perform these tests may have varying experience in HIV and time constraints in their clinical practices, there may be variability in the quality of pre- and posttest counseling provided. We surveyed DMPs regarding HIV testing, counseling, and immigration inadmissibility. A 16-item survey was mailed to all DMPs across Canada (N = 203). The survey inquired about DMP characteristics, knowledge of HIV, attitudes and practices regarding inadmissibility and counseling, and interest in continuing medical education. There were a total of 83 respondents (41%). Participants frequently rated their knowledge of HIV diagnostics, cultural competency, and HIV/AIDS service organizations as "fair" (40%, 43%, and 44%, respectively). About 25%, 46%, and 11% of the respondents agreed/strongly agreed with the statements "HIV infected individuals pose a danger to public health and safety," "HIV-positive immigrants cause excessive demand on the healthcare system," and "HIV seropositivity is a reasonable ground for denial into Canada," respectively. Language was cited as a barrier to counseling, which focused on transmission risks (46% discussed this as "always" or "often") more than coping and social support (37%). There was a high level of interest (47%) in continuing medical education in this area. There are areas for improvement regarding DMPs' knowledge, attitudes, and practices about HIV infection, counseling, and immigration criteria. Continuing medical education and support for DMPs to facilitate practice changes could benefit newcomers who test positive through the immigration process.
Hunter, Charlotte E; Palepu, Anita; Farrell, Susan; Gogosis, Evie; O'Brien, Kristen; Hwang, Stephen W
Medication adherence is an important determinant of successful medical treatment. Marginalized populations, such as homeless and vulnerably housed individuals, may face substantial barriers to medication adherence. This study aimed to determine the prevalence of, reasons for, and factors associated with medication nonadherence among homeless and vulnerably housed individuals. Additionally, we examined the association between medication nonadherence and subsequent emergency department utilization during a 1-year follow-up period. Data were collected as part of the Health and Housing in Transition study, a prospective cohort study tracking the health and housing status of 595 homeless and 596 vulnerably housed individuals in 3 Canadian cities. Logistic regression was used to identify factors associated with medication nonadherence, as well as the association between medication nonadherence at baseline and subsequent emergency department utilization. Among 716 participants who had been prescribed a medication, 189 (26%) reported nonadherence. Being ≥40 years old was associated with decreased likelihood of nonadherence (adjusted odds ratio [AOR] = 0.59; 95% confidence interval [CI] = 0.41-0.84), as was having a primary care provider (AOR = 0.49; 95% CI = 0.34-0.71). Having a positive screen on the AUDIT (Alcohol Use Disorders Identification Test; an indication of harmful or hazardous drinking) was associated with increased likelihood of nonadherence (AOR = 1.86; 95% CI = 1.31-2.63). Common reasons for nonadherence included side effects, cost, and lack of access to a physician. Self-reported nonadherence at baseline was significantly associated with frequent emergency department use (≥3 visits) over the follow-up period at the bivariate level (OR = 1.55; 95% CI = 1.02-2.35) but was not significant in a multivariate model (AOR = 1.49; 95% CI = 0.96-2.32). Homeless and vulnerably housed individuals face significant barriers to medication adherence. Health care
Andriole, Dorothy A; Jeffe, Donna B; Hageman, Heather L; Klingensmith, Mary E; McAlister, Rebecca P; Whelan, Alison J
To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates. Retrospective cohort study. Single medical institution. Recent US allopathic medical school graduates. Attrition from initial GME program. Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P sex (P = .67), or age (P = .12). In a multivariate logistic regression model, MD-PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition. Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.
Edwards, J C; Elam, C L; Wagoner, N E
Complex societal issues affect medical education and thus require new approaches from medical school admission officers. One of these issues--the recognition that the attributes of good doctors include character qualities such as compassion, altruism, respect, and integrity--has resulted in the recent focus on the greater use of qualitative variables, such as those just stated, for selected candidates. In addition, more emphasis is now being placed on teaching and licensure testing of the attributes of the profession during the four-year curriculum. The second and more contentious issue concerns the system used to admit white and minority applicants. Emphasizing character qualities of physicians in the admission criteria and selection process involves a paradigm shift that could serve to resolve both issues. To make this or any paradigm shift in admission policy, medical schools must think about all the elements of admission and their interrelationships. A model of medical school admission is proposed that can provide understanding of the admission system and serve as a heuristic guide. This model consists of (1) the applicant pool; (2) criteria for selection; (3) the admission committee; (4) selection processes and policies; and (5) outcomes. Each of these dimensions and the interrelationships among the dimensions are described. Finally, a hypothetical example is provided in which the model is used to help a medical school change its admission process to accommodate a new emphasis in the school's mission.
Lisa A. Hark
Full Text Available Deficiencies in medical school nutrition education have been noted since the 1960s. Nutrition-related non-communicable diseases, including heart disease, stroke, cancer, diabetes, and obesity, are now the most common, costly, and preventable health problems in the US. Training medical students to assess diet and nutritional status and advise patients about a healthy diet, exercise, body weight, smoking, and alcohol consumption are critical to reducing chronic disease risk. Barriers to improving medical school nutrition content include lack of faculty preparation, limited curricular time, and the absence of funding. Several new LCME standards provide important impetus for incorporating nutrition into existing medical school curriculum as self-directed material. Fortunately, with advances in technology, electronic learning platforms, and web-based modules, nutrition can be integrated and assessed across all four years of medical school at minimal costs to medical schools. Medical educators have access to a self-study nutrition textbook, Medical Nutrition and Disease, Nutrition in Medicine© online modules, and the NHLBI Nutrition Curriculum Guide for Training Physicians. This paper outlines how learner-directed nutrition content can be used to meet several US and Canadian LCME accreditation standards. The health of the nation depends upon future physicians’ ability to help their patients make diet and lifestyle changes.
Huang, Shih-Han Susan; Johnson, Karin; Pipe, Andrew L
To learn more about the prevalence of dietary supplement and medication use by Canadian athletes in the Olympic Games in Atlanta 1996 and Sydney 2000. Data were collected from personal interviews with Canadian athletes who participated at the 1996 Atlanta and 2000 Sydney Olympic Games. The athletes were interviewed by Canadian physicians regarding the use of vitamins, minerals, nutritional supplements, and prescribed and over-the-counter medications. Of the 271 Canadian athletes who participated at the Atlanta Olympics, 257 athletes were interviewed; at the Sydney Olympics, 300 of 304 Canadian athletes were interviewed. A quantitative and qualitative description of the use of dietary supplements by Canadian athletes at the Atlanta and Sydney Olympics. At the Atlanta Games, 69% of the athletes used some form of dietary supplements, whereas 74% of the athletes used dietary supplements at the Sydney Games. Vitamins were taken by 59% of men and 66% of women in Atlanta, and 65% of men and 58% women in Sydney. Mineral supplements were used by 16% of men and 45% of women in Atlanta, and 30% of men and 21% of women in Sydney. Nutritional supplements were used by 35% of men and 43% of women in Atlanta, and 43% of men and 51% of women in Sydney. The most popular vitamins were multivitamins in both Olympics. The most popular mineral supplements were iron supplements. The most commonly used nutritional supplement in Atlanta was creatine (14%), but amino acids (15%) were the most commonly used nutritional supplement in Sydney. In Atlanta, 61% of the athletes were using some form of medication, 54% of the athletes were using medications in Sydney. Nonsteroidal antiinflammatory drugs (NSAIDS) were the most commonly used medications at both Olympic Games. Among all sports, the highest prevalence of vitamin use occurred in boxing (91%) in Atlanta and swimming (76%) in Sydney. Rowers (56%) and cyclists (73%) demonstrated the highest use of mineral supplements. Nutritional supplement
Tannenbaum, Cara; Farrell, Barbara; Shaw, James; Morgan, Steve; Trimble, Johanna; Currie, Jane; Turner, Justin; Rochon, Paula; Silvius, James
Polypharmacy is growing in Canada, along with adverse drug events and drug-related costs. Part of the solution may be deprescribing, the planned and supervised process of dose reduction or stopping of medications that may be causing harm or are no longer providing benefit. Deprescribing can be a complex process, involving the intersection of patients, health care providers, and organizational and policy factors serving as enablers or barriers. This article describes the justification, theoretical foundation, and process for developing a Canadian Deprescribing Network (CaDeN), a network of individuals, organizations, and decision-makers committed to promoting the appropriate use of medications and non-pharmacological approaches to care, especially among older people in Canada. CaDeN will deploy multiple levels of action across multiple stakeholder groups simultaneously in an ecological approach to health system change. CaDeN proposes a unique model that might be applied both in national settings and for different transformational challenges in health care.
Alzahrani, Hasan Ali
Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. A cross-sectional questionnaire survey was conducted on a group of 542 clinical years' medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as "a "persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient". Results revealed that more than one quarter (28.0%) of the surveyed students reported exposure to some sort of bullying during their clinical. Ninety percent of the reported insults were verbal, 6% sexual and 4% physical. Males were more exposed but difference was not statistically significant. Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.
Full Text Available Abstract Background Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. Findings A cross-sectional questionnaire survey was conducted on a group of 542 clinical years’ medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as “a “persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient”. Results revealed that more than one quarter (28.0% of the surveyed students reported exposure to some sort of bullying during their clinical. Ninety percent of the reported insults were verbal, 6% sexual and 4% physical. Males were more exposed but difference was not statistically significant. Conclusions Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.
Wright, Bruce; Scott, Ian; Woloschuk, Wayne; Brenneis, Fraser; Bradley, Joelle
Over the last 10 years the number of medical students choosing family medicine as a career has steadily declined. Studies have demonstrated that career preference at the time that students begin medical school may be significantly associated with their ultimate career choice. We sought to identify the career preferences students have at entry to medical school and the factors related to family medicine as a first-choice career option. A questionnaire was administered to students entering medical school programs at the time of entry at the University of Calgary (programs beginning in 2001 and 2002), University of British Columbia (2001 and 2002) and University of Alberta (2002). Students were asked to indicate their top 3 career choices and to rank the importance of 25 variables with respect to their career choice. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choice were also calculated. A logistic regression was performed using career choice (family v. other) as the criterion variable and the factors plus demographic characteristics as predictor variables. Of 583 students, 519 (89%) completed the questionnaire. Only 20% of the respondents identified family medicine as their first career option, and about half ranked family medicine in their top 3 choices. Factor analysis produced 5 factors (medical lifestyle, societal orientation, prestige, hospital orientation and varied scope of practice) that explained 52% of the variance in responses. The 5 factors demonstrated acceptable internal consistency and correlated in the expected direction with the choice of family medicine. Logistic regression revealed that students who identified family medicine as their first choice tended to be older, to be concerned about medical lifestyle and to have lived in smaller communities at the time of completing high school; they were also less
Gropp, Kathleen; Janssen, Ian; Pickett, William
Active transportation to school provides a means for youth to incorporate physical activity into their daily routines, and this has obvious benefits for child health. Studies of active transportation have rarely focused on the negative health effects in terms of injury. This cross-sectional study is based on the 2009/10 Canadian Health Behaviour in School-Aged Children survey. A sample of children aged 11-15 years (n=20 076) was studied. Multi-level logistic regression was used to examine associations between walking or bicycling to school and related injury. Regular active transportation to school at larger distances (approximately >1.6 km; 1.0 miles) was associated with higher relative odds of active transportation injury (OR: 1.52; 95% CI 1.08 to 2.15), with a suggestion of a dose-response relationship between longer travel distances and injury (p=0.02). Physical activity interventions for youth should encourage participation in active transportation to school, while also recognising the potential for unintentional injury.
This study aimed to determine the prevalence and sources of stress among Thai medical students. The questionnaires,which consisted of the Thai Stress Test (TST) and questions asking about sources of stress, were sent to all medical students in the Faculty of Medicine, Ramathibodi Hospital, Thailand. A total of 686 students participated. The results showed that about 61.4% of students had some degree of stress. Seventeen students (2.4%) reported a high level of stress. The prevalence of stress is highest among third-year medical students. Academic problems were found to be a major cause of stress among all students. The most prevalent source of academic stress was the test/exam. Other sources of stress in medical school and their relationships are also discussed. The findings can help medical teachers understand more about stress among their students and guide the way to improvement in an academic context, which is important for student achievement.
Full Text Available Background and purpose:To measure the status of academic advising in medical schools, the present study was designed at the Secretariat for Education and Student Affairs of the Ministry of Health and Medical Education.Methods: A benchmarking tool, to assess the quality of different aspects of that field was devised. Every school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information.Results: All the divisions were visited by one of the project’s members to revise and approve the data. Then data retrieval was performed, verified and analyzed at the project’s office.Conclusion: There are 45 public and private medical schools nationwide, which were stratified based on their individual scores for academic advising.Keywords: ACADEMIC ADVISING, BENCHMARKING
Kim, Sang Hyun
The purpose of this study was to investigate medical school applicants' involvements in extracurricular activities including medical volunteering/community services, nonmedical community services, club activities, leadership role, and research. Extracurricular characteristics were compared for 448 applicants (223 males and 225 females) who applied to Kangwon Medical School in 2013 to 2014. Frequency analysis, chi-square test, and simple correlation were conducted with the collected data. The 448 applicants participated in medical volunteer/community services (15.3%), nonmedical community services (39.8%), club activities (22.9%), club officials (10%), and research (13.4%). On average, applicants from foreign universities participated in 0.9 medical volunteer/community service, 0.8 nonmedical community service, 1.7 club activities, and 0.6 research work. On the other hand, applicants from domestic universities reported 0.2 medical volunteer/community service, 1.0 nonmedical community service, 0.7 club activity, and 0.3 research. Involvement in extracurricular activities was extensive for medical school applicants. Participation in extracurricular activities differed between applicants from foreign and domestic universities. Females consistently reported greater participation in extracurricular activities than males. The data can be helpful for admission committees to recruit well-rounded applicants and compare between applicants with similar academic backgrounds.
Macnab, A J; Radziminski, N; Budden, H; Kasangaki, A; Zavuga, R; Gagnon, F A; Mbabali, M
PROJECT GOAL: To adapt a successful Canadian health-promoting school initiative to a Ugandan context through international partnership. Rural children face many health challenges worldwide; health professionals in training understand these better through community-based learning. Aboriginal leaders in a Canadian First-Nations community identified poor oral health as a child health issue with major long-term societal impact and intervened successfully with university partners through a school-based program called "Brighter Smiles". Makerere University, Kampala, Uganda (MUK) sought to implement this delivery model for both the benefit of communities and the dental students. MUK identified rural communities where hospitals could provide dental students with community-based learning and recruited four local schools. A joint Ugandan and Canadian team of both trainees and faculty planned the program, obtained ethics consent and baseline data, initiated the Brighter Smiles intervention model (daily at-school tooth-brushing; in-class education), and recruited a cohort to receive additional bi-annual topical fluoride. Hurdles included: challenging international communication and planning due to inconsistent internet connections; discrepancies between Canadian and developing world concepts of research ethics and informed consent; complex dynamics for community engagement and steep learning curve for accurate data collection; an itinerant population at one school; and difficulties coordinating Canadian and Ugandan university schedules. Four health-promoting schools were established; teachers, children, and families were engaged in the initiative; community-based learning was adopted for the university students; quarterly team education/evaluation/service delivery visits to schools were initiated; oral health improved, and new knowledge and practices were evident; an effective international partnership was formed providing global health education, research and health care
Annane, Djillali; Annane, Frédérique
The plagiarism has become very common in universities and medical school. Undoubtedly, the easy access to a huge amount of electronic documents is one explanation for the increasing prevalence of plagiarism among students. While most of universities and medical school have clear statements and rules about plagiarism, available tools for the detection of plagiarism remain inefficient and dedicate training program for students and teachers too scarce. As lack of time is one reason for students to choose plagiarism, it should be one main target for educational programs. Copyright © 2012. Published by Elsevier Masson SAS.
Wilkinson, Tim J; Hudson, Judith N; Mccoll, Geoffrey J; Hu, Wendy C Y; Jolly, Brian C; Schuwirth, Lambert W T
Benchmarking among medical schools is essential, but may result in unwanted effects. To apply a conceptual framework to selected benchmarking activities of medical schools. We present an analogy between the effects of assessment on student learning and the effects of benchmarking on medical school educational activities. A framework by which benchmarking can be evaluated was developed and applied to key current benchmarking activities in Australia and New Zealand. The analogy generated a conceptual framework that tested five questions to be considered in relation to benchmarking: what is the purpose? what are the attributes of value? what are the best tools to assess the attributes of value? what happens to the results? and, what is the likely "institutional impact" of the results? If the activities were compared against a blueprint of desirable medical graduate outcomes, notable omissions would emerge. Medical schools should benchmark their performance on a range of educational activities to ensure quality improvement and to assure stakeholders that standards are being met. Although benchmarking potentially has positive benefits, it could also result in perverse incentives with unforeseen and detrimental effects on learning if it is undertaken using only a few selected assessment tools.
Ko GD; Bober SL; Mindra S; Moreau JM
Gordon D Ko,1,2 Sara L Bober,1 Sean Mindra,3 Jason M Moreau1 1Apollo Applied Research Inc., 2Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, 3University of Ottawa Medical School, Ottawa, ON, Canada Abstract: Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is...
Andresen, Nicholas S.; Olson, Tyler S.; Krasowski, Matthew D.
Background Attitudes towards conflict of interest (COI) and COI policy are shaped during medical school and influence both the education of medical students and their future medical practice. Understanding the current attitudes of medical students and medical school teaching faculty may provide insight into what is taught about COI and COI policy within the ?hidden? medical curriculum. Differences between medical student and medical school teaching faculty perceptions of COI and COI policy ha...
Sadowsky, Donald; And Others
A study of physicians who had graduated from or had matriculated without graduating from dental school prior to entering a medical school focused on reasons for career choices, medical school admissions process, academic perfromance in both schools, medical specialty, and attitudes toward dentistry and medicine. (Editor/JT)
Camiré, Martin; Trundel, Pierre
In Canada, adolescent boys have been shown to have a higher high school dropout rate compared to girls. This situation is particularly evident in the country's second largest province by population, Quebec. The sport of Canadian football has recently gained in popularity in Quebec as many people believe that the sport can be used to promote both…
Taylor, Catherine G.; Meyer, Elizabeth J.; Peter, Tracey; Ristock, Janice; Short, Donn; Campbell, Christopher
The Every Teacher Project involved large-scale survey research conducted to identify the beliefs, perspectives, and practices of Kindergarten to Grade 12 educators in Canadian public schools regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ)-inclusive education. Comparisons are made between LGBTQ and cisgender heterosexual…
Brisebois, Ronald J; Tien, Homer C
The purpose of this study was to document the surgical experience of the Role 3 Multinational Medical Unit (R3MMU) at Kandahar Airfield Base while Canada was the lead nation for the facility. This study will help inform on future staffing, training, and deployment issues of field hospitals on military missions. From February 2, 2006, to October 15, 2009, the Canadian Forces Health Services served as the lead nation for the R3MMU. We retrospectively reviewed the electronic and the actual operative database during this timeframe to assess surgical workload, types of surgical procedures performed, and the involved anatomic regions of the surgical procedures. During this timeframe, there were 6,735 operative procedures performed on 4,434 patients. The majority of our patients were Afghan nationals, with Afghan civilians representing 34.8%, Afghan National Security Forces 31.6%, and North Atlantic Treaty Organization forces 25.3%. The number of operative procedures by specialty were 3,329 in orthopedic surgery (49.4%), 2,053 general surgery (30.5%), 930 oral maxillofacial surgery (13.8%), and 272 neurosurgery (6%). The most frequently operated on body region was the soft tissue, followed by the extremities and then the abdomen. Thoracic operations were very infrequent. Our operative data were slightly different from historical controls. Hopefully, this data will help with planning for future deployments of field hospitals on military missions.
Neese, Randolph M.; Schiffman, Joshua D.
Presents a study in which a questionnaire was given to deans at North American medical schools to determine which aspects of evolutionary biology are included in the curricula and the factors that influence this. Suggests that most future physicians should learn evolutionary biology as undergraduates if they are to learn it at all. (Author/NB)
accessibility to students, and a considerable clinical experience. I say this not to exclude the value of research but merely to put research, as it were, in its place ... within them a vitality and enthusiasm so often lacking in their elders. They have little of the grandeur of the capital's medical school or teaching hospital being ...
Elizabeth M. Altmaier
Full Text Available Introduction. Prospective medical school applicants use Internet websites to gain information about medical school interviews as well as to offer their experience in such interviews. This study examined applicants reported experiences of interviews and compared them to the purposes of the interview as purported by medical schools. Method. Content analysis of student feedback regarding medical school interviews at 161 medical schools was conducted for entries of over 4600 students applying to medical school who anonymously and voluntarily completed an online questionnaire. Results. Across all medical schools, nearly one half of all cited interview questions addressed non-cognitive characteristics of the applicants. Top ranked medical schools were reported to ask significantly more interpersonal and illegal questions and fewer academic/general knowledge questions than other medical schools. Lower ranked schools did not differ significantly in the types of questions reportedly asked applicants compared to other medical schools. Discussion. Medical school interviews are generally gathering types of information about applicants that admissions personnel identify as important in the admission decision. In addition to measuring interpersonal characteristics, medical school admissions interviews are assessing cognitive abilities and ethical decision-making. Sources on the Internet provide actual medical school interview questions to prospective students. This practice can help them gain an undue advantage in interviewing. Admissions committees and faculty who interview students may want to consider how best to obtain accurate and valid responses from applicants.
Rubin, Zachary; Blackham, Kristine
This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Liu, Ye; Cheng, Xunjia
Ideal medical care requires professional skills as well as appropriate communication skills. However, traditional medical education in medical schools mostly emphasizes the former. To remedy this situation, medical humanities education will be incorporated into education for medical students at Fudan University. Comprehensive medical education that includes both medical skills and humanities may greatly improve medical care.
Azagba, Sunday; Langille, Don; Asbridge, Mark
An emerging body of research has reported high consumption of alcohol mixed with energy drinks among young adults, particularly college students. However, little is known about adolescents' consumption of these drinks. The purpose of this study was to determine the prevalence of consumption of alcohol mixed with energy drinks and to examine its correlates among Canadian high school students. We used a nationally representative sample of 36 155 Canadian students in grades 7 to 12 who participated in the 2010/2011 Youth Smoking Survey. About 20% of Canadian high school students reported consuming alcohol mixed with energy drinks in the last year, with considerable variation across provinces. Multivariate logistic regression analyses showed that the odds of consumption of these drinks were higher among students in lower grades (grades 7 and 8) and among students who identified their ethnicity as black or "other." Consumption of alcohol mixed with energy drinks was positively associated with substance use (current smoking [adjusted odds ratio (OR) 1.52, 95% confidence interval (CI) 1.19-1.95], past-year heavy drinking [adjusted OR 3.41, 95% CI 2.84-4.09] and marijuana use [adjusted OR 2.29, 95% CI 1.90-2.76]), absence from school, participation in school team sports and having more weekly spending money. Students who felt more connected to school and had an academic average of 70% or higher were less likely to consume alcohol mixed with energy drinks. The consumption of alcohol mixed with energy drinks is an emerging public health concern. Consumption of these drinks is substantial among Canadian high school students and can lead to many potential harms, both acute (e.g., injury) and long term (e.g., increased alcohol dependence). Our findings highlight the need for further research into the long-term effects of consumption of alcohol mixed with energy drinks among young people, as well as the development of interventions aimed at reducing consumption of these drinks.
O'Neill, Lotte; Vonsild, Maria; Wallstedt, Birgitta
-based” admission track to make it easier for students who may not be eligible for admission through the “grade-based” track, to be admitted on the basis of attributes other than academic performance. The aim of this research was to examine whether there were significant differences in the social composition...... of students admitted via the two tracks between the years 2002-2007. Method: This prospective cohort study included 1074 medical students admitted between the years 2002-2007 to the University of Southern Denmark (USD) medical school. Of these, 454 were admitted by grade-based selection and 620 were selected...
Salter, Brian; Filippakou, Ourania; Tapper, Ted
Since 1997 there have been two concerted attempts to expand the number of medical school students in England: by increasing the size of existing medical schools, and by creating new medical schools. These initiatives have been a direct result of government policy, although policy implementation was delegated to the state apparatus. They also led…
McCally, Michael; And Others
Several medical schools have sponsored courses on medical aspects of nuclear war, and faculties of medical schools conducting or considering such courses have many questions about the organization of their teaching. A survey of U.S. schools of medicine presentations of nuclear war-related subject matter is discussed. (MLW)
Full Text Available Purpose: Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods: Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results: The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions: Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established.
Fornari, Alice; Murray, Thomas S.; Menzin, Andrew W.; Woo, Vivian A.; Clifton, Maurice; Lombardi, Marion; Shelov, Steven
Purpose Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established. PMID:24962112
Fornari, Alice; Murray, Thomas S; Menzin, Andrew W; Woo, Vivian A; Clifton, Maurice; Lombardi, Marion; Shelov, Steven
Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established.
Hudson, Geoffrey L; Maar, Marion
In 2005 the Northern Ontario School of Medicine (NOSM) in Canada implemented the world's first and (still) only mandatory Aboriginal community placement for all its medical students. The Aboriginal placement was created in part to address social accountability, defined as the obligation of medical schools to direct education, research and service activities towards addressing the priority health concerns of the community they serve. Concurrently, Aboriginal health policies have increasingly emphasized the need to involve Aboriginal people in healthcare planning and design health care that involves Aboriginal concepts of health and culturally safe care. Aboriginal delegates provided recommendations for the development of an Aboriginal health curriculum, which included the need for the medical school to acknowledge and respect Aboriginal history, health priorities and develop an Aboriginal community placement for all medical students. To anticipate the challenges (e.g., distance, communication, technologies, student and cultural safety, pedagogical effectiveness/appropriateness) presented by a mandatory placement for first-year students in Aboriginal communities a pilot placement project was designed. The locations of the communities were carefully selected in order to assess a variety of challenges that might be encountered with rural and remote Aboriginal community placements. Pilot lessons included managing student expectations, which leaned towards a clinical rather than a community-based cultural placement focus. Areas for increased coordination and administrative support were identified, as well as the need for more extensive community level support. The students had an overall positive experience and learned about the realities of health care in the communities. Aboriginal community staff commented that the experience with the students was fulfilling and beneficial. It was also recognized that curriculum delivery methods required major adjustments and that the
Lievens, Filip; Ones, Deniz S; Dilchert, Stephan
Admissions and personnel decisions rely on stable predictor-criterion relationships. The authors studied the validity of Big Five personality factors and their facets for predicting academic performance in medical school across multiple years, investigating whether criterion-related validities change over time. In this longitudinal investigation, an entire European country's 1997 cohort of medical students was studied throughout their medical school career (Year 1, N = 627; Year 7, N = 306). Over time, extraversion, openness, and conscientiousness factor and facet scale scores showed increases in operational validity for predicting grade point averages. Although there may not be any advantages to being open and extraverted for early academic performance, these traits gain importance for later academic performance when applied practice increasingly plays a part in the curriculum. Conscientiousness, perhaps more than any other personality trait, appears to be an increasing asset for medical students: Operational validities of conscientiousness increased from .18 to .45. In assessing the utility of personality measures, relying on early criteria might underestimate the predictive value of personality variables. Implications for personality measures to predict work performance are discussed.
Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin
To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [P = .005], acceptable on-call demands [P = .012], and lifestyle flexibility [P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [P = .014] and the opportunity to form long-term relationships [P families [P = .006]); and duration of residency program (P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert (P influence medical students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be encouraged to explore a career in family medicine or pediatrics by addressing misinformation, by encouraging realistic expectations of career outcomes in the various specialties, and by demonstrating the capacity of primary care fields to incorporate specific motivating factors. Copyright© the College of Family Physicians of Canada.
O'Neill, Lotte; Vonsild, Maria C; Wallstedt, Birgitta; Dornan, Tim
The under-representation in medical education of students from lower socio-economic backgrounds is an important social issue. There is currently little evidence about whether changes in admission strategies might increase the diversity of the medical student population. Denmark introduced an 'attribute-based' admission track to make it easier for students who may not be eligible for admission on the 'grade-based' track to be admitted on the basis of attributes other than academic performance. The aim of this research was to examine whether there were significant differences in the social composition of student cohorts admitted via each of the two tracks during the years 2002-2007. This prospective cohort study included 1074 medical students admitted during 2002-2007 to the University of Southern Denmark medical school. Of these, 454 were admitted by grade-based selection and 620 were selected on attributes other than grades. To explore the social mix of candidates admitted on each of the two tracks, respectively, we obtained information on social indices associated with educational attainment in Denmark (ethnic origin, father's education, mother's education, parenthood, parents living together, parent in receipt of social benefits). Selection strategy (grade-based or attribute-based) had no statistically significant effect on the social diversity of the medical student population. The choice of admission criteria may not be very important to widening access and increasing social diversity in medical schools. Attracting a sufficiently diverse applicant pool may represent a better strategy for increasing diversity in the student population. © 2013 John Wiley & Sons Ltd.
Dee, Cheryl R
An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.
Telner, Deanna E; Carroll, June C; Talbot, Yves
Genetic discoveries increasingly have an impact on clinical medicine. Primary care providers (PCPs) need to be prepared to address patients' concerns about their genetic risks. To explore family medicine residents' experiences with genetics in medical school and residency training and to understand their educational needs in genetics. Four focus groups were held with 33 family medicine residents at the University of Toronto, which represented graduates of 9 different Canadian medical schools. Groups were audio-taped, transcribed and analysed independently by 4 reviewers using content analysis. Recurrent themes were identified. Participants described their experiences with genetics in medical school as almost entirely related to rare disorders, so genetics was not perceived to be clinically relevant. There was little awareness of the complex ethical and psychosocial issues that accompany genetics. However, participants felt that genetics would become significant in medical care in the future and PCPs would play an important role. They expressed a need for more knowledge of genetics to fulfill this role and practical teaching in genetics by clinicians. Medical school educational experiences may not be preparing future PCPs to address genetic issues with patients. A change and a broadening of the teaching of genetics are required to fulfill this need.
Peter, Tracey; Taylor, Catherine; Chamberland, Line
The goal of the study is to examine how location (nationally, compared to Canadian regions) is related to indicators of a hostile school environment for sexual minority youth, particularly when physical abuse is used as the outcome variable. Data representing 5,766 Canadian students were analyzed using bivariate and multivariate techniques. Results from the multivariate analyses showed that non-physical abuse was the most significant predictor of homophobically based physical abuse, for both LGBQ and non-LGBQ students. Findings reiterate the importance of considering the progression of harmful events as an escalation of violence as well as the need to view homophobic bullying as having a significant impact on all students. Finally, while the presence of homophobia is prevalent across all Canadian regions, there are, nevertheless, many regional differences, which could be used to inform region-specific action plans.
Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre
To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Canada. General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. General duty medical officers were satisfied with many aspects of their family medicine residency training; however, military-specific areas for improvement
Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy
Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism
Van Melle, Elaine; Lockyer, Jocelyn; Curran, Vernon; Lieff, Susan; St Onge, Christina; Goldszmidt, Mark
Education scholarship (ES) is integral to the transformation of medical education. Faculty members who engage in ES need encouragement and recognition of this work. Beginning with the definition of ES as 'an umbrella term which can encompass both research and innovation in health professions education', and which as such represents an activity that is separate and distinct from teaching and leadership, the purpose of our study was to explore how promotion policies and processes are used in Canadian medical schools to support and promote ES. We conducted an analysis of the promotion policies of 17 Canadian medical schools and interviews with a key informant at each institution. We drew on an interpretive approach to policy analysis to analyse the data and to understand explicit messages about how ES was represented and supported. Of the 17 schools' promotion documents, only nine contained specific reference to ES. There was wide variation in focus and level of detail. All key informants indicated that ES is recognised and considered for academic promotion. Barriers to the support and recognition of ES included a lack of understanding of ES and its relationship to teaching and leadership. This was manifest in the variability in promotion policies and processes, support systems, and career planning and pathways for ES. This lack of clarity may make it challenging for medical school faculty members to make sense of how they might successfully align ES within an academic career. There is a need therefore to better articulate ES in promotion policies and support systems. Creating a common understanding of ES, developing guidelines to assess the impact of all forms of ES, developing an informed leadership and system of mentors, and creating explicit role descriptions and guidelines are identified as potential strategies to ensure that ES is appropriately valued. © 2014 John Wiley & Sons Ltd.
Faught, Erin L; Williams, Patty L; Willows, Noreen D; Asbridge, Mark; Veugelers, Paul J
Education is a crucial social determinant of health. Food insecurity can be detrimental to children's academic achievement, potentially perpetuating a cycle of poverty and food insecurity. We aimed to assess the relationship between food insecurity and academic achievement in Canadian school-aged children. Cross-sectional study of children and parents. Parents completed the short-form Household Food Security Survey Module and questions about income and education level (socio-economic status). Children completed FFQ. Data were prospectively linked to children's performance on standardized exams written one year later. Mixed-effect logistic regression was employed to assess the relationship between food insecurity and likelihood of meeting academic expectations adjusting for socio-economic status, diet quality and potential confounders. Nova Scotia, Canada in 2011-2012. Students (n 4105) in grade 5 (10-11 years; 2167 girls) and their parents. Low food security was reported by 9·8 % of households; very low food security by 7·1 % of households. Students from low-income households and reporting poor diet quality were less likely to do well in school. Children who lived in households reporting very low food security had 0·65 times the odds (OR=0·65; 95 % CI 0·44, 0·96) of meeting expectations for reading and 0·62 times the odds (OR=0·62; 95 % CI 0·45, 0·86) of meeting expectations for mathematics. Very low household insecurity is associated with poor academic achievement among children in Nova Scotia.
Full Text Available The voice of youth is crucial to advancing solutions that contribute to effective strategies to improve youth health outcomes. The problem, however, is that youth/student voices are often overlooked, and stakeholders typically engage in decision-making without involving youth. The burden of chronic disease is increasing worldwide, and in Canada chronic disease accounts for 89 per cent of deaths. However, currently, youth spend less time being physically active while engaging in more unhealthy eating behaviours than ever before. High rates of unhealthy behaviours such as physical inactivity, unhealthy eating and tobacco use are putting Canadian youth at risk of health problems such as increased levels of overweight and obesity, cardiovascular disease and type 2 diabetes. Focus group methodology was utilised to conduct 7 focus groups with 50 students in grades 7–12 from schools in Prince Edward Island, Canada. The key themes that emerged included: (1 youth health issues such as lack of opportunities to be physically active, cost and quality of healthy food options, and bullying; (2 facilitators and barriers to health promotion, including positive peer and adult role models, positive relationships with adults and competitiveness of school sports; and (3 lack of student voice. Our findings suggest that actively engaging youth provides opportunities to understand youth perspectives on how to encourage them to make healthy choices and engage in healthy behaviours. Attention needs to be paid to inclusive knowledge exchange practices that value and integrate youth perspectives and ideas as a basis for building health promotion actions and interventions. Keywords: knowledge exchange, youth health, youth engagement
Tongeren-Alers, M.L.G. van; Esch, M. van der; Verdonk, P.; Johansson, E.; Hamberg, K.; Lagro-Janssen, T.
BACKGROUND: Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know
Schiekirka-Schwake, Sarah; Dreiling, Katharina; Pyka, Katharina; Anders, Sven; von Steinbüchel, Nicole; Raupach, Tobias
Student evaluations of teaching can provide useful feedback for teachers and programme coordinators alike. We have designed a novel evaluation tool assessing teacher performance and student learning outcome. This tool was implemented at two German medical schools. In this article, we report student and teacher perceptions of the novel tool, and the implementation process. Focus group discussions as well as one-to-one interviews involving 22 teachers and 31 undergraduate medical students were conducted. Following adjustments to the feedback reports (e.g. the colour coding of results) at one medical school, 42 teachers were asked about their perceptions of the revised report and the personal benefit of the evaluation tool. Teachers appreciated the individual feedback provided by the evaluation tool and stated that they wanted to improve their teaching, based on the results; however, they missed most of the preparative communication. Students were unsure about the additional benefit of the instrument compared with traditional evaluation tools. A majority was unwilling to complete evaluation forms in their spare time, and some felt that the new questionnaire was too long and that the evaluations occurred too often. They were particularly interested in feedback on how their comments have helped to further improve teaching. Student evaluations of teaching can provide useful feedback CONCLUSION: Despite evidence of the utility of the tool for individual teachers, implementation of changes to the process of evaluation appears to have been suboptimal, mainly owing to a perceived lack of communication. In order to motivate students to provide evaluation data, feedback loops including aims and consequences should be established. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
White, Jonathan S; Lemay, Jean-Francois; Brownell, Keith; Lockyer, Jocelyn
Although essay questions are used in the admissions process in many medical schools, there has been little research on how applicants respond to essay questions. The purpose of this study was to explore how applicants to medical school approach essay questions used in the selection process. Qualitative analysis was conducted on 240 randomly selected essays written by individuals applying to a single Canadian medical school in 2007 using a modified grounded theory approach to develop a conceptual framework which was checked in interviews with applicants. Three core variables were identified: "balancing service and reward," "anticipating the physician role," and "readiness." We described the overall approach of applicants as "taking stock," writing about their journeys to the selection process, their experiences of the process itself, and about their anticipated future in medicine. Our findings suggest a disconnect between the approach of the applicants (to "show themselves" and be selected as individuals) and the stated intent of the process (to select applicants based on "objective" criteria). Our findings raise important questions about how applicants represent themselves when applying for medical school and suggest that it is important to understand the applicant's point of view when developing questions for selection processes.
Mcluckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia
Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change. There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.
O'Dochartaigh, Domhnall; Douma, Matthew; Alexiu, Chris; Ryan, Shell; MacKenzie, Mark
Introduction Prehospital ultrasound (PHUS) assessments by physicians and non-physicians are performed on medical and trauma patients with increasing frequency. Prehospital ultrasound has been shown to be of benefit by supporting interventions. Problem Which patients may benefit from PHUS has not been clearly identified. A multi-variable logistic regression analysis was performed on a previously created retrospective dataset of five years of physician- and non-physician-performed ultrasound scans in a Canadian critical care Helicopter Emergency Medical Service (HEMS). For separate medical and trauma patient groups, the a-priori outcome assessed was patient characteristics associated with the outcome variable of "PHUS-supported intervention." Both models were assessed (Likelihood Ratio, Score, and Wald) as a good fit. For medical patients, the characteristics of heart rate (HR) and shock index (SI) were found to be most significant for an intervention being supported by PHUS. An extremely low HR was found to be the most significant (OR=15.86 [95% confidence interval (CI), 1.46-171.73]; P=.02). The higher the SI, the more likely that an intervention was supported by PHUS (SI 0.9 toPrehospital Index (PHI) and SI were found to be most significant for PHUS support. The greatest effect was PHI, where increasing ORs were seen with increasing PHI (PHI 14-19: OR=13.36 [95% CI, 1.92-92.81]; P=.008; and PHI 20-24: OR=53.10 [95% CI, 4.83-583.86]; P=.001). Shock index was found to be similar, though, with lower impact and significance (SI 0.9 toprehospital ultrasound in a Canadian critical care Helicopter Emergency Medical Service: determining who might benefit. Prehosp Disaster Med. 2017;32(5):536-540.
Johnston, Rory; Crooks, Valorie A; Snyder, Jeremy
Medical tourism describes the private purchase and arrangement of medical care by patients across international borders. Increasing numbers of medical facilities in countries around the world are marketing their services to a receptive audience of international patients, a phenomenon that has largely been made possible by the growth of the Internet. The growth of the medical tourism industry has raised numerous concerns around patient safety and global health equity. In spite of these concerns, there is a lack of empirical research amongst medical tourism stakeholders. One such gap is a lack of engagement with medical tourists themselves, where there is currently little known about how medical tourists decide to access care abroad. We address this gap through examining aspects of Canadian medical tourists' decision-making processes. Semi-structured phone interviews were administered to 32 Canadians who had gone abroad as medical tourists. Interviews touched on motivations, assessment of risks, information seeking processes, and experiences at home and abroad. A thematic analysis of the interview transcripts followed. Three overarching themes emerged from the interviews: (1) information sources consulted; (2) motivations, considerations, and timing; and (3) personal and professional supports drawn upon. Patient testimonials and word of mouth connections amongst former medical tourists were accessed and relied upon more readily than the advice of family physicians. Neutral, third-party information sources were limited, which resulted in participants also relying on medical tourism facilitators and industry websites. While Canadian medical tourists are often thought to be motivated by wait times for surgery, cost and availability of procedures were common primary and secondary motivations for participants, demonstrating that motivations are layered and dynamic. The findings of this analysis offer a number of important factors that should be considered in the
Full Text Available Research over the past two decades has amply demonstrated the importance of literature to the formation of both regional and national cultural identity, particularly in the face of mass market globalization of children’s book publishing in the 21st century as well as the predominance of non-Canadian content from television, movies, books, magazines and internet media. However, Canadian children appear to have only very limited exposure to Canadian authors and illustrators. In Atlantic Canada, regional Atlantic Canadian authors and illustrators for children receive very limited critical attention, and resources for the study and teaching of Atlantic Canadian children’s literature are few. Print and digital information sources on regional children’s books, publishing, authors and illustrators are scattered and inconsistent in quality and currency. This research project directly addresses these key concerns by summarizing the findings of a survey of Atlantic Canadian teachers on their use of regional books. In response to survey findings, the paper concludes by describing the creation of the Sea Stacks Project an authoritative web-delivered information resource devoted to contemporary Atlantic Canadian literature for children and teens.
Ramey, David M.
In this article, the author examines how school- and district-level racial/ethnic and socioeconomic compositions influence schools' use of different types of criminalized and medicalized school discipline. Using a large data set containing information on over 60,000 schools in over 6,000 districts, the authors uses multilevel modeling and a…
Full Text Available Pooja Nair, Ishani Barai, Sunila Prasad, Karishma Gadhvi Department of Medicine, Imperial College School of Medicine, Imperial College London, London, UK Abstract: Guidelines in the UK require all doctors to actively take part in quality improvement. To ease future doctors into the process, formal quality improvement teaching can be delivered during medical school. Keywords: quality improvement, medical school, patient safety, patient satisfaction, medical student, clinical audit
Few people realize that indoor air pollution can contribute to health effects like asthma. Several agencies, notably the United States Environmental Protection Agency (EPA), have indicated that levels of indoor pollutants can be significantly higher than those found outside. As such, poor indoor air quality (IAQ) could impact the health of students and staff, as well as the educational process and costs. Many factors can influence IAQ, including building materials, furnishings, cleaning agents, pesticides, printing and copying devices, and more. Reduction in IAQ can also result from tighter buildings and reduced ventilation. This kit was developed by Health Canada in collaboration with the Indoor Air Quality Working Group of the Federal-Provincial-Territorial Committee on Environmental and Occupational Health (CEOH) to provide school officials with the tools to prevent, identify, assess, and address most indoor air problems while minimizing cost and involvement. It was suggested that trained professionals should perform the limited and well-defined set of operations and maintenance activities described in the kit.
Evren, Sevan; Bi, Andrew Yuzhong; Talwar, Shuchi; Yeh, Andrew; Teitelbaum, Howard
Doctors of osteopathic medicine (DO) are one of the fastest growing segments of health care professionals in the United States. Although Canada has taken significant leaps in the acknowledgment of US trained DOs, there continues to be a lack of understanding of the profession by Canadian trained physicians. In this article, we provide a brief overview of osteopathic medical education and training in the United States. Current information of osteopathic training by American Association of Colleges of Osteopathic Medicine (AACOM) and American Osteopathic Association (AOA) was presented. Data pertaining to Canadians enrolled in osteopathic colleges was compared with allopathic (MD) and international medical graduates (IMGs). Doctors of osteopathic medicine programs provide an additional pathway for students interested in pursuing a medical education. Canadian applications to osteopathic colleges are expected to grow due to successful post-graduate US residency matching, increased difficulty of matriculating at Canadian medical schools, and a greater awareness of the profession in Canada. Given the increasing enrollment of Canadian students in US osteopathic medical schools, we expect that Canadian DOs will play a significant role in shaping health care in both the US and Canada.
O'Mara, Deborah A; Canny, Ben J; Rothnie, Imogene P; Wilson, Ian G; Barnard, John; Davies, Llewelyn
To report the level of participation of medical schools in the Australian Medical Schools Assessment Collaboration (AMSAC); and to measure differences in student performance related to medical school characteristics and implementation methods. Retrospective analysis of data using the Rasch statistical model to correct for missing data and variability in item difficulty. Linear model analysis of variance was used to assess differences in student performance. 6401 preclinical students from 13 medical schools that participated in AMSAC from 2011 to 2013. Rasch estimates of preclinical basic and clinical science knowledge. Representation of Australian medical schools and students in AMSAC more than doubled between 2009 and 2013. In 2013 it included 12 of 19 medical schools and 68% of medical students. Graduate-entry students scored higher than students entering straight from school. Students at large schools scored higher than students at small schools. Although the significance level was high (P performance. The effect on performance of multiple assessments compared with the test items as part of a single end-of-year examination was negligible. The variables investigated explain only 12% of the total variation in student performance. An increasing number of medical schools are participating in AMSAC to monitor student performance in preclinical sciences against an external benchmark. Medical school characteristics account for only a small part of overall variation in student performance. Student performance was not affected by the different methods of administering test items.
Lipworth, Wendy; Kerridge, Ian; Little, Miles; Gordon, Jill; Markham, Pippa
Bioethics and professionalism are standard subjects in medical training programmes, and these curricula reflect particular representations of meaning and practice. It is important that these curricula cohere with the actual concerns of practicing clinicians so that students are prepared for real-world practice. We aimed to identify ethical and professional concerns that do not appear to be adequately addressed in standard curricula by comparing ethics curricula with themes that emerged from a qualitative study of medical practitioners. Curriculum analysis: Thirty-two prominent ethics and professionalism curricula were identified through a database search and were analysed thematically. Qualitative study: In-depth, semi-structured interviews were conducted with 20 medical practitioners. Participants were invited to reflect upon their perceptions of the ways in which values matter in their practices and their educational experiences. The themes emerging from the two studies were compared and contrasted. While representations of meaning and value in ethics and professionalism curricula overlap with the preoccupations of practicing clinicians, there are significant aspects of 'real-world' clinical practice that are largely ignored. These fell into two broad domains: (1) 'sociological' concerns about enculturation, bureaucracy, intra-professional relationships, and public perceptions of medicine; and (2) epistemic concerns about making good decisions, balancing different kinds of knowledge, and practising within the bounds of professional protocols. Our findings support the view that philosophy and sociology should be included in medical school and specialty training curricula. Curricula should be reframed to introduce students to habits of thought that recognize the need for critical reflection on the social processes in which they are embedded, and on the philosophical assumptions that underpin their practice. © 2012 Blackwell Publishing Ltd.
Kutikov, Alexander; Bonslaver, Jason; Casey, Jessica T.; Degrado, Justin; Dusseault, Beau N.; Fox, Janelle A.; Lashley-Rogers, Desri; Richardson, Ingride; Smaldone, Marc C.; Steinberg, Peter L.; Trivedi, Deep B.; Routh, Jonathan C.
Introduction Urology continues to be a highly desirable specialty, despite decreasing exposure of students to Urology in U.S. medical schools. In this study, we set out to assess how U.S. medical schools compare to one another with regard to the number of students that each sends into Urological training and to evaluate the reasons why some medical schools consistently send more students into urology than others. Materials and Methods The authors obtained AUA Match data for the 5 Match seasons from 2005–2009. A survey of all successful participants was then performed. The survey instrument was designed to determine what aspects of the medical school experience influenced students to choose to specialize in Urology. A bivariate and multivariate analysis was then performed to assess which factors correlated with more students entering Urology from a particular medical school. Results Between 2005 and 2009, 1,149 medical students from 130 medical schools successfully participated in the Urology match. Of the 132 allopathic medical schools, 128 sent at least 1 student into Urology (mean 8.9, median 8, SD 6.5). A handful of medical schools were remarkable outliers, sending significantly more students into Urology than other institutions. Multivariate analysis revealed that a number of medical-school related variables including strong mentorship, medical school ranking, and medical school size correlated with more medical students entering Urology. Conclusion Some medical schools launch more Urologic careers than others. Although reasons for these findings are multifactorial, recruitment of Urologic talent pivots on these realities. PMID:21168862
Hsu, Jiann-wien; Hsu, Roy
We describe and analyze the statistics of general physics and laboratory courses in the medical schools of Taiwan. We explore the development of the general physics curriculum for medical students of Taiwan. Also, an approach to designing a general physics course in combination with its application to medical sciences is proposed. We hope this preliminary study can provide a useful reference for physics colleagues in the medical schools of Taiwan to revolutionize the dynamics of teaching phys...
SFU Medical Tourism Research Group
Are you considering going abroad for medical care? The Simon Fraser University Medical Tourism Research Group has developed the following guide to help inform your decision. This information sheet was developed in consultation with health workers, medical tourism professionals, and researchers in order to help you consider the pros and cons of engaging in medical tourism.
Markert, R J
This paper reports an investigation of the incremental validity of noncognitive tests. Incremental validity is the predictive ability of a measure when entered into a regression equation after the routine predictors have first been included. Three noncognitive tests--Rotter Locus of Control, Adjective Check List, and Student Orientations Survey--were administered to a first-year medical school class. When entered after the usual academic predictors of success in medical school--Undergraduate Grade Point Average and Medical College Admission Test--the three noncognitive tests added little to the prediction of first-year medical school Grade Point Average. It is concluded that while noncognitive measures are useful in characterizing a medical school class and in discovering nonacademic correlates of academic success in medical school, limited incremental validity related to first-year academic performance was demonstrated.
Ali, Imran I.; Isaacson, Richard S.; Safdieh, Joseph E.; Finney, Glen R.; Sowell, Michael K.; Sam, Maria C.; Anderson, Heather S.; Shin, Robert K.; Kraakevik, Jeff A.; Coleman, Mary; Drogan, Oksana
Objective: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. Methods: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Results: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were “very satisfied” or “somewhat satisfied,” but more than half experienced “burnout” and 35% had considered relinquishing their role. Conclusion: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. PMID:25305155
Capers, Quinn; Clinchot, Daniel; McDougle, Leon; Greenwald, Anthony G
Implicit white race preference has been associated with discrimination in the education, criminal justice, and health care systems and could impede the entry of African Americans into the medical profession, where they and other minorities remain underrepresented. Little is known about implicit racial bias in medical school admissions committees. To measure implicit racial bias, all 140 members of the Ohio State University College of Medicine (OSUCOM) admissions committee took the black-white implicit association test (IAT) prior to the 2012-2013 cycle. Results were collated by gender and student versus faculty status. To record their impressions of the impact of the IAT on the admissions process, members took a survey at the end of the cycle, which 100 (71%) completed. All groups (men, women, students, faculty) displayed significant levels of implicit white preference; men (d = 0.697) and faculty (d = 0.820) had the largest bias measures (P bias, 48% were conscious of their individual results when interviewing candidates in the next cycle, and 21% reported knowledge of their IAT results impacted their admissions decisions in the subsequent cycle. The class that matriculated following the IAT exercise was the most diverse in OSUCOM's history at that time. Future directions include preceding and following the IAT with more robust reflection and education on unconscious bias. The authors join others in calling for an examination of bias at all levels of academic medicine.
Bullock, Samuel C.; Houston, Earline
Thirty-one black medical students attending five white medical schools were seen in individual interviews of one to two hours to evaluate their perceptions of racism in their medical school education. The interviews focused on racism experienced in high school, college, and medical school. Over one half of the population experienced racism during their high school and college education, while 30 of 31 subjects reported racist experiences in their medical school education. The students reported a variety of methods of coping with racist experiences and emphasized the importance of fellow minority students, faculty, and the minority office in coping with the stresses of racist experiences. Those offering counseling services to minority students should recognize the reality of racist experiences in medical education. PMID:3612829
Krause, Meggan; Vainio, Lauren; Zwetchkenbaum, Samuel; Inglehart, Marita R
The objectives of this study were to explore how U.S. and Canadian dental schools educate students about special needs patients and which challenges and intentions for curricular changes they perceive. Data were collected from twenty-two dental schools in the United States and Canada with a web-based survey. While 91 percent of the programs covered this topic in their clinical education, only 64 percent offered a separate course about special needs patients. The clinical education varied widely. Thirty-seven percent of the responding schools had a special clinical area in their school for treating these patients. These areas had between three and twenty-two chairs and were funded and staffed quite differently. Most programs covered the treatment of patients with more prevalent impairments such as Down syndrome (91 percent), autism spectrum disorders (91 percent), and motion impairments (86 percent). Written exams were the most common outcome assessments (91 percent), while objective structured clinical examinations (18 percent) and standardized patient experiences (9 percent) were used less frequently. The most commonly reported challenge was curriculum overload (55 percent). The majority (77 percent) planned educational changes over the next three years, with 36 percent of schools planning to increase clinical and 27 percent extramural experiences. The findings showed that the responding U.S. and Canadian dental schools had a wide range of approaches to educating predoctoral students about treating special needs patients. In order to eliminate oral health disparities and access to care issues for these patients, future research should focus on developing best practices for educational efforts in this context.
The Japanese medical education program has radically improved during the last 10 years. In 1999, the Task Force Committee on Innovation of Medical Education for the 21st Century proposed a tutorial education system, a core curriculum, and a medical student evaluation system for clinical clerkship. In 2001, the Model Core Curriculum of medical education was instituted, in which medical ethics became part of the core material. Since 2005, a nationwide medical student evaluation system has been applied for entrance to clinical clerkship. Within the Japan Society for Medical Education, the Working Group of Medical Ethics proposed a medical ethics education curriculum in 2001. In line with this, the Japanese Association for Philosophical and Ethical Research in Medicine has begun to address the standardization of the curriculum of medical ethics. A medical philosophy curriculum should also be included in considering illness, health, life, death, the body, and human welfare.
Martin, Glenna C; Kirgis, Julianne; Sid, Eric; Sabin, Janice A
The unequal representation of women and people of color compared with men and whites in medical school textbooks has been well documented, as have health care inequities, and biases-both overt and implicit-by health care providers and in access to care. The authors investigated whether this bias exists in PowerPoint slides used in didactic material for preclinical students at one medical school. The authors analyzed 747 "decks" of slides from 33 preclinical courses in the medical school curriculum at the University of Washington School of Medicine in the years spanning 2009 to 2011. The authors coded the human images into various sex- and race-specific classifications and evaluated the distribution of images into these categories. Of the 4,033 images that could be coded by sex, 39.6% (1,595) were female and 60.5% (2,438) were male. Of the 5,230 images that could be coded by race/ethnicity, 78.4% (4,100) were white and 21.6% (1,130) were persons of color. Thus, images of whites and males predominated. The proportion of images used in didactic courses at one school of medicine is not representative of the U.S. population in terms of race or sex. The authors discuss the potential sources and impact of this bias, make a case for sex and race diversity in didactic imagery, and propose possible avenues for further research and curricular reform in an era when the population is becoming increasingly racially and ethnically diverse.
Statistics on medical education in Canada are presented for 1981-1982, with English and French explanations and tables of contents. Overall areas of concern include undergraduate medical enrollment, graduate medical enrollment for academic and clinical study, research expenditure levels, type and sources of funds, and opportunities for Canadians…
There is deficiency and gaps among medical graduates in performing certain procedures and skills. Till recent years, some school used an apprenticeship model for teaching procedures. The way of teaching skills should be revised and reinforced. Medical schools showed adopt formal curricula based training for teaching ...
Simunović, Vladimir J; Sonntag, Hans-Günther; Hren, Darko; Dørup, Jens; Krivokuća, Zdenka; Bokonjić, Dejan; Verhaaren, Henry; Horsch, Axel; Mimica, Mladen; Vojniković, Benjamin; Selesković, Hajrija; Marz, Richard; Marusić, Ana; Marusić, Matko
To perform internal and external evaluations of all 5 medical schools in Bosnia and Herzegovina against international standards. We carried out a 2-stage survey study using the same 5-point Likert scale for internal and external evaluations of 5 medical schools in Bosnia and Herzegovina (Banja Luka, Foca/East Sarajevo, Mostar, Sarajevo and Tuzla). Participants consisted of managerial staff, teaching staff and students of medical schools, and external expert assessors. Main outcome measures included scores on internal and external evaluation forms for 10 items concerning aspects of school curriculum and functioning: 'School mission and objectives'; 'Curriculum'; 'Management'; 'Staff'; 'Students'; 'Facilities and technology'; 'Financial issues'; 'International relationships'; 'Internal quality assurance', and 'Development plans'. During internal assessment, schools consistently either overrated their overall functioning (Foca/East Sarajevo, Mostar and Tuzla) or markedly overrated or underrated their performance on individual items on the survey (Banja Luka and Sarajevo). Scores for internal assessment differed from those for external assessment. These differences were not consistent, except for the sections 'School mission and objectives', 'Curriculum' and 'Development plans', which were consistently overrated in the internal assessments. External assessments was more positive than internal assessments on 'Students' and 'Facilities and technology' in 3 of 5 schools. This assessment exercise in 5 medical schools showed that constructive and structured evaluation of medical education is possible, even in complex and unfavourable conditions. Medical schools in Bosnia and Herzegovina have successfully formed a national consortium for formal collaboration in curriculum development and reform.
Full Text Available Background: Medical ethics has been accepted as part of every accredited medical curriculum for the past 40 years. Medical students’ attitudes have an important role for development and improvement of the curriculum. Faculty of Medicine Siriraj Hospital is the oldest and largest medical school in Thailand, and has been teaching medical ethics since 1907. Objective: To determine attitudes among medical students and interns toward medical ethics education and understand the factors influencing their attitudes. Methods: Mixed quantitative and qualitative research was conducted with early 6th year medical students and interns. A questionnaire was adapted from previous studies and included some original items. Results: Of the 550 questionnaires distributed, 386 were returned (70.2% response rate. Males (n=180 made up 46.63 % of the sample. Interns (n=219, 56.74 % tended to have more positive attitudes toward ethics learning than did medical students (n = 167, 43.26 %. Male participants tended to agree more with negative statements about ethics learning than did females. There was no statistically significant effect of hometown (Bangkok versus elsewhere or grade point average on attitudes. The main problem cited with medical ethics education was lack of engaging methods. Conclusion: Because clinical experience has an effect on learners’ attitudes towards ethics education, medical ethics should be taught at the appropriate time and with proper techniques, such as drawing explicit ties between ethical principles and real-life situations. Attention to the more detailed aspects of these data should also facilitate improvements to curriculum content, thereby ensuring better educational outcomes.
Osinski, G. R.; Gilbert, A.; Brown, P.
abilities) outline the independent variables, and design an experiment. This is conducted in groups after the proposed experiment is approved by the teacher. (4) Students draw conclusions on their experiment, and present results in the lab hand out and to their peers. Learning outcomes based on the Ontario curriculum have been pre-identified allowing the teachers to know what portion of the curriculum is being taught. Future activities include increasing the number of activity-based learning themes and modules available, implementing more Teacher Training Courses and workshops, increasing the number of schools that participate to the programme and continuing to participate in the annual Science Teacher's Association of Ontario Conference. Acknowledgements: Funding from the Canadian Space Agency's Space Awaremess and Learning program and an Interdisciplinary Development Initiative award from Western has made this program possible. Melissa Battler, Anna Chanou, Heather Henry, Emily McCullough, Alexandra Pontefract, and Alaura Singleton are thanked for their participation in this program.
Sánchez-Román, Francisco Raúl; Medina-Figueroa, Alda María; Rangel-Zertuche, Ricardo Alfonso; Sánchez-Ramos, Apolinar
To analyze the current situation of teaching occupational medicine (OM) in academic programs and medical schools in Mexico. A descriptive survey was conducted and schools were identified through the main directories of medical schools. For the analysis of information descriptive and inferential statistics were used. A total of 75 medical schools were identified. In 39 (52%) the subject is mandatory, with a predominance in public schools (pschools that offer the subject, only 15 (38%) have professors specialized in OM. Disparity in teaching basic aspects of OM in medical schools explains the little development and social and professional recognition of the specialty; it also highlights serious problems for public health, derived from the lack of prevention of risks in work environments.
Babenko, Oksana; Mosewich, Amber; Abraham, Joseph; Lai, Hollis
To investigate the contributions of psychological needs (autonomy, competence, and relatedness) and coping strategies (self-compassion, leisure-time exercise, and achievement goals) to engagement and exhaustion in Canadian medical students. This was an observational study. Two hundred undergraduate medical students participated in the study: 60.4% were female, 95.4% were 20-29 years old, and 23.0% were in year 1, 30.0% in year 2, 21.0% in year 3, and 26.0% in year 4. Students completed an online survey with measures of engagement and exhaustion from the Oldenburg Burnout Inventory-student version; autonomy, competence, and relatedness from the Basic Psychological Needs Scale; self-compassion from the Self-Compassion Scale-short form; leisure-time exercise from the Godin Leisure-Time Exercise Questionnaire; and mastery approach, mastery avoidance, performance approach, and performance avoidance goals from the Achievement Goals Instrument. Descriptive and inferential analyses were performed. The need for competence was the strongest predictor of student engagement (β= 0.35, P= 0.000) and exhaustion (β= -0.33, P= 0.000). Students who endorsed mastery approach goals (β= 0.21, P= 0.005) and who were more self-compassionate (β= 0.13, P= 0.050) reported greater engagement with their medical studies. Students who were less self-compassionate (β= -0.32, P= 0.000), who exercised less (β= -0.12, P= 0.044), and who endorsed mastery avoidance goals (β= 0.22, P= 0.003) reported greater exhaustion from their studies. Students' gender (β= 0.18, P= 0.005) and year in medical school (β= -0.18, P= 0.004) were related to engagement, but not to exhaustion. Supporting students' need for competence and raising students' awareness of self-compassion, leisure-time exercise, and mastery approach goals may help protect students from burnout-related exhaustion and enhance their engagement with their medical school studies.
McIlwraith, Robert D
Comments on the original article by Robiner et al. (see record 2014-07939-001) regarding psychologists in medical schools and academic medical center settings. Robiner et al. reported that their extensive review "revealed no independent departments of psychology in U.S. medical schools." The current authors note north of the border in Canada there is one department of psychology in a medical school. The Department of Clinical Health Psychology has been a department within the Faculty of Medicine of the University of Manitoba since 1995. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Cole, Adam G; Leatherdale, Scott T
The use of alternative tobacco products (ATPs) has grown in popularity among Canadian youth. This study examined the association between a school-level characteristic (the senior student tobacco use rate) and the current use of manufactured cigarettes, little cigars or cigarillos, cigars, roll-your-own cigarettes, smokeless tobacco (SLT), and a hookah among junior students. This study used nationally representative Canadian data from 29,495 students in grades 9 to 12 as part of the 2010/2011 Youth Smoking Survey. For each ATP, we described rates of senior and junior tobacco use, calculated the variance attributed to school-level factors, and examined the association between the senior student (grades 11 and 12) tobacco use rate and the current use of each ATP among junior students (grades 9 and 10) while accounting for relevant student-level characteristics. SAS 9.3 was used for all analyses. Over half of schools sampled had senior students that reported using each ATP. School-level differences accounted for between 14.1% and 29.7% of the variability in ATP current use among junior students. Each one percent increase in the number of senior students at a school that currently use manufactured cigarettes, SLT, or a hookah was significantly independently associated with an increased likelihood that a junior student at that school currently used manufactured cigarettes (OR 1.04, 95% CI 1.01 to 1.06), SLT (OR 1.14, 95% CI 1.06 to 1.24), or a hookah (OR 1.09, 95% CI 1.03 to 1.14). Characteristics of the school environment a junior student attends appear to play an important role in ATP use, and tobacco control programs and policies should be designed to ensure that they include strategies to curb the use of all tobacco products. Additional evidence is needed for the impact of comprehensive school-based tobacco control approaches.
Unlike the schools of old, where students spent two years focused on science and theory before they set foot in a hospital, new medical schools are integrating clinical care into the first two years. Existing schools have taken steps in this direction. But, says John E. Prescott, chief academic officer of the Association of American Medical…
Cole, Leonard A; Wagner, Katherine; Scott, Sandra; Connell, Nancy D; Cooper, Arthur; Kennedy, Cheryl Ann; Natal, Brenda; Lamba, Sangeeta
Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ, USA. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training.
Leonard A Cole
Full Text Available Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training.
Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep
Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…
Full Text Available Abstract Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21; problem-based learning at 29% (n = 10, e-learning at 3% (n = 1, and internship in ambulance service is mandatory at 11% (n = 4. In terms of assessment methods, multiple-choice exams (15 to 70 questions are favoured (89%, n = 31, partially supplemented by open questions (31%, n = 11. Some faculties also perform single practical tests (43%, n = 15, objective structured clinical examination (OSCE; 29%, n = 10 or oral examinations (17%, n = 6. Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard
Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix
Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.
When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists. PMID:23634159
Kamin, Carol; Souza, Kevin H; Heestand, Diane; Moses, Anna; O'Sullivan, Patricia
To describe the current educational technology infrastructure and services provided by North American allopathic medical schools that are members of the Association of American Medical Colleges (AAMC), to present information needed for institutional benchmarking. A Web-based survey instrument was developed and administered in the fall of 2004 by the authors, sent to representatives of 137 medical schools and completed by representatives of 88, a response rate of 64%. Schools were given scores for infrastructure and services provided. Data were analyzed with one-way analyses of variance, chi-square, and correlation coefficients. There was no difference in the number of infrastructure features or services offered based on region of the country, public versus private schools, or size of graduating class. Schools implemented 3.0 (SD = 1.5) of 6 infrastructure items and offered 11.6 (SD = 4.1) of 22 services. Over 90% of schools had wireless access (97%), used online course materials for undergraduate medical education (97%), course management system for graduate medical education (95%) and online teaching evaluations (90%). Use of services differed across the undergraduate, graduate, and continuing medical education continuum. Outside of e-portfolios for undergraduates, the least-offered services were for services to graduate and continuing medical education. The results of this survey provide a benchmark for the level of services and infrastructure currently supporting educational technology by AAMC-member allopathic medical schools.
Morales, Raymond; Rodriguez, Lauren; Singh, Angad; Stratta, Erin; Mendoza, Lydia; Valerio, Melissa A; Vela, Monica
Patients with limited English proficiency (LEP) may be at risk for medical errors and worse health outcomes. Language concordance between patient and provider has been shown to improve health outcomes for Spanish-speaking patients. Nearly 40 % of Hispanics, a growing population in the United States, are categorized as having limited English proficiency. Many medical schools have incorporated a medical Spanish curriculum to prepare students for clinical encounters with LEP patients. To describe the current state of medical Spanish curricula at United States medical schools. The Latino Medical Student Association distributed an e-mail survey comprising 39 items to deans from each U.S. medical school from July 2012 through July 2014. This study was IRB-exempt. Eighty-three percent (110/132) of the U.S. medical schools completed the survey. Sixty-six percent (73/110) of these schools reported offering a medical Spanish curriculum. In addition, of schools with no curriculum, 32 % (12/37) planned to incorporate the curriculum within the next two years. Most existing curricula were elective, not eligible for course credit, and taught by faculty or students. Teaching modalities included didactic instruction, role play, and immersion activities. Schools with the curriculum reported that the diverse patient populations in their respective service areas and/or student interest drove course development. Barriers to implementing the curriculum included lack of time in students' schedules, overly heterogeneous student language skill levels, and a lack of financial resources. Few schools reported the use of validated instruments to measure language proficiency after completion of the curriculum. Growing LEP patient populations and medical student interest have driven the implementation of medical Spanish curricula at U.S. medical schools, and more schools have plans to incorporate this curriculum in the near future. Studies are needed to reveal best practices for developing and
Hsu, Jiann-wien; Hsu, Roy
We describe and analyze the statistics of general physics and laboratory courses in the medical schools of Taiwan. We explore the development of the general physics curriculum for medical students of Taiwan. Also, an approach to designing a general physics course in combination with its application to medical sciences is proposed. We hope this preliminary study can provide a useful reference for physics colleagues in the medical schools of Taiwan to revolutionize the dynamics of teaching physics to the medical students of Taiwan. Copyright © 2011. Published by Elsevier B.V.
Peterson, Carole; Wang, Qi; Hou, Yubo
Recollection of early childhood experiences was investigated in 225 European Canadian and 133 Chinese children (ages 8, 11, and 14) by a memory fluency task that measured accessibility of multiple early memories and elicited the earliest memory. Younger children provided memories of events that occurred at earlier ages than older children.…
Beagan, Brenda L
Faced with an increasingly diverse student body, educators in the health professions struggle for ways to foster equality and understand racism. The concept of 'everyday racism' provides an important tool for examining subtle processes that construct a racialised climate in medical schools and other institutions. To examine the ways racism is understood and experienced within one medical school and investigate the micro level interactional processes that may perpetuate inequality. A survey (n = 72) and interviews (n = 25) were conducted with third year students at one Canadian medical school. A second class was surveyed (n = 61) 3 years later and 25 more students were interviewed. Students identified the linguistic advantage enjoyed by some classmates from ethno-cultural minority groups, but were less likely to identify the advantages enjoyed by white students, who may be more readily granted student-doctor status. Students from racialised minority groups experienced marginalisation through segregation, and struggled to respond appropriately to racist jokes and comments from patients and staff. A third (29%) of those who identified as 'minority' group members did not feel they fitted in particularly well at medical school, compared with only 7% of 'non-minority' students (chi2 P = 0.006; t-test P = 0.004). Medical students from racialised minority groups may experience 'everyday racism', mundane daily practices which intentionally or unintentionally convey disregard, disrespect or marginality. Such experiences are particularly difficult to deal with. Educators have a responsibility to counter with sustained antiracism, learning to acknowledge salient differences without reinforcing hierarchies of superiority and inferiority.
Stegers-Jager, Karen M.; Cohen-Schotanus, Janke; Themmen, Axel P. N.
Medical Education 2012: 46:678688 Context Medical schools wish to better understand why some students excel academically and others have difficulty in passing medical courses. Components of self-regulated learning (SRL), such as motivational beliefs and learning strategies, as well as participation
This study examined the associations between co-occurring cyberbullying and school bullying victimization with poor self-rated mental health, psychological distress, and suicidal ideation and attempts among 4,886 Canadian students in Grades 7-12 and tested whether these associations differed between middle and high school students. There are 12.2% of students who were victims of both cyberbullying and school bullying. After adjusting for covariates, victims of both cyberbullying and school bullying presented the highest odds of poor self-rated mental health (odds ratio [OR] = 5.02; 95% CI [3.75, 6.74]), psychological distress (OR = 5.91; 95% CI [4.38, 7.96]), and suicidal ideation (OR = 6.17; 95% CI [4.44, 8.56]) and attempts (OR = 7.68; 95% CI [3.95, 14.93]). These associations were stronger among middle-school youth than their high school counterparts. Results suggest that victims of both cyberbullying and school bullying may constitute the most vulnerable group and that there is a need for intervention programs addressing both forms of bullying simultaneously, particularly among middle school students.
Moberg, T F; Whitcomb, M E
The present article is the second in a series of Background Papers prepared as part of the AAMC's Medical School Objectives Project (MSOP). This report provides information about and insight into U.S. medical schools' use of educational technology in 1998. The authors define educational technology as the use of information technology to facilitate students' learning. They note that in the last two decades, a number of reports have recommended that medical schools incorporate educational technology into their teaching programs. To gain insight into the effects of these recommendations, particularly those of the ACME-TRI Report in 1992, the authors analyzed the responses of administrators at 125 U.S. medical schools to relevant items of the 1997-98 Liaison Committee on Medical Education Part II Medical School Questionnaire and students' responses to relevant items of the 1998 AAMC Medical Student Graduation Questionnaire. In addition, site visits were made to six medical schools believed to be among the more advanced ones in the use of educational technology, to see what was happening on the "cutting edge" of educational technology applications. Data from 20 other schools were also used. The authors found that by 1998, medical schools as a group had made limited progress in accomplishing the recommended educational technology goals, and that there was a much greater use of such technology in basic sciences courses than in clinical clerkships. However, great variability existed across schools in the use of such technology and in the administrative arrangements for it. They observe that the use of educational technology in medical schools is increasing rapidly, and recommend that each school develop a strategic approach that will guarantee that it can meet the future educational technology needs of its students.
Full Text Available Background and purpose: After two decades of expansion of medical schools and increasing the number of medical students as one of the most attainable solutions for the problem of substandard status of Iranian community health, recently, quality-based policies in medical education have taken priority over most of the national health plans. To determine differences in the field of education between Iranian medical schools by stratifying their educational services.Method: To measure the educational performance that could be utilized to rate the schools nationwide, a benchmarking tool, consisting of more than 60 indicators, was devised. Each school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information. In the next step, all the divisions were visited by one of the project’s members and the school’s representative to revise and approve the data. Then, data retrieval was performed and verified at the project’s office. Finally, a special computer software was exploited to perform the final analysis.Results: There were 45 public and private medical schools nationwide, which were stratified based on their individual scores. Furthermore, all schools were also ranked in each indicator.Conclusion: This study as one of the phases of Strategy Compilation for Educational Missions of the National System of Medical Education, defines the educational strengths and weaknesses of Iranian medical schools that could be used as a measure for authorities to determine the developmental limits and current stance of the medical schools; and optimize their budget and facilities.Keywords: EDUCATION, MEDICAL, IRAN, RANKINGS, EDUCATIONAL PERFORMANCE, STRATIFICATION, SCHOOL,BENCHMARKING, RANKING.
Ohba, Hisateru; Ogasawara, Katsuhiko; Hoshino, Shuhei; Hosoba, Minoru; Okuda, Yasuo; Konishi, Yasuhiko; Ikeda, Ryuji
The purpose of this study was to clarify actual conditions and problems in medical information education and to propose the educational concept to be adopted in medical information. A questionnaire survey was carried out by the anonymous method in June 2008. The survey was intended for 40 radiological technology schools. The questionnaire items were as follows: (1) educational environment in medical information education, (2) content of a lecture in medical information, (3) problems in medical information education. The response rate was 55.0% (22 schools). Half of the responding schools had a laboratory on medical information. Seventeen schools had a medical information education facility, and out of them, approximately 50% had an educational medical information system. The main problems of the medical information education were as follows: (a) motivation of the students is low, (b) the educational coverage and level for medical information are uncertain, (c) there are not an appropriate textbook and educational guidance. In conclusion, these findings suggest that it is necessary to have a vision of medical information education in the education of radiological technologists.
P Ravi Shankar, MD
Full Text Available Medical humanities (MH is using subjects traditionally known as the humanities for specific purposes in medical education. The first author of this manuscript had previously facilitated MH modules in the Himalayan country of Nepal. Since January 2013 he has been facilitating a module for first semester undergraduate medical students in Aruba. The second author has been co-facilitating the module since the last several semesters. In this manuscript the authors described how MH has gradually become more accepted and mainstream in the institution. They also briefly mention the use of movies with a medical theme and activities to further develop on and expand issues addressed during the MH module.
Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving
Chen, Candice; Buch, Eric; Wassermann, Travis; Frehywot, Seble; Mullan, Fitzhugh; Omaswa, Francis; Greysen, S Ryan; Kolars, Joseph C; Dovlo, Delanyo; El Gali Abu Bakr, Diaa Eldin; Haileamlak, Abraham; Koumare, Abdel Karim; Olapade-Olaopa, Emiola Oluwabunmi
Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to
Full Text Available Abstract Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate. An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64 increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68. The most significant reported barriers to increasing the number of
Background Medical tourism describes the private purchase and arrangement of medical care by patients across international borders. Increasing numbers of medical facilities in countries around the world are marketing their services to a receptive audience of international patients, a phenomenon that has largely been made possible by the growth of the Internet. The growth of the medical tourism industry has raised numerous concerns around patient safety and global health equity. In spite of these concerns, there is a lack of empirical research amongst medical tourism stakeholders. One such gap is a lack of engagement with medical tourists themselves, where there is currently little known about how medical tourists decide to access care abroad. We address this gap through examining aspects of Canadian medical tourists’ decision-making processes. Methods Semi-structured phone interviews were administered to 32 Canadians who had gone abroad as medical tourists. Interviews touched on motivations, assessment of risks, information seeking processes, and experiences at home and abroad. A thematic analysis of the interview transcripts followed. Results Three overarching themes emerged from the interviews: (1) information sources consulted; (2) motivations, considerations, and timing; and (3) personal and professional supports drawn upon. Patient testimonials and word of mouth connections amongst former medical tourists were accessed and relied upon more readily than the advice of family physicians. Neutral, third-party information sources were limited, which resulted in participants also relying on medical tourism facilitators and industry websites. Conclusions While Canadian medical tourists are often thought to be motivated by wait times for surgery, cost and availability of procedures were common primary and secondary motivations for participants, demonstrating that motivations are layered and dynamic. The findings of this analysis offer a number of important factors
Full Text Available Abstract Background Medical tourism describes the private purchase and arrangement of medical care by patients across international borders. Increasing numbers of medical facilities in countries around the world are marketing their services to a receptive audience of international patients, a phenomenon that has largely been made possible by the growth of the Internet. The growth of the medical tourism industry has raised numerous concerns around patient safety and global health equity. In spite of these concerns, there is a lack of empirical research amongst medical tourism stakeholders. One such gap is a lack of engagement with medical tourists themselves, where there is currently little known about how medical tourists decide to access care abroad. We address this gap through examining aspects of Canadian medical tourists’ decision-making processes. Methods Semi-structured phone interviews were administered to 32 Canadians who had gone abroad as medical tourists. Interviews touched on motivations, assessment of risks, information seeking processes, and experiences at home and abroad. A thematic analysis of the interview transcripts followed. Results Three overarching themes emerged from the interviews: (1 information sources consulted; (2 motivations, considerations, and timing; and (3 personal and professional supports drawn upon. Patient testimonials and word of mouth connections amongst former medical tourists were accessed and relied upon more readily than the advice of family physicians. Neutral, third-party information sources were limited, which resulted in participants also relying on medical tourism facilitators and industry websites. Conclusions While Canadian medical tourists are often thought to be motivated by wait times for surgery, cost and availability of procedures were common primary and secondary motivations for participants, demonstrating that motivations are layered and dynamic. The findings of this analysis offer a
Fronteira, Inês; Rodrigues, Amabélia; Pereira, Camilo; Silva, Augusto P; Mercer, Hugo; Dussault, Guilles; Ferrinho, Paulo
In Guinea Bissau, the majority of university level professionals are still being trained abroad and most of them do not return to their country. This was a major incentive for creating Guinea Bissau's Medical School. An observational, cross-sectional, analytic study was conducted on the second trimester of 2007 to characterize the socio-demographic, familial and educational profile of medical students, their satisfaction levels, difficulties and expectations concerning the medicine course. A questionnaire was used and a response rate of 63% achieved (81 students). Data was analyzed using SPSS v.17 for descriptive statistics. Students are very committed to their education. They tend to decide to take the medicine course early in their lives and are influenced by their relatives. They choose to be medical doctors because they like it but also for altruistic reasons and the desire to save lives. Although many face financial and material difficulties, they tend to have success in their academic live. They live with their parents, do not have children and some have side jobs to provide for extra income to help with their education. They expect their education to make them good doctors in any part of the world and want to work simultaneously in the public (to serve their country and pay their debt to the State) and in the private sector (to enhance their income). The large majority wants to work in a hospital, in Bissau, and to be a pediatrician or obstetrician. They have unreasonably high expectations concerning their future income as medical doctors.
Sampasa-Kanyinga, Hugues; Roumeliotis, Paul; Xu, Hao
.... The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students...
Attitudes of medical students towards patients, psychosocial factors in illness, and care-delivery have been assessed. The influence of (parts of) the medical curriculum has been studied. Students' evaluations of attitude and communication courses have been investigated. The main results were:
Court, John P M
Charles Darwin's scientific paradigm was largely welcomed in Canadian academic biology and medicine, while reaction among other faculty and laypeople ranged from interest to outrage. In 1874, Ramsay Wright, a Darwinian-era biologist from Edinburgh, was appointed to the University of Toronto's Chair of Natural History. Over his 38-year career Wright integrated the evolutionary perspective into medical and biology teaching without accentuating its controversial source. He also applied the emerging German experimental research model and laboratory technology. This study identifies five categories of scientific and personal influences upon Wright through archival research on biographical sources and his writings.
Meats, Emma; Heneghan, Carl; Crilly, Mike; Glasziou, Paul
It is recognized that clinicians need training in evidence-based medicine (EBM), however there is considerable variation in the content and methods of the EBM curriculum in UK medical schools. To determine current practice and variation in EBM undergraduate teaching in UK medical schools and inform the strategy of medical schools and the National Knowledge Service. We contacted all 32 medical schools in the UK and requested that the person primarily responsible for EBM undergraduate teaching complete a short online survey and provide their EBM curriculum. The survey was completed by representatives from 20 (63%) medical schools and curriculum details were received from 5 (16%). There is considerable variation in the methods and content of the EBM curriculum. Although the majority of schools teach core EBM topics, relatively few allow students to practice the skills or assess such skills. EBM teaching is restricted by lack of curriculum time, trained tutors and teaching materials. Key elements to progress include the integration of EBM with clinical specialties, tutor training and the availability of high-quality teaching resources. The development of a national undergraduate EBM curriculum may help in promoting progress in EBM teaching and assessment in UK medical schools.
Scheffer, Paul; Guy-Coichard, Christian; Outh-Gauer, David; Calet-Froissart, Zoéline; Boursier, Mathilde; Mintzes, Barbara; Borde, Jean-Sébastien
Medical faculties have a role in ensuring that their students are protected from undue commercial influence during their training, and are educated about professional-industry interactions. In North America, many medical faculties have introduced more stringent conflict of interest (COI) policies during the last decade. We asked whether similar steps had been taken in France. We hypothesized that such policies may have been introduced following a 2009-2010 drug safety scandal (benfluorex, Mediator) in which COIs in medicine received prominent press attention. We searched the websites of all 37 French Faculties of Medicine in May 2015 for COI policies and curriculum, using standardized keyword searches. We also surveyed all deans of medicine on institutional COI policies and curriculum, based on criteria developed in similar US and Canadian surveys. Personal contacts were also consulted. We calculated a summary score per faculty based on 13 criteria. [range 0-26; higher scores denoting stronger policies]. In total, we found that 9/37 (24%) of French medical schools had either introduced related curriculum or implemented a COI-related policy. Of these, only 1 (2.5%) had restrictive policies for any category. No official COI policies were found at any of the schools. However, at 2 (5%), informal policies were reported. The maximum score per faculty was 5/26, with 28 (76%) scoring 0. This is the first survey in France to examine COI policies at medical faculties. We found little evidence that protection of medical students from undue commercial influence is a priority, either through institutional policies or education. This is despite national transparency legislation on industry financing of health professionals and limits on gifts. The French National Medical Students Association (ANEMF) has called for more attention to COI in medical education; our results strongly support such a call.
Mateen, Farrah J; McKenzie, Erica D; Rose, Sherri
To report on medical schools in fragile states, countries with severe development challenges, and the impact on the workforce for health care delivery. 2007 and 2012 World Bank Harmonized List of Fragile Situations; 1998-2012 WHO Global Health Observatory; 2014 World Directory of Medical Schools. Fragile classification established from 2007 and 2012 World Bank status. Population, gross national income, health expenditure, and life expectancy were 2007 figures. Physician density was most recently available from WHO Global Health Observatory (1998-2012), with number of medical schools from 2014 World Directory of Medical Schools. Regression analyses assessed impact of fragile state status in 2012 on the number of medical schools in 2014. Fragile states were 1.76 (95 percent CI 1.07-2.45) to 2.37 (95 percent CI 1.44-3.30) times more likely to have fewer than two medical schools than nonfragile states. Fragile states lack the infrastructure to train sufficient numbers of medical professionals to meet their population health needs. © Health Research and Educational Trust.
instruments of data collection. SPSS statistical software version 16.0 was used for the ... during and even after attaining the desired qualification from such school system. The child in school spends more ... the school system, it is not completely devoid of health challenges to the enrolee if adequate measures are not put.
Lynoe, N; Löfmark, R; Thulesius, H O
The goal of the present study was to elucidate what influences medical students' attitudes and interests in medical ethics. At the end of their first, fifth and last terms, 409 medical students from all six medical schools in Sweden participated in an attitude survey. The questions focused on the students' experience of good and poor role models, attitudes towards medical ethics in general and perceived effects of the teaching of medical ethics. Despite a low response rate at some schools, this study indicates that increased interest in medical ethics was related to encountering good physician role models, and decreased interest, to encountering poor role models. Physicians involved in the education of medical students seem to teach medical ethics as role models even when ethics is not on the schedule. The low response rate prevents us from drawing definite conclusions, but the results could be used as hypotheses to be further scrutinised.
Jorm, Christine; Roberts, Chris
Contemporary medical school evaluations are narrow in focus and often do not consider the wider systems implications of the relationship between learning and teaching, research, clinical care, and community engagement. The result is graduates who lack the necessary knowledge and skills for the modern health care system and an educational system that is limited in its ability to learn and change.To address this issue, the authors apply complexity theory to medical school evaluation, using four key factors-nesting, diversity, self-organization, and emergent outcomes. To help medical educators apply this evaluation approach in their own settings, the authors offer two tools-a modified program logic model and sensemaking. In sensemaking, they use the organic metaphor of the medical school as a neuron situated within a complex neural network to enable medical educators to reframe the way they think about program evaluation. The authors then offer practical guidance for applying this model, including describing the example of addressing graduates' engagement in the health care system. The authors consider the input of teachers, the role of culture and curriculum, and the clinical care system in this example.Medical school evaluation is reframed as an improvement science for complex social interventions (medical school is such an intervention) in this model. With complexity theory's focus on emergent outcomes, evaluation takes on a new focus, reimagining medical students as reaching their future potential as change agents, who transform health systems and the lives of patients.
Mileder, Lukas Peter
Junior medical staff provides a large proportion of undergraduate student education. However, despite increasing numbers of resident-as-teacher training programs, junior doctors may still not be sufficiently prepared to teach medical students. Hence, medical schools should consider implementing formal teaching skills training into undergraduate curricula.
Salomons, Greg J; Kelly, Diane
This paper reports on a survey of medical physicists who write and use in-house written software as part of their professional work. The goal of the survey was to assess the extent of in-house software usage and the desire or need for related software quality guidelines. The survey contained eight multiple-choice questions, a ranking question, and seven free text questions. The survey was sent to medical physicists associated with cancer centers across Canada. The respondents to the survey expressed interest in having guidelines to help them in their software-related work, but also demonstrated extensive skills in the area of testing, safety, and communication. These existing skills form a basis for medical physicists to establish a set of software quality guidelines.
Hoferichter, Frances; Raufelder, Diana; Eid, Michael; Bukowski, William M.
This cross-national study investigates the perception of the impact of students' relationships towards teachers and peers on scholastic motivation in a total sample of 1477 seventh and eighth grade German (N?=?1088) and Canadian (N?=?389) secondary school students. By applying Multigroup Confirmatory Latent Class Analysis in Mplus we confirmed…
where a person in a position of power harasses a subordinate) and contra power sexual harassment, (where a subordinate is the harasser of authority figure) in medical schools in Ghana. among. Design: Cross-sectional study. Method: Four ...
Full Text Available Background. Psychotropic medications, in particular second-generation antipsychotics (SGAs and benzodiazepines, have been associated with harm in elderly populations. Health agencies around the world have issued warnings about the risks of prescribing such medications to frail individuals affected by dementia and current guidelines recommend their use only in cases where the benefits clearly outweigh the risks. This study documents the use of psychotropic medications in the entire elderly population of a Canadian province in the context of current clinical guidelines for the treatment of behavioural disturbances. Methods. Prevalent and incident utilization of antipsychotics, benzodiazepines and related medications (zopiclone and zaleplon were determined in the population of Manitobans over age 65 in the time period 1997/98 to 2008/09 fiscal years. Comparisons between patients living in the community and those living in personal care (nursing homes (PCH were conducted. Influence of sociodemographic characteristics on prescribing was assessed by generalized estimating equations. Non-optimal use was defined as the prescribing of high dose of antipsychotic medications and the use of combination therapy of a benzodiazepine (or zopiclone/zaleplon with an antipsychotic. A decrease in intensity of use over time and lower proportions of patients treated with antipsychotics at high dose or in combination with benzodiazepines (or zopiclone/zaleplon was considered a trend toward better prescribing. Multiple regression analysis determined predictors of non-optimal use in the elderly population. Results. A 20-fold greater prevalent utilization of SGAs was observed in PCH-dwelling elderly persons compared to those living in the community. In 2008/09, 27% of PCH-dwelling individuals received a prescription for an SGA. Patient characteristics, such as younger age, male gender, diagnoses of dementia (or use of an acetylcholinesterase inhibitor or psychosis in the
Alessi-Severini, Silvia; Dahl, Matthew; Schultz, Jennifer; Metge, Colleen; Raymond, Colette
Background. Psychotropic medications, in particular second-generation antipsychotics (SGAs) and benzodiazepines, have been associated with harm in elderly populations. Health agencies around the world have issued warnings about the risks of prescribing such medications to frail individuals affected by dementia and current guidelines recommend their use only in cases where the benefits clearly outweigh the risks. This study documents the use of psychotropic medications in the entire elderly population of a Canadian province in the context of current clinical guidelines for the treatment of behavioural disturbances. Methods. Prevalent and incident utilization of antipsychotics, benzodiazepines and related medications (zopiclone and zaleplon) were determined in the population of Manitobans over age 65 in the time period 1997/98 to 2008/09 fiscal years. Comparisons between patients living in the community and those living in personal care (nursing) homes (PCH) were conducted. Influence of sociodemographic characteristics on prescribing was assessed by generalized estimating equations. Non-optimal use was defined as the prescribing of high dose of antipsychotic medications and the use of combination therapy of a benzodiazepine (or zopiclone/zaleplon) with an antipsychotic. A decrease in intensity of use over time and lower proportions of patients treated with antipsychotics at high dose or in combination with benzodiazepines (or zopiclone/zaleplon) was considered a trend toward better prescribing. Multiple regression analysis determined predictors of non-optimal use in the elderly population. Results. A 20-fold greater prevalent utilization of SGAs was observed in PCH-dwelling elderly persons compared to those living in the community. In 2008/09, 27% of PCH-dwelling individuals received a prescription for an SGA. Patient characteristics, such as younger age, male gender, diagnoses of dementia (or use of an acetylcholinesterase inhibitor) or psychosis in the year prior
Guy, Pierre; Sheehan, Katie J; Morin, Suzanne N; Waddell, James; Dunbar, Michael; Harvey, Edward; Sirett, Susan; Sobolev, Boris; Kuramoto, Lisa; Tang, Michael
Failure to account for medically necessary delays may lead to an underestimation of early surgery benefits. This study investigated the feasibility of using administrative data to identify the National Institute for Health and Care Excellence (NICE) 124 guideline list of conditions that appropriately delay hip fracture surgery. We assembled a list of diagnosis and procedure codes to reflect the NICE 124 conditions. The list was reviewed and updated by an advanced clinical coder. The list was refined by five clinical experts. We then screened Canadian Institute for Health Information discharge abstracts for 153 918 patients surgically treated for a non-pathological first hip fracture between 1 January 2004 and 31 December 2012 for diagnosis codes present on admission and procedure codes that antedated hip fracture surgery. We classified abstracts as having medical reasons for delaying surgery based on the presence of these codes. In total, 10 237 (6.7%; 95% CI 6.5% to 6.8%) patients had diagnostic and procedure codes indicating medical reasons for delay. The most common reasons for medical delay were exacerbation of a chronic chest condition (35.9%) and acute chest infection (23.2%). The proportion of patients with reasons for medical delays increased with time from admission to surgery: 3.9% (95% CI 3.6% to 4.1%) for same day surgery; 4.7% (95% CI 4.5% to 4.8%) for surgery 1 day after admission; 7.1% (95% CI 6.9% to 7.4%) for surgery 2 days after admission; and 15.5% (95% CI 15.1% to 16.0%) for surgery more than 2 days after admission. The trend was seen for admissions on weekday working hours, weekday after hours and on weekends. Administrative data can be considered to identify conditions that appropriately delay hip fracture surgery. Accounting for medically necessary delays can improve estimates of the effectiveness of early surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights
Richmond, Robyn; Zwar, Nicholas; Taylor, Rachel; Hunnisett, Joanne; Hyslop, Fran
As medical practitioners of the future, medical students should be taught about tobacco control strategies and smoking cessation interventions. By including education about tobacco in the medical curricula, they can be informed about the health effects of tobacco use and learn to assist smokers to quit. Our study aimed to estimate the extent of teaching about tobacco and smoking cessation techniques in medical schools worldwide and compare with results we reported 10 years ago, to determine the content of curricula and range of teaching formats and to identify barriers to teaching about tobacco in medical schools and solutions. A cross-sectional survey of all existing medical schools (n = 2090) in 171 countries was conducted. A questionnaire was designed, translated and sent to all medical schools. Main outcome measures included whether and how tobacco is taught; comparisons with the survey conducted 10 years ago; tobacco content in the curriculum; format of teaching; and barriers to teaching and solutions. 665 medical schools from 109 countries completed the full questionnaire, with a response rate of 31.8% from medical schools and 64% of countries and consisting of 39% of medical schools in developed and 28% in less developed countries. A further 67 medical schools responded to a single question on whether they taught about tobacco. The total response rate was 35%. Of 561 medical schools responding to questions on teaching options, 27% of medical schools taught a specific module on tobacco compared with only 11% in our survey of medical schools conducted a decade ago; 77% integrated teaching on tobacco with other topics compared with 40% 10 years ago; 31% taught about tobacco informally as the topic arose (vs. 58%) and 4% did not teach about tobacco (vs. 12%). Most common topics taught were: health effects of smoking (94%), health effects of passive smoking (84.5%), epidemiology of tobacco use (81%), nicotine dependence (78%) and taking a smoking history (75
Jefferies, Richard; Sheriff, Ibrahim H N; Matthews, Jacob H; Jagger, Olivia; Curtis, Sarah; Lees, Peter; Spurgeon, Peter C; Fountain, Daniel Mark; Oldman, Alex; Habib, Ali; Saied, Azam; Court, Jessica; Giannoudi, Marilena; Sayma, Meelad; Ward, Nicholas; Cork, Nick; Olatokun, Olamide; Devine, Oliver; O'Connell, Paul; Carr, Phoebe; Kotronias, Rafail Angelos; Gardiner, Rebecca; Buckle, Rory T; Thomson, Ross J; Williams, Sarah; Nicholson, Simon J; Goga, Usman
Purpose Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues. Design/methodology/approach This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement. Findings Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods. Research limitations/implications There is widespread inclusion of MLM in UK medical schools' curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students' desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these. Originality/value This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.
O’Brien, Bridget C.; Brian Niehaus; Arianne Teherani; Young, John Q.
Objectives: To characterize junior residents' perspectives on the purpose, value, and potential improvement of the final year of medical school. Methods: Eighteen interviews were conducted with junior residents who graduated from nine different medical schools and who were in internal medicine, surgery, and psychiatry programs at one institution in the United States. Interview transcripts were coded and analyzed inductively for themes. Results: Participants' descriptions of the purpose of the...
Thakore, Sidd; Ismail, Zahinoor; Jarvis, Scott; Payne, Eric; Keetbaas, Shayne; Payne, Rob; Rothenburg, Lana
Objective: The authors aim to quantify the extent, and to assess student perception, of alcohol and tobacco use among medical students at the University of Calgary, and the relationship of these attitudes to problem drinking (according to the CAGE questionnaire). Methods: A questionnaire was distributed to first-, second-, and third-year medical…
Caramiciu, Justin; Arcella, David; Desai, Manisha S
To determine the extent to which the history of medicine (HOM) and its related topics are included within the curriculum of accredited medical schools in the United States. Survey instrument. US allopathic medical schools. An online survey was sent to officials from every medical school in the US. Respondents were asked to provide institutional identifiers, the presence of an HOM elective offered to medical students, the years during which the elective is offered, the existence of an HOM department, and the contact information for that particular department. Nonresponders were contacted by phone to elicit the same information. History of medicine electives included didactic sessions and seminars with varying degrees of credit offered in different years of medical school. Based on responses from 119 of 121 contacted medical schools (98%), 45 (37%) included formal lectures or weekly seminars in the medical school curriculum. Five (11%) curricula had or have required HOM, whereas 89% offered elective HOM instruction. Course duration and credit awarded varied. Eighteen (15%) medical schools included departments dedicated to HOM. Providing education in HOM was limited by faculty interest, clinical training hours, and low interest. Data collected by our study suggest that substantial barriers exist within the academic medical community towards a wider acceptance of the importance of HOM. Causes for such lack of interest include absence of questions on written or oral tests related to HOM, difficulty in publishing articles related to HOM in peer reviewed journals, near absence of research grants in HOM, difficulty in getting academic promotions or recognition for activities related to HOM, and a lack of support from academic chairpersons for activities related to HOM. Copyright © 2015 Anesthesia History Association. Published by Elsevier Inc. All rights reserved.
Shin, Hong-Im; Jeon, Woo Tack; Yang, Eunbae B
Cognitive researchers assume that learning strategies are related to three types of learning processes: 'surface learning,' 'strategy learning,' and 'deep learning.' A 'deep learning' approach is widely accepted to be associated with long-term success in medical school, contributing to the development of doctors who take desirable approaches to self-directed learning and studying in medical practice. Therefore, this study measured how medical students learn and determined whether the use of learning strategies differs between high and low academic performers. In addition, we compared medical college students with graduate medical school students with regard to the use of learning strategies. To explore the learning strategies of students and their relation to academic achievement, we performed LIST (Learning Strategies in Higher Education Inventory) in a sample of 111 Year 1 medical students. Medical students with high academic performance scored higher in most learning strategies than low performers. Additionally, learning strategies were used more frequently by graduate medical school students than medical students, specifically with regard to organization, elaboration, critical thinking, and time management. We conclude that learning strategy instruments provide information that enables medical students to optimize their study. To foster deep learning and intrinsic motivation in students, it might also be necessary to adopt more changes in teaching and assessment in medical schools.
Journal of Blacks in Higher Education, 2001
Reviews the racial history of Harvard University Medical School. Highlights include: the schools' founding (1782); unsuccessful petitioning by black men for entry (1850); graduation of the first black student (1896); graduation of the first black women (1951); attacks on affirmative action policies (1976); founding of the Coleus Society (1988);…
Aktan, Ahmet O.; Gulluoglu, Bahadir M.
In Turkey there are 83 medical schools and the oldest six are regarded as the best institutions. Marmara University School of Medicine (MUSM) is one of the 6 leading institutions. MUSM Hospital was delivered to Turkish Ministry of Health (TMoH) for its operational management in 2010. In this study, we aim to assess the current status and trend of…
DuPaul, George J.; And Others
Information is presented to familiarize school psychologists with (1) behavioral effects and side-effects associated with stimulant medications used for the Attention-Deficit Hyperactivity Disorder (ADHD); (2) factors to consider in recommending medicine trials for individual children; (3) methods to assess treatment response within schools; and…
Medical emergencies can happen in any school at any time. They can be the result of preexisting health problems, accidents, violence, unintentional actions, natural disasters, and toxins. Premature deaths in schools from sudden cardiac arrest, blunt trauma to the chest, firearm injuries, asthma, head injuries, drug overdose, allergic reactions,…
Walton, Merrilyn; Woodward, Helen; Van Staalduinen, Samantha; Lemer, C; Greaves, F; Noble, D; Ellis, B; Donaldson, L; Barraclough, B
The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate patient safety learning into existing curriculum. To address this gap and provide a foothold for medical schools all around the world, the WHO's World Alliance for Patient Safety sponsored the development of a patient safety curriculum guide for medical students. The WHO Patient Safety Curriculum Guide for Medical Schools adopts a 'one-stop-shop' approach in that it includes a teacher's manual providing a step-by-step guide for teachers new to patient safety learning as well as a comprehensive curriculum on the main patient safety areas. This paper establishes the need for patient safety education of medical students, describes the development of the WHO Patient Safety Curriculum Guide for Medical Schools and outlines the content of the Guide.
Full Text Available Glaucoma is a medical term describing a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and retinal nerve fibre layer and resulting in changes in the optic nerve head. Glaucoma is a leading cause of irreversible vision loss worldwide. With the aging population it is expected that the prevalence of glaucoma will continue to increase. Despite recent advances in imaging and visual field testing techniques that allow establishment of earlier diagnosis and treatment initiation, significant numbers of glaucoma patients are undiagnosed and present late in the course of their disease. This can lead to irreversible vision loss, reduced quality of life, and a higher socioeconomic burden. Selection of therapeutic approaches for glaucoma should be based on careful ocular examination, patient medical history, presence of comorbidities, and awareness of concomitant systemic therapies. Therapy should also be individualized to patients’ needs and preferences. Recent developments in this therapeutic field require revisiting treatment algorithms and integration of traditional and novel approaches in order to ensure optimal visual outcomes. This article provides an overview of recent developments and practice trends in the medical management of glaucoma in Canada. A discussion of the surgical management is beyond the scope of this paper.
Bainbridge, Joyce; Carbonaro, Mike; Green, Nicole
This article presents the findings of an online survey administered to Alberta elementary school teachers in 2000-2001. The survey explored the teachers' knowledge and use of Canadian children's literature and their thoughts about the role of Canadian literature in elementary school classrooms. Canadian children's trade books espouse particular…
Papadakis, Maxine A; Teherani, Arianne; Banach, Mary A; Knettler, Timothy R; Rattner, Susan L; Stern, David T; Veloski, J Jon; Hodgson, Carol S
Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. The study included 235 graduates of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003 (case physicians). The 469 control physicians were matched with the case physicians according to medical school and graduation year. Predictor variables from medical school included the presence or absence of narratives describing unprofessional behavior, grades, standardized-test scores, and demographic characteristics. Narratives were assigned an overall rating for unprofessional behavior. Those that met the threshold for unprofessional behavior were further classified among eight types of behavior and assigned a severity rating (moderate to severe). Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical school (odds ratio, 3.0; 95 percent confidence interval, 1.9 to 4.8), for a population attributable risk of disciplinary action of 26 percent. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility (odds ratio, 8.5; 95 percent confidence interval, 1.8 to 40.1) and severely diminished capacity for self-improvement (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.2). Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school (1 percent and 7 percent population attributable risk, respectively), but the association with these variables was less strong than that with
Malik Samina; Hasan Shahid; Shah Mohsin; Sreeramareddy Chandrashekhar T
Abstract Background Recently there is a growing concern about stress during undergraduate medical training. However, studies about the same are lacking from Pakistani medical schools. The objectives of our study were to assess perceived stress, sources of stress and their severity and to assess the determinants of stressed cases. Methods A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of CMH Lahore Medical College, Pakistan during January to ...
Rademakers, J.J.D.J.M.; Muijsenbergh, M.E.T.C. van den; Slappendel, G.; Lagro-Janssen, A.L.M.; Borleffs, J.C.C.
Context Sexual harassment of medical students has been the focus of many international studies. Prevalence rates from 18% to over 60% have been reported. However, a Dutch study at Nijmegen Medical School found the prevalence rate to be lower (13.3% in the total group; 20% among female students
Rademakers, J.J.D.J.M.; Muijsenbergh, M.E.T.C. van den; Slappendel, G.; Lagro-Janssen, A.L.M.; Borleffs, J.C.C.
CONTEXT: Sexual harassment of medical students has been the focus of many international studies. Prevalence rates from 18% to over 60% have been reported. However, a Dutch study at Nijmegen Medical School found the prevalence rate to be lower (13.3% in the total group; 20% among female students
Education of the General Practitioner and the Other Medical Schools in. R. S. TEN CATE, Wassenaar, The Netherlands in Leyden. Holland*. SUMMARY. The new medical curriculum and specialization in the. Netherlands are discussed. In Leyden a 'peripheral clinic' has been established where 128 GPs work together with.
de Visser, Marieke; Fluit, Cornelia; Fransen, Jaap; Latijnhouwers, Mieke; Cohen-Schotanus, Janke; Laan, Roland F. J.
In the Netherlands, students are admitted to medical school through (1) selection, (2) direct access by high pre-university Grade Point Average (pu-GPA), (3) lottery after being rejected in the selection procedure, or (4) lottery. At Radboud University Medical Center, 2010 was the first year we
de Visser, Marieke; Fluit, Cornelia; Fransen, Jaap; Latijnhouwers, Mieke; Cohen-Schotanus, Janke; Laan, Roland
In the Netherlands, students are admitted to medical school through (1) selection, (2) direct access by high pre-university Grade Point Average (pu-GPA), (3) lottery after being rejected in the selection procedure, or (4) lottery. At Radboud University Medical Center, 2010 was the first year we selected applicants. We designed a procedure based on…
I note disquiet among those who teach in the regions medical schools. Two recent articles in this journal report their unresponsiveness to the needs of the students and, even more importantly, to the needs of the populace who look towards them to provide the medical services the region sorely needs. The issue of this ...
My exploration of the nature of the high school music experience was undertaken with 33 young adults who had graduated from high school one to six years previous to the data collection. All of these participants had been involved in their school music programmes and 30 had not continued formal music study following graduation. One might predict…
The residential school system is one of the darkest examples of Canada's colonial policy. Education about the residential schools is believed to be the path to reconciliation; that is, the restoration of equality between Aboriginal and non-Aboriginal peoples in Canada. While the acquisition of the long-ignored history of residential schools has…
Kötter, Thomas; Wagner, Josefin; Brüheim, Linda; Voltmer, Edgar
Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the "Perceived Medical School Stress Instrument" (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance. We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students (n = 456). PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students' M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance. PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students' M1 grade. More research is needed to identify potential confounders.
Bercovitch, Lionel; Long, Thomas P
Both American and Canadian residency accreditation bodies have formal requirements in core competencies that include training in ethics and professionalism without prescribing content. A structured seminar series in medical ethics and professionalism relating to dermatology practice was started at Brown Medical School's dermatology residency in 2001. Methods of instruction include discussion groups, review of medical and lay literature, book review, didactic teaching, case presentation, and informal e-mail exchange. Some of the topics that have been covered include basic medical ethics, research ethics, physician-industry relationships, truth telling, privacy and confidentiality, duty to treat, and ethical and legal issues in cosmetic dermatology, dermatologic surgery, dermatologic genetics, occupational dermatology, and pediatric dermatology. The main goals of the curriculum are to fulfill the core competency requirement in professionalism of the specialty certifying boards, introduce trainees to the cross-disciplinary literature of biomedical ethics and current ethical controversies, and encourage dialogue on ethics and professionalism among faculty, colleagues in other specialties, and dermatology trainees.
Miller, Lynn E; Weiss, Richard M
The dramatic decline in the number of US medical schools in the early twentieth century has been traced to a medical education reform movement that gained momentum after the Civil War. The major parties to reform-the universities themselves, the Association of American Medical Colleges (AAMC), state licensing boards, the American Medical Association (AMA), and Flexner-had different interests and strategies, however, and scholars have continued to debate the impact each had on the decline. To isolate the independent effects that the temporally intertwined forces for reform had on medical school failures, this study applies statistical survival analysis to an extensive and unique data set on medical schools operating in the United States between 1870 and 1930. Contrary to the views of some scholars, the results indicate that schools closed in response to critical evaluations published by the Illinois State Board of Health in the nineteenth century and the AMA and Flexner in the twentieth century. Additionally, the results indicate that schools were less likely to have failed if they adopted certain reforms implemented at leading schools or joined the AAMC, and were more likely to have failed if their state's licensing regulations mandated lengthier premedical and medical training.
Yoshioka, Toshimasa; Nara, Nobuo
An internationalization of practical medicine evoked international migrations of medical professionals. Since basic medical education is different among countries, the internationalization required international quality assurance of medical education. Global trend moves toward establishment of international accreditation system based on international standards. The World Federation for Medical Education proposed Global Standards for Quality Improvement as the international standards. Medical schools in Japan have started to establish program evaluation system. The standards which incorporated international standards have been published. The system for accreditation is being considered. An accreditation body, Japan Accreditation Council for Medical Education, is under construction. The accreditation is expected to enhance quality of education in Japan.
Full Text Available Virginia S Cowen,1 Vicki Cyr2 1Rutgers School of Health Related Professions Institute for Complementary and Alternative Medicine, Newark, NJ, USA; 2Department of Interdisciplinary Studies at the Rutgers University School of Health Related Professions, Newark, NJ, USA Abstract: An analysis of complementary and alternative medicine (CAM in US medical school curriculum was undertaken. Websites for 130 US medical schools were systematically analyzed for course listings and content. Half of the schools (50.8% offered at least one CAM course or clerkship. A total of 127 different course listings were identified, embracing a range of topics and methods of instruction. The most frequently listed topics were traditional medicine, acupuncture, spirituality, and herbs, along with the general topic of CAM. Nearly 25.0% of the courses referenced personal growth or self-care through CAM practices, while only 11.0% referenced inter-professional education activities involving interaction with CAM providers. The most frequently reported instructional methods were lectures, readings, and observation of, or receiving a CAM treatment. The findings of this analysis indicated fewer medical schools offered instruction in CAM than previously reported and a wide range of approaches to the topic across the schools where CAM is taught. Keywords: complementary and alternative medicine, CAM, medical education, curriculum
Full Text Available Background: The Medical Council of Canada and most Canadian residency programs require international medical graduates seeking training in Canada to pass the Medical Council of Canada Entrance Examination, in addition to the newly established National Collaborative Assessment. In order to facilitate this additional examination, the Medical Council of Canada has altered the suggested examination timeline and examination eligibility criteria. Methods: A cross-sectional survey was sent via an online survey tool to members of the North American Irish Medical Student Association. The survey aimed to elicit differences in the Medical Council of Canada Entrance Examination experience between two cohorts of Canadians studying abroad in Ireland: those who completed the examination before and after the new timeline. Statistical analysis was conducted with independent t-tests and Pearson’s Chi-Square tests using SPSS version 21. Results: Of 24 respondents, 13 had completed the examination after the timeline change. Participants who attended the examination prior to the change achieved higher results (353.8 ± 56.5 than participants who attended the examination after the change (342.3 ± 35.1, although not statistically significant (p=0.56. In the cohort who took the examination after the timeline change, 61.5% of participants expressed discontent with their examination results; 84.6% ‘strongly agreed’ or ‘agreed’ to feeling disadvantaged due to the change. Conclusion: The new Medical Council of Canada examination timeline has had an impact on the examination experience of Canadians studying in Ireland. Simple modifications to the current timeline are warranted to reduce unnecessary disadvantage for this cohort of students applying to postgraduate training in Canada.
Norman, I D; Aikins, M; Binka, F N
This study investigated the prevalence and incidence of Traditional (where a person in a position of power harasses a subordinate) and contra power sexual harassment, (where a subordinate is the harasser of authority figure) in medical schools in Ghana. among. Cross-sectional study. Four hundred and nine medical students from four medical schools in Ghana were interviewed. We also considered if academic and financial dependence would predict either traditional or contra power sexual harassment. We further investigated, whether women were more bothered by sexual harassment than men and the correlation between sexual harassment and health. Women were 61% more likely to be sexually harassed than men 39%. Sexual harassment negatively affects the victims' health outcome. We found that the traditional form of sexual harassment was prevalent in medical schools in Ghana and that academic dependence predicted attacks. In the first and second years, women at these institutions are more likely to be sexually harassed than men. Sexual harassment policies of medical school need to be widely circulated. The various medical schools should provide reporting procedures and counseling for victims. This paper would inform policy and research.
Rezansoff, Stefanie N; Moniruzzaman, Akm; Fazel, Seena; McCandless, Lawrence; Somers, Julian M
Preliminary evidence suggests that adherence to antipsychotic medication reduces criminal recidivism among patients diagnosed with schizophrenia. However, existing studies operationalize antipsychotic adherence as a binary variable (usually using a threshold of ≥80%), which does not reflect the prevalence of suboptimal adherence in real-world settings. The purpose of the current analysis was to investigate the association between successive ordinal levels of antipsychotic adherence and criminal recidivism in a well-defined sample of offenders diagnosed with schizophrenia (n = 11462). Adherence was measured using the medication possession ratio (MPR) and analyzed as a time-dependent covariate in multivariable regression models. Data were drawn from linked, comprehensive diagnostic, pharmacy and justice system records, and individuals were followed for an average of 10 years. Adjusted rate ratios (ARR) and confidence intervals (CI) are reported. Overall mean MPR was 0.41. Increasing levels of antipsychotic adherence were not associated with progressively lower rates of offending. However, when compared to the reference group (MPR ≥ 80%) all lower adherence levels were significantly associated (P recidivism. Future research addressing functional outcomes of antipsychotic adherence should conceptualize adherence as an incremental independent variable. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
de Oliveira Vidal, Edison Iglesias; Silva, Vanessa Dos Santos; Santos, Maria Fernanda Dos; Jacinto, Alessandro Ferrari; Boas, Paulo José Fortes Villas; Fukushima, Fernanda Bono
The exposure to unethical and unprofessional behavior is thought to play a major role in the declining empathy experienced by medical students during their training. We reflect on the reasons why medical schools are tolerant of unethical behavior of faculty. First, there are barriers to reporting unprofessional behavior within medical schools including fear of retaliation and lack of mechanisms to ensure anonymity. Second, deans and directors do not want to look for unethical behavior in their colleagues. Third, most of us have learned to take disrespectful circumstances in health care institutions for granted. Fourth, the accreditation of medical schools around the world does not usually cover the processes or outcomes associated with fostering ethical behavior in students. Several initiatives promise to change that picture. © 2015 Annals of Family Medicine, Inc.
Shah, Mohsin; Hasan, Shahid; Malik, Samina; Sreeramareddy, Chandrashekhar T
.... However, studies about the same are lacking from Pakistani medical schools. The objectives of our study were to assess perceived stress, sources of stress and their severity and to assess the determinants of stressed cases...
Huang, Lei; Cheng, Liming; Cai, Qiaoling; Kosik, Russell Olive; Huang, Yun; Zhao, Xudong; Xu, Guo-Tong; Su, Tung-Ping; Chiu, Allen Wen-Hsiang; Fan, Angela Pei-Chen
Curriculum reform at Chinese medical schools has attracted a lot of attention recently. Several leading medical schools in China have undergone exploratory reforms and in so doing, have accumulated significant experience and have made considerable progress. An analysis of the reforms conducted by 38 Chinese medical colleges that were targeted by the government for upgrade was performed. Drawing from both domestic and international literature, we designed a questionnaire to determine what types of curricular reforms have occurred at these institutions and how they were implemented. Major questions touched upon the purpose of the reforms, curricular patterns, improvements in teaching methods post-reform, changes made to evaluation systems post-reform, intra-university reform assessment, and what difficulties the schools faced when instituting the reforms. Besides the questionnaire, relevant administrators from each medical school were also interviewed to obtain more qualitative data. Out of the 38 included universities, twenty-five have undergone major curricular reforms. Among them, 60.0% adopted an organ system-based curriculum model, 32.0% adopted a problem-based curriculum model, and 8.0% adopted a hybrid curriculum model. About 60.0% of the schools' reforms involved both the "pre-clinical" and the "clinical" curricula, 32.0% of the schools' reforms were limited to the "pre-clinical" curricula, and 8.0% of the schools' reforms only involved the "clinical" curricula. Following curricular reform, 60.0% of medical schools experienced an overall reduction in teaching hours, 76.0% reported an increase in their students' clinical skills, and 60.0% reported an increase in their students' research skills. Medical curricular reform is still in its infancy in China. The republic's leading medical schools have engaged in various approaches to bring innovative teaching methods to their respective institutions. However, due to limited resources and the shackle of traditional
Sa, B; Baboolal, N; Williams, S; Ramsewak, S
Objective: To explore the emotional intelligence (EI) in medical students in a Caribbean medical school and investigate its association with gender, age, year of study and ethnicity. Design and Methods: A cross-sectional design using convenient sampling of 304 years two to five undergraduate medical students at the School of Medicine, The University of the West Indies (UWI), St Augustine campus, was conducted. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-V2.0) was administered to test four branches of EI: perceiving emotions, facilitating thought, understanding emotions and managing emotions. Data were analysed using SPSS version 19. T-test, analysis of variance (ANOVA) and r (product moment correlation) were calculated to establish the effects of selected variables (gender, age, year of study and ethnicity) on total and sub-scales EI scores and tested against 0.05 and 0.01 significance levels. Results: The total mean score for EI fell within the average according to MSCEIT standards. Gender analysis showed significantly higher scores for males and for younger age groups (emotional stability. It would be valuable to widen this study by including other UWI campuses and offshore medical schools in the Caribbean. This preliminary study examined a sample of medical students from a well-established Caribbean medical school. Since EI is considered to be important in the assessment and training of medical undergraduates, consideration should be given to introducing interventions aimed at increasing EI. PMID:25303251
Sa, B; Baboolal, N; Williams, S; Ramsewak, S
To explore the emotional intelligence (EI) in medical students in a Caribbean medical school and investigate its association with gender, age, year of study and ethnicity. A cross-sectional design using convenient sampling of 304 years two to five undergraduate medical students at the School of Medicine, the University of the West Indies (UWI), St Augustine campus, was conducted. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-V2.0) was administered to test four branches of EI: perceiving emotions, facilitating thought, understanding emotions and managing emotions. Data were analysed using SPSS version 19. T-test, analysis of variance (ANOVA) and r (product moment correlation) were calculated to establish the effects of selected variables (gender, age, year of study and ethnicity) on total and sub-scales EI scores and tested against 0.05 and 0.01 significance levels. The total mean score for EI fell within the average according to MSCEIT standards. Gender analysis showed significantly higher scores for males and for younger age groups (emotional stability. It would be valuable to widen this study by including other UWI campuses and offshore medical schools in the Caribbean. This preliminary study examined a sample of medical students from a well-established Caribbean medical school. Since EI is considered to be important in the assessment and training of medical undergraduates, consideration should be given to introducing interventions aimed at increasing EI.
Klugman, Craig M
Although the AAMC requires annual reporting of medical humanities teaching, most literature is based on single-school case reports and studies using information reported on schools' websites. This study sought to discover what medical humanities is offered in North American allopathic and osteopathic undergraduate medical schools. An 18-question, semi-structured survey was distributed to all 146 (as of June 2016) member schools of the American Association of Medical Colleges and the American Association of Colleges of Osteopathic Medicine. The survey sought information on required and elective humanities content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. The survey was completed by 134 schools (145 AAMC; 31 AACOM). 70.8% of schools offered required and 80.6% offered electives in humanities. Global health and writing were the most common disciplines. Schools required 43.9 mean (MD 45.4; DO 37.1) and 30 (MD 29; DO 37.5) median hours in humanities. In the first two years, most humanities are integrated into other course work; most electives are offered as stand-alone classes. 50.0% of schools report only 0-25% of students participating in humanities electives. Presence of a certificate, concentration or arts journal increased likelihood of humanities content but decreased mean hours. Schools with a medical humanities MA had a higher number of required humanities hours. Medical humanities content in undergraduate curriculum is lower than is indicated in the AAMC annual report. Schools with a formal structure have a greater humanities presence in the curriculum and are taken by more students.
Hong, Bong Sik; Kim, Tae Ho; Seo, Jeong Seok; Kim, Tong Wook; Moon, Seok Woo
The aim of this study was to compare patient-centeredness changes between medical school graduates and medical students after a psychiatric clinical clerkship. We focused on 40 medical school graduates. We received permission to use data from a 2006 study on patient-centeredness of 94 medical students. The following was repeated before and after clerkship: Minnesota Multiphasic Personality Inventory (MMPI), Meyers-Briggs type indicator (MBTI), Patient-practitioner Orientation Scale (PPOS) and Authoritarian Personality (AP) scale. In the 2006 study on patient-centeredness of medical students, the AP scores were significantly lower than before clerkship and the PPOS scores were significantly higher than before clerkship. AP score changes were related to MBTI, correlated with MMPI subscales, but inversely correlated with PPOS changes. In this study, the change in PPOS scores was not significant after clerkship in case of medical school graduates. AP score changes inversely correlated with PPOS changes, but neither correlated with MMPI subscales or MBTI. Considering previous findings, medical school graduates tend to be more patient-centered than medical students, but medical students can adopt a more patient-centered attitude than graduates through a psychiatric clinical clerkship.
Mowat, D L; White, C
Children who were scheduled for medical examination before entering school were followed in school one or two years later. Non-attenders had a two-fold risk of repeating grades, special class placement, referral for speech/language problems, teacher-reported learning or behavior problems, failure of vision or hearing screening, and transfer between schools. Absenteeism was also significantly more common. Children not brought in for preventive health care are at greater risk than others for difficulties in school.
Guèvremont, Anne; Findlay, Leanne; Kohen, Dafna
Background: Participation in extracurricular activities can have positive effects on youth, with greater participation associated with higher academic as well as better socioemotional and behavioral outcomes. Little research has examined differential effects of in-school and out-of-school activities. Methods: This study examines in-school and…
Shankar, P Ravi; Dubey, Arun K; Nandy, Atanu; Herz, Burton L; Little, Brian W
role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.
de Visser, Marieke; Fluit, Cornelia; Fransen, Jaap; Latijnhouwers, Mieke; Cohen-Schotanus, Janke; Laan, Roland
In the Netherlands, students are admitted to medical school through (1) selection, (2) direct access by high pre-university Grade Point Average (pu-GPA), (3) lottery after being rejected in the selection procedure, or (4) lottery. At Radboud University Medical Center, 2010 was the first year we selected applicants. We designed a procedure based on tasks mimicking the reality of early medical school. Applicants took an online course followed by an on-site exam, resembling courses and exams in early medical school. Based on the exam scores, applicants were selected or rejected. The aim of our study is to determine whether curriculum sample selection explains performance in medical school and is preferable compared to selection based on performance in secondary school. We gathered data on the performance of students of three consecutive cohorts (2010-2012, N = 954). We compared medical school performance (course credits and grade points) of selected students to the three groups admitted in other ways, especially lottery admissions. In regression analyses, we controlled for out of context cognitive performance by adjusting for pu-GPA. Selection-admitted students outperformed lottery-admitted students on most outcome measures, unadjusted as well as adjusted for pu-GPA (p ≤ 0.05). They had higher grade points than non-selected lottery students, both unadjusted and adjusted for pu-GPA (p ≤ 0.025). Adjusted for pu-GPA, selection-admitted students and high-pu-GPA students performed equally. We recommend this selection procedure as it adds to secondary school cognitive performance for the general population of students, is efficient for large numbers of applicants and not labour-intensive.
Full Text Available Background: The motivations behind why people choose to study medicine in Iraqi medical schools are unknown. Such information could help school pupils to make more informed career decisions and assist medical schools in enhancing the student selection process. Aims: To investigate why people choose to study medicine in Iraq. Subjects and methods: The first-year students admitted on the academic year 2015-2016 to Baghdad College of Medicine, University of Baghdad, were invited to complete a structured questionnaire, which was administered through the college electronic education portal. The data were analyzed using IBM SPSS version 21 software. Results: A total of 152 (50% response rate students responded. Women constituted 69.1% of respondents. Most students (61.8% had made their choice by themselves without family pressure. The most frequent reasons that affected this choice were “humanitarian reasons and a wish to provide help to others” as well as “childhood dream,” “positive community appraisal of doctors,” and “ready availability of work for physicians.” About three-quarters (73.6% of the students made some inquiry about medical school before making their choice, and the people asked were most frequently a medical student or a doctor. Information provided by the consulted parties was regarded as satisfactory by 64.2% of the surveyed students, had a positive value in 47.2%, and affected their decision in 34.9%. The highest proportion (42.2% of the study sample was thinking about studying medicine since primary school. In addition, students with personal preference made their choice at a significantly younger age. Conclusions: Reasons to apply for medical schools in Iraq are similar to those in many countries. Most of the students who inquired about studying medicine had not contacted the medical school itself.
Mâsse, Louise C; de Niet-Fitzgerald, Judith Evelyn; Watts, Allison W; Naylor, Patti-Jean; Saewyc, Elizabeth M
Increasing attention has been paid to the school food environment as a strategy to reduce childhood obesity. The purpose of this study was to examine associations between the school food environment, students' dietary intake, and obesity in British Columbia (BC), Canada. In 2007/08, principal responses about the school environment (N=174) were linked to grades 7-12 students (N=11,385) from corresponding schools, who participated in the BC Adolescent Health Survey. Hierarchical mixed-effect regression analyses examined the association between the school food environment and student's intake of sugar-sweetened beverages (SSBs), food consumption, and body mass index. Analyses controlled for school setting, neighborhood education level and student's age and sex. School availability of SSBs was positively associated with moderate (Odds Ratio (OR)=1.15, 95% Confidence Interval (CI)=1.02-1.30) and high (OR=1.43, 95% CI=1.13-1.80) SSB intake as were less healthful school nutrition guidelines for moderate SSB consumers only (OR=0.65, 95% CI=0.48-0.88). Availability of SSBs at school and its consumption were positively associated with student obesity (OR=1.50, 95% CI=1.12-2.01 and OR=1.66, 95% CI=1.19-2.34, respectively) but not with overweight. In contrast, consumption of less healthful food was positively associated with overweight (OR=1.03, 95% CI=1.01-1.06). The results of this study provide further evidence to support the important role of schools in shaping adolescents' dietary habits. Availability and consumption of SSBs, but not less healthful foods, at school were associated with higher adolescent obesity highlighting that other environments also contribute to adolescent obesity.
Full Text Available Background: Matriculation of international students to United States’ (US medical schools has not mirrored the remarkable influx of these students to other US institutions of higher education. Methods: While these students’ numbers are on the rise, the visibility for their unique issues remains largely ignored in the medical literature. Results: These students are disadvantaged in the medical school admissions process due to financial and immigration-related concerns, and academic standards for admittance also continue to be significantly higher compared with their US-citizen peers. Furthermore, it is simply beyond the mission of many medical schools – both public and private – to support international students’ education, especially since federal, state-allocated or institutional funds are limited and these institutions have a commitment to fulfill the healthcare education needs of qualified domestic candidates. In spite of these obstacles, a select group of international students do gain admission to US medical schools and, upon graduation, are credentialed equally as their US-citizen counterparts by the Accreditation Council for Graduate Medical Education (ACGME. However, owing to their foreign citizenship, these students have visa requirements for post-graduate training that may adversely impact their candidacy for residency placement. Conclusion: By raising such issues, this article aims to increase the awareness of considerations pertinent to this unique population of medical students. The argument is also made to support continued recruitment of international students to US medical schools in spite of these impediments. In our experience, these students are not only qualified to tackle the rigors of a US medical education, but also enrich the cultural diversity of the medical student body. Moreover, these graduates could effectively complement the efforts to augment US physician workforce diversity while contributing to
Chauvin, Sheila W; Anderson, William; Mylona, Elza; Greenberg, Ruth; Yang, Tong
Little is known about common elements or "best practices" of new faculty orientation (NFO) programs in medical schools. The objective was to examine school-wide NFO programs in North American medical schools. We reviewed the literature and conducted a web-based survey. Analyses included descriptive statistics and content analysis. We found little evidence of "best practices." Of the 106 responding schools (106/148=71.62%), 72 (67.9%) reported some type of school-wide NFO program. The typical program was organized by an Office of Faculty Affairs or Faculty Development, targeted broad goals, 4 to 8 hour long, offered early in the academic year, and used 2 or more presentation formats (e.g., oral, print). Based on the literature, this study appears to be the first comprehensive description of NFO programs in medical schools. Multiple types of NFO are needed to accommodate the diversity of faculty and faculty responsibilities. School-wide programs may serve best to develop institutional affiliation and collegiality.
Stringer, Neil; Chan, Michael; Bimpeh, Yaw; Chan, Philip
This study investigates the effects of socioeconomic status and schooling on the academic attainment of a cohort of students at a single medical school (N = 240). Partial least squares structural equation modelling was used to explore how students' summative assessment scores over 4 years of medical school were affected by: attainment in secondary school examinations (GCSEs and A-levels); the Income Deprivation Affecting Children Index (IDACI) rank associated with students' home postcodes; the performance of students' A-level institutions, measured as the percentage of A-level students achieving 3 A-levels at AAB or higher in two or more facilitating subjects. The effects were consistent across time; the final linear regression model used students' cumulative scores (the basis of the medical school's UK Foundation Programme submission) as the dependent variable. The final model fit was quite poor (R 2 = .184, n = 178). IDACI Rank was non-significant and excluded from the final model. Both GCSE (.340, p School Performance was associated with decreasing Cumulative Score (-.159, p schooling and medical course performance as previous studies. The study found no evidence that socioeconomic background affects course performance; however, students admitted to medicine from poorly performing schools achieve higher academic attainment throughout the course than students admitted from better-performing schools with the same grades. Schooling could be taken into account for admissions purposes.
Phillips, S P; Ferguson, K E
Medical school has historically reinforced traditional views of women. This cohort study follows implementation of a revitalized curriculum and examines students' attitudes toward women on entry into an Ontario medical school, and 3 years later. Of the 75 students entering first year at Queen's University medical school 70 completed the initial survey in September 1994 and 54 were resurveyed in May 1997. First-year students at 2 other Ontario medical schools were also surveyed in 1994, and these 166 respondents formed a comparison group. Changes in responses to statements about sex-role stereotypes, willingness to control decision-making of female patients, and conceptualization of women as "other" or "abnormal" because they are women were examined. Responses from the comparison group were used to indicate whether the Queen's group was representative. Attitudinal differences between the primary group and the comparison group were not significant. After 3 years of medical education students were somewhat less accepting of sex-role stereotypes and less controlling in the doctor-patient encounter. They continued, however, to equate adults with men and to see women as "not adult" or "other." Female students began and remained somewhat more open-minded in all areas studied. A predicted trend toward conservatism was not seen as students became older, more aware and closer to completion of medical training, although they continued to equate adults with male and to see women as "other." Findings may validate new curricular approaches and increased attention to gender issues in the academic environment.
Chervenak, Frank A; McCullough, Laurence B
The relationship between medical schools and their teaching hospitals involves a complex and variable mixture of monopoly and monopsony power, which has not been previously been ethically analyzed. As a consequence, there is currently no ethical framework to guide leaders of both institutions in the responsible management of this complex power relationship. The authors define these two forms of power and, using economic concepts, analyze the nature of such power in the medical school-teaching hospital relationship, emphasizing the potential for exploitation. Using concepts from both business ethics and medical ethics, the authors analyze the nature of transparency and co-fiduciary responsibility in this relationship. On the basis of both rational self-interest, drawn from business ethics, and co-fiduciary responsibility, drawn from medical ethics, they argue for the centrality of transparency in the medical school-teaching hospital relationship. Understanding the ethics of monopoly and monopsony power is essential for the responsible management of the complex relationship between medical schools and their teaching hospitals and can assist the leadership of academic health centers in carrying out one of their major responsibilities: to prevent the exploitation of monopoly power and monopsony power in this relationship.
Suvarnabhumi, Krishna; Sowanna, Non; Jiraniramai, Surin; Jaturapatporn, Darin; Kanitsap, Nonglak; Soorapanth, Chiroj; Thanaghumtorn, Kanate; Limratana, Napa; Akkayagorn, Lanchasak; Staworn, Dusit; Praditsuwan, Rungnirand; Uengarporn, Naporn; Sirithanawutichai, Teabaluck; Konchalard, Komwudh; Tangsangwornthamma, Chaturon; Vasinanukorn, Mayuree; Phungrassami, Temsak
The Thai Medical School Palliative Care Network conducted this study to establish the current state of palliative care education in Thai medical schools. A questionnaire survey was given to 2 groups that included final year medical students and instructors in 16 Thai medical schools. The questionnaire covered 4 areas related to palliative care education. An insufficient proportion of students (defined as fewer than 60%) learned nonpain symptoms control (50.0%), goal setting and care planning (39.0%), teamwork (38.7%), and pain management (32.7%). Both medical students and instructors reflected that palliative care education was important as it helps to improve quality of care and professional competence. The percentage of students confident to provide palliative care services under supervision of their senior, those able to provide services on their own, and those not confident to provide palliative care services were 57.3%, 33.3%, and 9.4%, respectively. The lack of knowledge in palliative care in students may lower their level of confidence to practice palliative care. In order to prepare students to achieve a basic level of competency in palliative care, each medical school has to carefully put palliative care content into the undergraduate curriculum.
Johnson, Joy L.; Moffat, Barbara; Bottorff, Joan; Shoveller, Jean; Fischer, Benedikt; Haines, Rebecca J.
This ethnographic study aimed at developing a richer understanding of how youth, their schools, and the communities in which they are emplaced coincide to generate a set of local social processes that affect marijuana use. We trace the interplay between high school staff and students with regards to marijuana use in the proximity of a local high…
Vander Ploeg, Kerry Ann; Wu, Biao; McGavock, Jon; Veugelers, Paul J
Schools are frequently cited as a favorable venue to promote physical activity (PA), however little data exist describing times when students are least active. Our objective was to overcome this limitation and describe time periods when students are least active. We used a cross-sectional design to assess patterns of PA in 923 grade 5 students [mean age: 10.9 (± 0.4) years] from 30 schools in Alberta, Canada. Students wore time-stamped pedometers for 9 consecutive days, providing 7 full days of data. We compared step counts adjusted for nonwear time between school days and nonschool days as well as during school hours and after school hours. 689 (75%) students provided complete data. The average daily step count was higher on school days (boys 13,476 ± 4123 step/day; girls 11,436 ± 3158 steps/day) than nonschool days (boys 11,009 ± 5542 steps/day; girls 10,256 ± 5206 steps/day). More steps were also taken during school hours than nonschool hours (boys +206 ± 420 steps/hour, P school hours, and weekends.
Robson, Karen; Albanese, Patrizia; Harrison, Deborah; Sanders, Chris
There has been a growing body of literature on adolescents in military families since 2002. This research has focused on how frequent moves and parental deployments are two unique potential stressors for youth in military families, and are associated with negative school outcomes. Analyzing data collected from a school in a military community, and…
Beaubier, Dean M.; Gadbois, Shannon A.; Stick, Sheldon L.
In 2004 twin sisters Amy and Jesse Pasternak competed for the prospect of playing high school hockey, vying for the boys' team rather than the girls'. The sisters' opportunities were negated by the Manitoba High School Athletic Association (MHSAA). This paper examines the 2006 decision by the Manitoba Human Rights Commission and a 2008 judgment by…
Formal schooling is less than 100 years old in the Kivalliq region of Nunavut. In the last three decades, efforts to reflect and value Inuit culture in northern schools have increased, in light of concerns over whether the dominant culture's education system was appropriate or effective for Inuit children. These efforts have resulted in varying…
Durkin, Shane R.; Bascomb, Angela; Turnbull, Deborah; Marley, John
A survey of 163 senior medical students attending a South Australian medical school found that rural students were more likely than urban students to experience stress; be concerned about getting a provider number (license); feel that consultants had little time for them; have made the decision to study medicine without pressure from others; and…
Matthies, Herbert K.
Full Text Available In the recent years various multimedia learning modules were developed at the Hannover Medical School. So, for example the web-based content management system Schoolbook is used to collect medical cases for education. It enables authors to present their specialised knowledge in the World Wide Web without the need to be familiar with internet technologies. The System provides access to several sources of medical knowledge and is used as an elearning platform for different medical departments. Furthermore it was established in combination with the learning management system ILIAS which contains web-based learning units as well as self-tests (multiple choice with direct feedback.
Bagshaw, Sean M; Mondor, Eugene E; Scouten, Cindy; Montgomery, Carmel; Slater-MacLean, Linda; Jones, Daryl A; Bellomo, Rinaldo; Gibney, R T Noel
Nurses are the primary activators of the medical emergency team (MET). Although the MET system can empower nurses to seek help in managing acutely ill patients, few data on nurses' beliefs about the system are available. To evaluate nurses' beliefs and behaviors about the MET system. Nurses from a large academic hospital in Canada were surveyed (2 demography-related questions and 17 Likert-scale questions). Of 614 nurses employed on units participating in the MET system, 293 (47.7%) were approached and 275 completed the survey (response rate, 93.9%). Most respondents (84.2%) believed that the MET could prevent cardiopulmonary arrest in acutely ill patients, and 94% believed that the MET allowed them to seek help for patients they were worried about. Most nurses (75.9%) would call the responsible physician before activating the MET. Fifteen percent indicated reluctance to activate the MET because of fear of criticism, but only 2.2% considered the MET overused. Most (81.3%) believed that the MET did not increase their workload, and 91.3% did not believe that the MET reduced their skills. Forty-eight percent of nurses indicated that they would activate the MET for a patient they were worried about, even if the patient had normal vital signs. Nurses value the MET system. Nurses believe that the MET can help them care for acutely ill patients and improve outcomes. However, barriers to MET activation exist, including a fear of criticism and an adherence to a more traditional model of first contacting the responsible physician before activating the MET.
Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena
Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.
Dingle, Arden D.
Objective: The author describes child and adolescent psychiatry (CAP) undergraduate teaching in American and Canadian medical schools. Methods: A survey asking for information on CAP teaching, student interest in CAP, and opinions about the CAP importance was sent to the medical student psychiatry director at 142 accredited medical schools in the…
Sampasa-Kanyinga, Hugues; Roumeliotis, Paul; Xu, Hao
Purpose The negative effects of peer aggression on mental health are key issues for public health. The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students, and to test whether these relationships were mediated by reports of depression. Methods Data for this study are from the 2011 Eastern Ontario Youth Risk Behaviour Survey, which is a cross-sectional regional school-based survey that was conducted among students in selected Grade 7 to 12 classes (1658 girls, 1341 boys; mean±SD age: 14.3±1.8 years). Results Victims of cyberbullying and school bullying incurred a significantly higher risk of suicidal ideation (cyberbullying: crude odds ratio, 95% confidence interval = 3.31, 2.16–5.07; school bullying: 3.48, 2.48–4.89), plans (cyberbullying: 2.79, 1.63–4.77; school bullying: 2.76, 2.20–3.45) and attempts (cyberbullying: 1.73, 1.26–2.38; school bullying: 1.64, 1.18–2.27) compared to those who had not encountered such threats. Results were similar when adjusting for sociodemographic characteristics, substance use, and sedentary activities. Mediation analyses indicated that depression fully mediated the relationship between cyberbullying victimization and each of the outcomes of suicidal ideation, plans and attempts. Depression also fully mediated the relationship between school bullying victimization and suicide attempts, but partially mediated the relationship between school bullying victimization and both suicidal ideation and plans. Conclusion These findings support an association between both cyberbullying and school bullying victimization and risk of suicidal ideation, plans and attempts. The mediating role of depression on these links justifies the need for addressing depression among victims of both forms of bullying to prevent the risk of subsequent suicidal behaviours. PMID:25076490
Full Text Available The negative effects of peer aggression on mental health are key issues for public health. The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students, and to test whether these relationships were mediated by reports of depression.Data for this study are from the 2011 Eastern Ontario Youth Risk Behaviour Survey, which is a cross-sectional regional school-based survey that was conducted among students in selected Grade 7 to 12 classes (1658 girls, 1341 boys; mean ± SD age: 14.3 ± 1.8 years.Victims of cyberbullying and school bullying incurred a significantly higher risk of suicidal ideation (cyberbullying: crude odds ratio, 95% confidence interval = 3.31, 2.16-5.07; school bullying: 3.48, 2.48-4.89, plans (cyberbullying: 2.79, 1.63-4.77; school bullying: 2.76, 2.20-3.45 and attempts (cyberbullying: 1.73, 1.26-2.38; school bullying: 1.64, 1.18-2.27 compared to those who had not encountered such threats. Results were similar when adjusting for sociodemographic characteristics, substance use, and sedentary activities. Mediation analyses indicated that depression fully mediated the relationship between cyberbullying victimization and each of the outcomes of suicidal ideation, plans and attempts. Depression also fully mediated the relationship between school bullying victimization and suicide attempts, but partially mediated the relationship between school bullying victimization and both suicidal ideation and plans.These findings support an association between both cyberbullying and school bullying victimization and risk of suicidal ideation, plans and attempts. The mediating role of depression on these links justifies the need for addressing depression among victims of both forms of bullying to prevent the risk of subsequent suicidal behaviours.
Sampasa-Kanyinga, Hugues; Roumeliotis, Paul; Xu, Hao
The negative effects of peer aggression on mental health are key issues for public health. The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students, and to test whether these relationships were mediated by reports of depression. Data for this study are from the 2011 Eastern Ontario Youth Risk Behaviour Survey, which is a cross-sectional regional school-based survey that was conducted among students in selected Grade 7 to 12 classes (1658 girls, 1341 boys; mean ± SD age: 14.3 ± 1.8 years). Victims of cyberbullying and school bullying incurred a significantly higher risk of suicidal ideation (cyberbullying: crude odds ratio, 95% confidence interval = 3.31, 2.16-5.07; school bullying: 3.48, 2.48-4.89), plans (cyberbullying: 2.79, 1.63-4.77; school bullying: 2.76, 2.20-3.45) and attempts (cyberbullying: 1.73, 1.26-2.38; school bullying: 1.64, 1.18-2.27) compared to those who had not encountered such threats. Results were similar when adjusting for sociodemographic characteristics, substance use, and sedentary activities. Mediation analyses indicated that depression fully mediated the relationship between cyberbullying victimization and each of the outcomes of suicidal ideation, plans and attempts. Depression also fully mediated the relationship between school bullying victimization and suicide attempts, but partially mediated the relationship between school bullying victimization and both suicidal ideation and plans. These findings support an association between both cyberbullying and school bullying victimization and risk of suicidal ideation, plans and attempts. The mediating role of depression on these links justifies the need for addressing depression among victims of both forms of bullying to prevent the risk of subsequent suicidal behaviours.
McGaghie, William C.
Ten qualitative categories associated with excellence in medical education and practice are identified: character and integrity; breadth of knowledge; leadership; geographic preferences; gender, race, and religious preference; work habits and motivation to study; personality and attitude; personal orientation toward service; altruism; and personal…
Kelly, Jeffrey A.; And Others
An effort to teach medical students practical stress management skills is discussed. A group of students volunteered to participate in a six-session program that taught them personal stress management techniques including self-relaxation training, schedule-planning, priority-setting, leisure time-planning, and cognitive modification techniques.…
Chae, Sujin; Lim, Kiyoung
This study aimed to examine the necessity for research ethics and learning objectives in ethics education at the undergraduate level. A total of 393 fourth-year students, selected from nine medical schools, participated in a survey about learning achievement and the necessity for it. It was found that the students had very few chances to receive systematic education in research ethics and that they assumed that research ethics education was provided during graduate school or residency programs. Moreover, the students showed a relatively high learning performance in life ethics, while learning achievement was low in research ethics. Medical school students revealed low interest in and expectations of research ethics in general; therefore, it is necessary to develop guidelines for research ethics in the present situation, in which medical education mainly focuses on life ethics.
de la Garza-Aguilar, Javier
At the end of the XXth century, collegiate efforts (evaluation and accreditation) were carried out to identify the quality of undergraduate medical education in Mexico. The growth of medical schools during the 1970's had stabilized and the combination of other factors had contributed to increase its quality. Analytic-descriptive research of selected indicators of the medical curricula from the sixties to the year 2000: entry, enrollment, and drop out rates, graduates, title, selection by the national postgraduate exam of medical residences (ENARM), faculty members and creation of medical schools. Statistical analysis included chi2 and T tests. In the seventies the number of medical schools doubled and the country increased its entry by 400%, enrollment by 700% and the number of graduates by 600%. The drop out rates and title efficiencies remained stable with averages of 76.2 and 76.4%, respectively: the first one that reflects the efficiency of the educational system, was not different in the period studied, when student's t- test (p ENARM in 1991 and in 2001, one out of six. The growth in enrollment and graduates once again, stands in contrast with the drop out rate that has remained stable. This suggests that the country has not increased significantly the quality of its medical education. The latter could be verified for each institution with the indicators used in the present study and by the assessment and accreditation of the programs.
Wilson, Sam; Denison, Alan R; McKenzie, Hamish
Undergraduate medical education in the UK has changed considerably over the last decade. One development has involved the creation of teaching-specific posts for junior doctors by medical schools. These posts are generally termed 'clinical teaching fellowships', but it is not known how many of them exist, or whether they are similar in terms of educational activities, professional development, and research and clinical experience opportunities. Teaching deans in all UK medical schools were sent a questionnaire relating to clinical teaching fellowships, and were asked to distribute a second set of different questionnaires to their clinical teaching fellows, which were to be returned to the authors separately. A total of 28 deans and 46 fellows responded. Fifteen medical schools had clinical teaching fellows and there appeared to be a total of 77 such posts in the UK. There was little uniformity in the activities undertaken within the posts. Deans who employed clinical teaching fellows were unanimously positive regarding the posts. Fellows were generally positive but expressed reservations relating to approval for postgraduate training, career development, deterioration in clinical skills, financial disincentives, credibility within one's own specialty, and provision of training and support. Clinical teaching fellow posts are generally enjoyed by fellows and valued by deans. Fellows carry out differing duties and their training in medical education is variable. The posts can be unstructured and may lack credibility to doctors outside medical education. Providing specific structured training in medical education, recognised at a national level, would help deal with these concerns.
Almohaya, Abdulellah; Qrmli, Abdulaziz; Almagal, Naeif; Alamri, Khaled; Bahammam, Salman; Al-Enizi, Mashhour; Alanazi, Atif; Almeneessier, Aljohara S; Sharif, Munir M; Bahammam, Ahmed S
Limited information is available regarding sleep medicine education worldwide. Nevertheless, medical education has been blamed for the under-recognition of sleep disorders among physicians. This study was designed to assess the knowledge of Saudi undergraduate medical students about sleep and sleep disorders and the prevalence of education on sleep medicine in medical schools as well as to identify the obstacles to providing such education. We surveyed medical schools that were established more than 10 years ago, asking fourth- and fifth-year medical students (men and women) to participate. Seven medical schools were selected. To assess knowledge on sleep and sleep disorders, we used the Assessment of Sleep Knowledge in Medical Education (ASKME) Survey, which is a validated 30-item questionnaire. The participants were separated into two groups: those who scored ≥60% and those who scored students completed the survey (54.9% male). Among the participants, 27.7% had a specific interest in sleep medicine. More than 80% of the study sample had rated their knowledge in sleep medicine as below average. Only 4.6% of the respondents correctly answered ≥60% of the questions. There was no difference in the scores of the respondents with regard to university, gender, grade-point average (GPA) or student academic levels. Only five universities provided data on sleep medicine education. The time spent teaching sleep medicine in the surveyed medical schools ranged from 0-8 hours with a mean of 2.6 ±2.6 hours. Identified obstacles included the following: (1) sleep medicine has a lower priority in the curriculum (53%) and (2) time constraints do not allow the incorporation of sleep medicine topics in the curriculum (47%). Medical students in the surveyed institutions possess poor knowledge regarding sleep medicine, which reflects the weak level of education in this field of medicine. To improve the recognition of sleep disorders among practicing physicians, medical schools
Whalen, Desmond; Harris, Chelsea; Harty, Chris; Greene, Alison; Faour, Elizabeth; Thomson, Kalen; Ravalia, Mohamed
A major goal of the Faculty of Medicine at the Memorial University of Newfoundland is to produce physicians who will return to rural areas that are currently underserviced. Research shows that the strongest indicator of practice in a rural area is a rural background, and thus it is important that rural students apply to medical school. We investigated what high school students believe to be preventing them from pursuing medical education. Between September 2013 and June 2014, we administered a paper survey to high school students in Newfoundland and Labrador, New Brunswick and Prince Edward Island. A total of 665 participants completed the survey. We found that fewer rural students (75.6%) than urban students (98.6%) believed that they could gain admission to medical school (p career choice in fewer rural schools (55.7%) than urban schools (69.7%). Also, 55.4% of urban students, but only 44.4% of rural students, believed that rural students were disadvantaged when applying to medical school. In our study, rural students believed they were less likely to be accepted into medical school than urban students, and fewer rural students felt that medicine was promoted as a potential career choice. Our results may be explained by a lack of role models or perhaps by financial barriers, although further research is needed.
Bunton, Sarah A; Walling, Anne; Durham, Dianne
To assess post-tenure review policies at U.S. medical schools by examining how prevalent post-tenure review is, what models of post-tenure review are employed, and what outcomes result from post-tenure review processes. In late 2014, a Web-based survey was sent to the associate dean for faculty affairs (or equivalent) at each U.S. medical school accredited by the Liaison Committee on Medical Education (N = 141). The survey addressed elements of post-tenure review policies, including whether a policy was in place, the frequency of the review, and the review outcomes. Descriptive statistics were calculated. Of the 94 responding schools with a tenure system, 39 (41%) had an established post-tenure review policy. Although these policies showed great variability across schools in duration, having been in place from 1 to 50 years, 12 (31%) were established within the last 5 years. The outcomes of post-tenure review also varied. Superior performance ratings generally resulted in notations in the faculty member's personnel file and notifications to school leadership. Conversely, when a faculty member received an unsatisfactory rating, a remediation or development plan was sometimes required. At least 40% of medical schools with a tenure system have post-tenure review, and it is becoming more common. These findings about the prevalence and use of post-tenure review across institutions can assist medical school leaders as they strive to shape policies to facilitate faculty engagement and productivity. They also can provide the foundation for future evaluative studies on the effectiveness, outcomes, and impact of post-tenure review.
Full Text Available Objectives: A potential new avenue to address the shortage of country doctors is to change the rules for admission to medical school. We therefore study the link between high-school grade point average and prospective physicians’ choice to work in rural areas. To further inform the discussion about rules for admission, we also study the effects of other predictors: a measure of students’ attitudes towards risk; whether they waited for their place of study (; whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector.Methods: We conducted two internet surveys in 2012 and 2014. In the first survey, the sample comprised 701 students and in the second, 474 students. In both surveys, we asked students for their regional preferences; in the 2014 survey, we additionally asked students for their first, second, and third preferences among a comprehensive set of specializations, including becoming a general practitioner. In both surveys, we asked students for basic demographic information (age and gender, their parents’ occupation, a measure of subjective income expectations, a measure of risk attitudes, and their high-school grade point average (, and First National Boards Examination grade (. In 2014, we additionally asked for waiting periods ( as well as for prior professional experience in the health-care sector.Results: We find that three factors increase the probability of having a preference for working in a rural area significantly, holding constant all other influences: Moreover, we find that those willing to work in the countryside have significantly more experience in the medical sector before admission to medical school.Discussion: Our results suggest that a change in the selection process for medical school may increase the supply of country doctors. Instead of focusing on the high-school grade point average, universities could even more intensely screen for study motivation
Full Text Available Background: Much evidence exists to demonstrate that poor handover can directly impact patient safety. There have been calls for formal education on handover, but evidence to guide intervention design and implementation is limited. It is unclear how undergraduate medical schools are tackling this issue and what barrier or facilitators exist to handover education. We set out to determine curriculum objectives, teaching and assessment methods, as well as institutional attitudes towards handover within UK medical schools. Methods: A descriptive, non-experimental, cross-sectional study design was used. A locally developed online questionnaire survey was sent to all UK Medical Schools, after piloting. Descriptive statistics were calculated for closed-ended responses, and free text responses were analysed using a grounded theory approach, with constant comparison taking place through several stages of analysis. Results: Fifty percent of UK medical schools took part in the study. Nine schools (56% reported having curriculum outcomes for handover. Significant variations in the teaching and assessments employed were found. Qualitative analysis yielded four key themes: the importance of handover as an education issue, when to educate on handover, the need for further provision of teaching and the need for validated assessment tools to support handover education. Conclusions: Whilst undergraduate medical schools recognised handover as an important education issue, they do not feel they should have the ultimate responsibility for training in this area and as such are responding in varying ways. Undergraduate medical educators should seek to reach consensus as to the extent of provision they will offer. Weaknesses in the literature regarding how to design such education have exacerbated the problem, but the contemporaneous and growing published evidence base should be employed by educators to address this issue.
Shindel, Alan W; Ando, Kathryn A; Nelson, Christian J; Breyer, Benjamin N; Lue, Tom F; Smith, James F
To determine factors associated with students' comfort in addressing patients' sexuality in the clinical context. The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. The authors' analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as "other" gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients' sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students' difficulty in addressing patients' sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients' sexuality and should be a priority for medical education.
Shindel, Alan W.; Ando, Kathryn A.; Nelson, Christian J.; Breyer, Benjamin N.; Lue, Tom F.; Smith, James F.
Purpose To determine factors associated with students’ comfort in addressing patients’ sexuality in the clinical context. Method The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. Results The authors’ analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as “other” gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients’ sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Conclusions Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students’ difficulty in addressing patients’ sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients’ sexuality and should be a priority for medical education. PMID:20671459
Cleland, Jennifer; Johnston, Peter W; French, Fiona H; Needham, Gillian
Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students' medical training. Year 1 (2009-2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors. The response rate was 87.9% (883/1005). No significant differences were found among medical schools with regard to first-choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work-life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job-related factors by most respondents. Few differences were found among schools in terms of the impact of job-related factors on future career preferences. Students for whom the work-life balance was extremely important (odds ratio [OR]=0.6) were less likely to prefer surgery. Students for whom the work-life balance (OR=2.2) and continuity of care (OR=2.1) were extremely important were more likely to prefer general practice. Students' early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work-life balance is very important to tomorrow's doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students' career preferences change as they progress through medical school and training. © Blackwell Publishing Ltd 2012.
Hugues Sampasa-Kanyinga; Paul Roumeliotis; Hao Xu
Purpose The negative effects of peer aggression on mental health are key issues for public health. The purpose of this study was to examine the associations between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students, and to test whether these relationships were mediated by reports of depression. Methods Data for this study are from the 2011 Eastern Ontario Youth Risk Behaviour Survey, which is a cross-sectional regi...
Grover, P L; Smith, D U
Programs designed to assist medical students in academic difficulty typically fail to consider the importance of such factors as academic anxiety and the individual's mechanisms for coping with stress. The authors have addressed this issue by examining relationships among prior achievement, academic anxiety, locus of control, and performance in the first year of medical school. Academic anxiety not only was found to be significantly related to first year performance, but also, when combined with a measure of prior achievement, resulted in a significant increase in prediction. Additional evidence is presented which suggests that the relationship between academic anxiety and achievement may be curvilinear. Locus of control was found to correlate significantly with academic anxiety and tended to shift in a direction of greater externality during the first year of medical school. Findings are discussed within the framework of existing psychological research, and implications are presented for medical admissions, curricula, and counseling.
Interest in global health (GH) among medical students worldwide is measurably increasing. There is a concomitant emphasis on emphasizing globally-relevant health professions education. Through a structured literature review, expert consensus recommendations, and contact with relevant professional organizations, we review the existing state of GH education in US medical schools for which data were available. Several recommendations from professional societies have been developed, along with a renewed emphasis on competencies in global health. The implementation of these recommendations was not observed as being uniform across medical schools, with variation noted in the presence of global health curricula. Recommendations for including GH in medical education are suggested, as well as ways to formalize GH curricula, while providing flexibility for innovation and adaptation PMID:23331630
Physicians have to visit, diagnose and refer patients with genetic disorders, so they need to be familiar with the basics and indications of genetic tests. In other words, they should have effective theoretical and practical knowledge about medical genetics before they do their job. Medical genetics courses at Medical Universities of Iran are generally presented as a theoretical subject in the first period of medical education. In this descriptive research, the results of interviews with teachers of medical genetics in 30 medical schools in Islamic Republic of Iran and responses to a questionnaire by 125 medical students of Ahvaz Jundishapour University of medical sciences, about presentation time, curricula and also efficacy of medical genetics courses were analyzed. The interviews with teachers were done on phone and the students' comments were collected by a researcher-made questionnaire. The data were analyzed, using SPSS software, version 14. In two thirds of medical universities, medical genetics is taught in the third or fourth semester and in 5 universities in the fifth semester. 86% of the students believed that the quality of genetics courses is moderate and such courses are very beneficial to medical students. This article suggests that medical genetics be offered in the second or third period of medical education (physiopathology or stagger period). Furthermore, in teaching such courses advanced educational methods (animation presentation, case-based learning, problem-based learning, etc.) should be used, together with simple genetic tests in laboratories, and the visit of genetic patients in hospitals and genetics centers.
Galván-Molina, Jesús Francisco; Jiménez-Capdeville, María E; Hernández-Mata, José María; Arellano-Cano, José Ramón
Screening of psychopathology and associated factors in medical students employing an electronic self-report survey. A transversal, observational, and comparative study that consisted of the following instruments: Sociodemographic survey; 2. Adult Self-Report Scale-V1 (ASRS); State-Trait Anxiety Inventory (STAI); Zung and Conde Self-Rating Depression Scale, Almonte-Herskovic Sexual Orientation Self-Report; Plutchik Suicide Risk Scale; Alcohol Use Disorders Identification Test Identification (AUDIT); Fagerström Test for Nicotine Dependence; 9. Maslach Burnout Inventory (MBI); Eating Disorder Inventory 2 (EDI). We gathered 323 student surveys from medical students of the first, third and sixth grades. The three more prevalent disorders were depression (24%), attention deficit disorders with hyperactivity (28%) and anxiety (13%); the prevalence of high-level burnout syndrome was 13%. Also, the fifth part of the students had detrimental use of tobacco and alcohol. Sixty percent of medical students had either one or more probable disorder or burnout. An adequate screening and treatment of this population could prevent severe mental disorders and the associated factors could help us to create a risk profile. This model is an efficient research tool for screening and secondary prevention.
Mansh, Matthew; White, William; Gee-Tong, Lea; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Goldsmith, Elizabeth; Brenman, Stephanie; Tran, Eric; Wells, Maggie; Fetterman, David; Garcia, Gabriel
To assess identity disclosure among sexual and gender minority (SGM) students pursuing undergraduate medical training in the United States and Canada. From 2009 to 2010, a survey was made available to all medical students enrolled in the 176 MD- and DO-granting medical schools in the United States and Canada. Respondents were asked about their sexual and gender identity, whether they were "out" (i.e., had publicly disclosed their identity), and, if they were not, their reasons for concealing their identity. The authors used a mixed-methods approach and analyzed quantitative and qualitative survey data. Of 5,812 completed responses (of 101,473 eligible respondents; response rate 5.7%), 920 (15.8%) students from 152 (of 176; 86.4%) institutions identified as SGMs. Of the 912 sexual minorities, 269 (29.5%) concealed their sexual identity in medical school. Factors associated with sexual identity concealment included sexual minority identity other than lesbian or gay, male gender, East Asian race, and medical school enrollment in the South or Central regions of North America. The most common reasons for concealing one's sexual identity were "nobody's business" (165/269; 61.3%), fear of discrimination in medical school (117/269; 43.5%), and social or cultural norms (110/269; 40.9%). Of the 35 gender minorities, 21 (60.0%) concealed their gender identity, citing fear of discrimination in medical school (9/21; 42.9%) and lack of support (9/21; 42.9%). SGM students continue to conceal their identity during undergraduate medical training. Medical institutions should adopt targeted policies and programs to better support these individuals.
Egnew, Thomas R; Lewis, Peter R; Schaad, Douglas C; Karuppiah, Sabesan; Mitchell, Suzanne
Little is known about what students perceive they are taught about suffering in medical school. We sought to explore medical student perceptions of their medical school education about suffering. We used an online survey of medical students enrolled in four US medical schools with chi-square analysis of responses by gender and preclinical/clinical status. A total of 1,043 students (38%) responded and indicated that teaching about suffering is occurring in the schools surveyed. Respondents most strongly endorsed statements that their medical school education explicitly teaches that the relief of suffering is an inherent function of being a physician (46.5%) and that most of what they learned about dealing with suffering patients is taught by modeling (46.6%). They reported that their education explicitly teaches about suffering (32.8%), provides a good understanding of suffering (31.7%), and teaches how to interact with suffering patients (31.7%). Students gave the least support to statements that their education prepares them to personally deal with their reactions to the suffering of patients (25.1%) and teaches how to diagnose suffering (15.3%). Responses varied markedly according to gender and clinical status at two of the four schools surveyed. Teaching about suffering is occurring in the schools surveyed and can be variably experienced according to gender and clinical status. Implied curricular gaps include teaching about how to diagnose suffering and how to personally deal with the feelings that arise when caring for suffering patients. Further research on how students are learning about suffering is warranted to guide curriculum development and implementation.
The author maintains that the quality of medical education has been dropping for the last few decades as medical schools become less and less focused on their primary purpose of training physicians. Until the years immediately following World War II, the administration of the medical school was carried out by a small staff headed by a dean whose role was to provide leadership in educational matters. Academic departments managed the educational program, and the faculty were expected to be teachers and to participate in educational planning, preparation of teaching materials, advising of students, assessment of students' performances, admission, and all other tasks associated with having a teaching position. Today, the administration of a typical school includes any number of assistants to the dean and a wide variety of other staff dealing not only with educational functions but with grant management, public relations, fund-raising, personnel policy, budgeting, and an enormous and complex parallel structure designed to manage clinical practice and to respond to market pressures. The role of faculty has also changed greatly; faculty are expected to be researchers and clinicians first, and teaching is usually shortchanged. The author explains why he believes these changes have come about; for example, the strong federal support of research after World War II, which encouraged a growing dependence of medical schools on research grants and consequently raised in importance those faculty who could obtain such grants. He concludes with common-sense proposals for reform (such as having the education of medical students in the hands of a small number of faculty whose prime responsibility is teaching), but admits that there are fundamental barriers to such reforms, especially vested interests and resistance to change. In the end, change will come only when those in power recognize that medical schools must be returned to their primary role of training physicians.
Carlson, John S.; Thaler, Cara L.; Hirsch, Amanda J.
Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the…
Bakker, Nelleke; de Beer, Fedor
In this article the authors address the question of why school medical inspection in the Netherlands developed not only considerably slower than the British service but did so also on a more modest scale in terms of the impact on children's lives. In the Netherlands school doctors were not allowed
Rowan, Margo S; Rukholm, Ellen; Bourque-Bearskin, Lisa; Baker, Cynthia; Voyageur, Evelyn; Robitaille, Annie
Cultural competence and cultural safety are essential knowledge in contemporary nursing care. Using a three-phase, mixed methods sequential triangulation design, this study examines the extent to which Anglophone Schools of Nursing in Canada have integrated cultural competence and/or cultural safety into the undergraduate nursing curricula. Factors that influence successful integration are identified through the lens of Donabedian's structure, process, and outcome model. Results suggest that several facilitating factors are present, such as leadership, partnerships and linkages, and educational supports for students. Of particular concern is the lack of policies to recruit and retain Aboriginal faculty, financial resources, and outcome evaluation indicators. A conceptual model of integration is offered to explain how Schools of Nursing function to support the implementation of these concepts into their curriculum. This study provides theoretical and practical implications for initiation and improvement of cultural competence and/or cultural safety integration strategies in Schools of Nursing.
Andrews, Kenneth G; Smith, Linda A; Henzi, David; Demps, Elaine
The issues of cheating and plagiarism in educational settings have received a large amount of attention in recent years. The purpose of this study was to assess the degree to which academic integrity issues currently exist in the dental schools throughout the United States and Canada. An online survey was developed to gather data pertaining to this topic from two key groups in dental education: faculty and students. Responses were obtained from 1,153 students and 423 faculty members. The results of the survey clearly reveal that cheating is a significant problem in dental schools and that significant differences exist between students' and faculty members' perceptions of academic integrity. The challenge for dental schools is to identify effective strategies to prevent cheating opportunities and to implement and enforce effective means of dealing with specific examples of cheating.
Sherer, Renslow; Dong, Hongmei; Cong, Yali; Wan, Jing; Chen, Hua; Wang, Yanxia; Ma, Zhiying; Cooper, Brian; Jiang, Ivy; Roth, Hannah; Siegler, Mark
Ethics teaching is a relatively new area of medical education in China, with ethics curricula at different levels of development. This study examined ethics education at three medical schools in China to understand their curricular content, teaching and learning methods, forms of assessments, changes over time, and what changes are needed for further improvement. We used student and faculty surveys to obtain information about the ethics courses' content, teaching methods, and revisions over time. The surveys also included five realistic cases and asked participants whether each would be appropriate to use for discussion in ethics courses. Students rated the cases on a scale and gave written comments. Finally, participants were asked to indicate how much they would agree with the statement that medical professionalism is about putting the interests of patients and society above one's own. There were both similarities and differences among these schools with regard to course topics, teaching and assessment methods, and course faculty compositions, suggesting their courses are at different levels of development. Areas of improvement for the schools' courses were identified based on this study's findings and available literature. A model of the evolution of medical ethics education in China was proposed to guide reform in medical ethics instruction in China. Analysis identified characteristics of appropriate cases and participants' attitudes toward the ideal of professionalism. We conclude that the development of medical ethics education in China is promising while much improvement is needed. In addition, ethics education is not confined to the walls of medical schools; the society at large can have significant influence on the formation of students' professional values.
Stegers-Jager, Karen M; Cohen-Schotanus, Janke; Themmen, Axel P N
Medical schools wish to better understand why some students excel academically and others have difficulty in passing medical courses. Components of self-regulated learning (SRL), such as motivational beliefs and learning strategies, as well as participation in scheduled learning activities, have been found to relate to student performance. Although participation may be a form of SRL, little is known about the relationships among motivational beliefs, learning strategies, participation and medical school performance. This study aimed to test and cross-validate a hypothesised model of relationships among motivational beliefs (value and self-efficacy), learning strategies (deep learning and resource management), participation (lecture attendance, skills training attendance and completion of optional study assignments) and Year 1 performance at medical school. Year 1 medical students in the cohorts of 2008 (n = 303) and 2009 (n = 369) completed a questionnaire on motivational beliefs and learning strategies (sourced from the Motivated Strategies for Learning Questionnaire) and participation. Year 1 performance was operationalised as students' average Year 1 course examination grades. Structural equation modelling was used to analyse the data. Participation and self-efficacy beliefs were positively associated with Year 1 performance (β = 0.78 and β = 0.19, respectively). Deep learning strategies were negatively associated with Year 1 performance (β =- 0.31), but positively related to resource management strategies (β = 0.77), which, in turn, were positively related to participation (β = 0.79). Value beliefs were positively related to deep learning strategies only (β = 0.71). The overall structural model for the 2008 cohort accounted for 47% of the variance in Year 1 grade point average and was cross-validated in the 2009 cohort. This study suggests that participation mediates the relationships between motivation and learning strategies, and medical school
Saguil, Aaron; Dong, Ting; Gingerich, Robert J; Swygert, Kimberly; LaRochelle, Jeffrey S; Artino, Anthony R; Cruess, David F; Durning, Steven J
The Medical College Admissions Test (MCAT) is a high-stakes test required for entry to most U. S. medical schools; admissions committees use this test to predict future accomplishment. Although there is evidence that the MCAT predicts success on multiple choice-based assessments, there is little information on whether the MCAT predicts clinical-based assessments of undergraduate and graduate medical education performance. This study looked at associations between the MCAT and medical school grade point average (GPA), Medical Licensing Examination (USMLE) scores, observed patient care encounters, and residency performance assessments. This study used data collected as part of the Long-Term Career Outcome Study to determine associations between MCAT scores, USMLE Step 1, Step 2 clinical knowledge and clinical skill, and Step 3 scores, Objective Structured Clinical Examination performance, medical school GPA, and PGY-1 program director (PD) assessment of physician performance for students graduating 2010 and 2011. MCAT data were available for all students, and the PGY PD evaluation response rate was 86.2% (N = 340). All permutations of MCAT scores (first, last, highest, average) were weakly associated with GPA, Step 2 clinical knowledge scores, and Step 3 scores. MCAT scores were weakly to moderately associated with Step 1 scores. MCAT scores were not significantly associated with Step 2 clinical skills Integrated Clinical Encounter and Communication and Interpersonal Skills subscores, Objective Structured Clinical Examination performance or PGY-1 PD evaluations. MCAT scores were weakly to moderately associated with assessments that rely on multiple choice testing. The association is somewhat stronger for assessments occurring earlier in medical school, such as USMLE Step 1. The MCAT was not able to predict assessments relying on direct clinical observation, nor was it able to predict PD assessment of PGY-1 performance. Reprint & Copyright © 2015 Association of
Eckhert, N Lynn
Twenty-five percent of the U.S. physician workforce is made up of international medical graduates (IMGs), a growing proportion of whom (27% in 2005) are U.S. citizens. Most IMGs graduate from "offshore medical schools" (OMSs), for-profit institutions primarily located in the Caribbean region and established to train U.S. students who will return home to practice medicine. Following the recent call for a larger physician workforce, OMSs rapidly increased in number. Unlike U.S. schools, which must be accredited by the Liaison Committee on Medical Education, OMSs are recognized by their home countries and may not be subject to a rigorous accreditation process. Although gaps in specific data exist, a closer look at OMSs reveals that most enroll three groups of students per year, and many educate students initially at "offshore campuses" and later at clinical sites in the United States. Students from some OMSs are eligible for the U.S. Federal Family Education Loan Program. The lack of uniform data on OMSs is problematic for state medical boards, which struggle to assess the quality of the medical education offered at any one school and which, in some cases, disapprove a school. With the United States' continued reliance on IMGs to meet its health needs, the public and the profession will be best served by knowing more about medical education outside of the United States. Review of medical education in OMSs whose graduates will become part of U.S. health care delivery is timely as the United States reforms its health-care-delivery system.
Derck, Jordan; Zahn, Kate; Finks, Jonathan F; Mand, Simanjit; Sandhu, Gurjit
Racial minorities continue to be underrepresented in medicine (URiM). Increasing provider diversity is an essential component of addressing disparity in health delivery and outcomes. The pool of students URiM that are competitive applicants to medical school is often limited early on by educational inequalities in primary and secondary schooling. A growing body of evidence recognizing the importance of diversifying health professions advances the need for medical schools to develop outreach collaborations with primary and secondary schools to attract URiMs. The goal of this paper is to describe and evaluate a program that seeks to create a pipeline for URiMs early in secondary schooling by connecting these students with support and resources in the medical community that may be transformative in empowering these students to be stronger university and medical school applicants. The authors described a medical student-led, action-oriented pipeline program, Doctors of Tomorrow, which connects faculty and medical students at the University of Michigan Medical School with 9th grade students at Cass Technical High School (Cass Tech) in Detroit, Michigan. The program includes a core curriculum of hands-on experiential learning, development, and presentation of a capstone project, and mentoring of 9th grade students by medical students. Cass Tech student feedback was collected using focus groups, critical incident written narratives, and individual interviews. Medical student feedback was collected reviewing monthly meeting minutes from the Doctors of Tomorrow medical student leadership. Data were analyzed using thematic analysis. Two strong themes emerged from the Cass Tech student feedback: (i) Personal identity and its perceived effect on goal achievement and (ii) positive affect of direct mentorship and engagement with current healthcare providers through Doctors of Tomorrow. A challenge noted by the medical students was the lack of structured curriculum beyond the 1st
Tucker, James B.; And Others
A survey of New York secondary schools showed that nearly 25 percent do not employ a physician to oversee medical coverage of football games. The authors suggest several ways to improve this much-needed coverage--not only to protect athletes but also to shield the administration from litigation. (JD)
Sep 1, 2013 ... SUMMARY. Objective: This study investigated the prevalence and incidence of Traditional (where a person in a position of power harasses a subordinate) and contra power sexual harassment, (where a subordinate is the harasser of authority figure) in medical schools in Ghana. among. Design: ...
Gadow, Kenneth D.
Intended as a primer for school personnel, the book discusses children whose various disorders require them to be on medication, and describes the behavioral effects of these drugs along with their major side effects. Fundamental concepts in pharmacotherapy are reviewed, including dosage adjustment and side effects, and a brief introduction to the…
Feminist scholarship has considered how pedagogical identities and emotions are implicated in the gender politics of belonging and othering in higher education. This paper examines how gendered and embodied pedagogy is mobilised in Greek medical schools to construct notions of the ideal academic and assert women's position women in Academic…
Mindell, Jodi A; Bartle, Alex; Wahab, Norrashidah Abd; Ahn, Youngmin; Ramamurthy, Mahesh Babu; Huong, Huynh Thi Duy; Kohyama, Jun; Ruangdaraganon, Nichara; Sekartini, Rini; Teng, Arthur; Goh, Daniel Y T
The objective of this study was to assess the prevalence of education about sleep and sleep disorders in medical school education and to identify barriers to providing such education. Surveys were sent to 409 medical schools across 12 countries (Australia, India, Indonesia, Japan, Malaysia, New Zealand, Singapore, South Korea, Thailand, United States, Canada and Viet Nam). Overall, the response rate was 25.9%, ranging from 0% in some countries (India) to 100% in other countries (New Zealand and Singapore). Overall, the average amount of time spent on sleep education is just under 2.5h, with 27% responding that their medical school provides no sleep education. Three countries (Indonesia, Malaysia, and Viet Nam) provide no education, and only Australia and the United States/Canada provide more than 3h of education. Paediatric topics were covered for a mere 17 min compared to over 2h on adult-related topics. These results suggest that there continues to be very limited coverage of sleep in medical school education despite an incredible increase in acknowledgement of the importance of sleep and need for recognition of sleep disorders by physicians. Copyright Â© 2011 Elsevier B.V. All rights reserved.
Pindiprolu, Sekhar S.
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders among children today. Stimulants are commonly prescribed to children with ADHD to improve attention span and decrease distractibility, hyperactivity, and impulsivity. Given the increased use of stimulant medication, school personnel need to be aware of…
Cameron, Keri; Crooks, Valorie A; Chouinard, Vera; Snyder, Jeremy; Johnston, Rory; Casey, Victoria
Contributing to health geography scholarship on the topic, the objective of this paper is to reveal Canadian medical tourists' perspectives regarding their choices to seek knee replacement or hip replacement or resurfacing (KRHRR) at medical tourism facilities abroad rather than domestically. We address this objective by examining the 'talk strategies' used by these patients in discussing their choices and the ways in which such talk is co-constructed by others. Fourteen interviews were conducted with Canadians aged 42-77 who had gone abroad for KRHRR. Three types of talk strategies emerged through thematic analysis of their narratives: motivation, justification, and normalization talk. Motivation talk referenced participants' desires to maintain or resume physical activity, employment, and participation in daily life. Justification talk emerged when participants described how limitations in the domestic system drove them abroad. Finally, being a medical tourist was talked about as being normal on several bases. Among other findings, the use of these three talk strategies in patients' narratives surrounding medical tourism for KRHRR offers new insight into the language-health-place interconnection. Specifically, they reveal the complex ways in which medical tourists use talk strategies to assert the soundness of their choice to shift the site of their own medical care on a global scale while also anticipating, if not even guarding against, criticism of what ultimately is their own patient mobility. These talk strategies provide valuable insight into why international patients are opting to engage in the spatially explicit practice of medical tourism and who and what are informing their choices. Copyright © 2014 Elsevier Ltd. All rights reserved.
Crooks Valorie A
Full Text Available Abstract Background Medical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries. Methods Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Results Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1 comfortable health-related decision-makers; (2 unwavering in their views about procedure necessity and urgency; and (3 firm in their desires to maintain active lives. Conclusions Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on
Full Text Available Raihan Mohammed, Jamil Shah Foridi, Innocent OgunmwonyiFaculty of Medicine, University of Cambridge, Cambridge, UKAs clinical medical students, we read with great interest the perspective by Malik et al.1 Although medical schools excel at educating students on the pathology and treatment of diseases, we agree on the severe deficiency in teaching health policy (HP in the medical curriculum. However, the authors fail to include challenges facing this implementation, which is an important aspect of the analysis. Thus, here we outline 3 key barriers that must be considered when including HP teaching in the medical curricula.First, as the authors mention, the medical curriculum is already saturated and there is insufficient space to add obligatory HP learning in timetables. The UK curriculum is so packed that lecturers resort to teaching facts, which students then rote-learn and commit to memory. This leaves little time for students to develop a deep understanding of the pathophysiology of diseases and subsequent management, and they also fail to develop core lifelong skills, including problem solving and critical thinking.2 It is well acknowledged that the medical course is extremely rigorous, and up to 90% of students have admitted to suffering from stress and up to 75% have complained of burnout.3 With mental health issues among students reaching epidemic levels, adding HP lectures to the timetable would put undue strain on both the medical school curricula and the students.View the original article by Malik et al.
Krzic, Maja; Wilson, Julie; Basiliko, Nathan; Bedard-Haughn, Angela; Humphreys, Elyn; Dyanatkar, Saeed; Hazlett, Paul; Strivelli, Rachel; Crowley, Chris; Dampier, Lesley
As global issues continue to place increasing demands on soil resources, the need to provide soil science education to the next generation of soil scientists and the general public is becoming more imminent. In many countries around the world, including Canada, soil is either not included in the high school curriculum or it is not covered in…
Drawing from a 2.4-year ethnography with Korean Early Study Abroad (ESA, pre-college-aged study abroad) students in Toronto high schools, I examine the intersections among race, class, language, culture and citizenship (including immigrant status) in the identity construction and language learning of these students. Conceptualising race as a…
Browne, Dillon T.; Wade, Mark; Prime, Heather; Jenkins, Jennifer M.
There is an ongoing need for literature that identifies the effects of broad contextual risk on school readiness outcomes via family mediating mechanisms. This is especially true amongst diverse and urban samples characterized by variability in immigration history. To address this limitation, family profiles of sociodemographic and contextual risk…
Bessette, Jennifer; Camden, Chantal
Canadian medical (MD), physiotherapy (PT) and occupational therapy (OT) students increasingly show an interest in global health experiences (GHEs). As certain moral hazards can occur as a result of student GHEs, a growing consensus exists that universities must have an established selection process, in-depth pre-departure training (PDT), adequate onsite supervision and formal debriefing for their students. This study aimed to identify current practices in Canadian MD, PT and OT programs and discuss areas for improvement by comparing them with recommendations found in the literature. Canadian MD, PT and OT programs (n = 45) were invited to answer an online survey about their current practices for GHE support and training. The survey included 24 close-ended questions and 18 open-ended questions. Descriptive statistics and a thematic analysis were performed on the data and results were discussed in comparison with recommendations found in the literature. Twenty-three programs responded to the survey. Student selection processes varied across universities; examples included using academic performance, interviews and motivation letters. All but one MD program had mandatory PDT; content and teaching formats varied, as did training duration (2-38 hours). All but one MD program had onsite supervision; local clinicians were frequently involved. Debriefing, although not systematic, covered similar content; debriefing was variable in duration (1-8 hours). Many current practices are encouraging, but areas for improvement exist. Integrating global health content into the regular curriculum, with advanced study options for students participating in GHEs, could help universities standardize support and training.
Kesternich, Iris; Schumacher, Heiner; Winter, Joachim; Fischer, Martin R; Holzer, Matthias
Objectives: A potential new avenue to address the shortage of country doctors is to change the rules for admission to medical school. We therefore study the link between high-school grade point average and prospective physicians' choice to work in rural areas. To further inform the discussion about rules for admission, we also study the effects of other predictors: a measure of students' attitudes towards risk; whether they waited for their place of study (Wartesemester); whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector. Methods: We conducted two internet surveys in 2012 and 2014. In the first survey, the sample comprised 701 students and in the second, 474 students. In both surveys, we asked students for their regional preferences; in the 2014 survey, we additionally asked students for their first, second, and third preferences among a comprehensive set of specializations, including becoming a general practitioner. In both surveys, we asked students for basic demographic information (age and gender), their parents' occupation, a measure of subjective income expectations, a measure of risk attitudes, and their high-school grade point average (Abiturnote), and First National Boards Examination grade (Physikum). In 2014, we additionally asked for waiting periods (Wartesemester) as well as for prior professional experience in the health-care sector. Results: We find that three factors increase the probability of having a preference for working in a rural area significantly, holding constant all other influences: having a medical doctor among the parents, having worse grades in the high-school grade point average, and being more risk averse. Moreover, we find that those willing to work in the countryside have significantly more experience in the medical sector before admission to medical school. Discussion: Our results suggest that a change in the selection process for medical school may increase the
Batistatou, A; Doulis, E A; Tiniakos, D; Anogiannaki, A; Charalabopoulos, K
Medical humanities is a multidisciplinary field, consisting of humanities (theory of literature and arts, philosophy, ethics, history and theology), social sciences (anthropology, psychology and sociology) and arts (literature, theater, cinema, music and visual arts), integrated in the undergraduate curriculum of Medical schools. The aim of the present study is to discuss medical humanities and support the necessity of introduction of a medical humanities course in the curriculum of Greek medical schools. Through the relevant Pub-Med search as well as taking into account various curricula of medical schools, it is evident that medical education today is characterized by acquisition of knowledge and skills and development of medical values and attitudes. Clinical observation with the recognition of key data and patterns in the collected information, is crucial in the final medical decision, i.e. in the complex process, through which doctors accumulate data, reach conclusions and decide on therapy. All sciences included in medical humanities are important for the high quality education of future doctors. The practice of Medicine is in large an image-related science. The history of anatomy and art are closely related, already from the Renaissance time. Studies have shown that attendance of courses on art critics improves the observational skills of medical students. Literature is the source of information about the nature and source of human emotions and behavior and of narratives of illness, and increases imagination. Philosophy aids in the development of analytical and synthetical thinking. Teaching of history of medicine develops humility and aids in avoiding the repetition of mistakes of the past, and quite often raises research and therapeutic skepticism. The comprehension of medical ethics and professional deontology guides the patient-doctor relationship, as well as the relations between physicians and their colleagues. The Medical Humanities course, which is
van Tongeren-Alers, Margret; van Esch, Maartje; Verdonk, Petra; Johansson, Eva; Hamberg, Katarina; Lagro-Janssen, Toine
Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know importance stipulated to motivational factors. Our study investigates new medical students' early specialization preferences and motivational factors. New students at a Dutch medical school (n = 657) filled in a questionnaire about specialty preferences (response rate = 94%; 69.5% female, 30.5% male). The students chose out of internal medicine, psychiatry, neurology, pediatrics, surgery, gynecology and family medicine, "other" or "I don't know." Finally, they valued ten motivational factors. Forty percent of the medical students reported no specialty preference yet. Taken together, female medical students preferred pediatrics and wished to combine work and care, whereas male students opted for surgery and valued career opportunities. Gender-driven professional preferences in new medical students should be noticed in order to use competencies. Changes in specialty preferences and motivational factors in pre- and post graduates should further assess the role of medical education.
Fando, R A
The article considers medical genetic studies carried out by S.G. Levit scientific School. The workers of the Medical biologic institute studied geographical prevalence of different forms of colorblindness, early canities and surdomutism. The hospital examination of twins was another direction of research studies of Levit School. The organization of the mentioned research was clear-cut planned. The groups of researchers were organized to study normal and pathologic characteristics. The special research program was developed. The institute permanently carried out active workshops and conferences, published scientific transactions. The consolidation of various specialists around the scientific school made it possible to resolve many inter-disciplinary problems in the field of inherent pathology.
Fox, Joshua; Faber, David; Pikarsky, Solomon; Zhang, Chi; Riley, Richard; Mechaber, Alex; O'Connell, Mark; Kirsner, Robert S
The flipped classroom module incorporates independent study in advance of in-class instructional sessions. It is unproven whether this methodology is effective within a medical school second-year organ system module. We report the development, implementation, and effectiveness of the flipped classroom methodology in a second-year medical student dermatology module at the University of Miami Leonard M. Miller School of Medicine. In a retrospective cohort analysis, we compared attitudinal survey data and mean scores for a 50-item multiple-choice final examination of the second-year medical students who participated in this 1-week flipped course with those of the previous year's traditional, lecture-based course. Each group comprised nearly 200 students. Students' age, sex, Medical College Admission Test scores, and undergraduate grade point averages were comparable between the flipped and traditional classroom students. The flipped module students' mean final examination score of 92.71% ± 5.03% was greater than that of the traditional module students' 90.92% ± 5.51% ( P flipped methodology to attending live lectures or watching previously recorded lectures. The flipped classroom can be an effective instructional methodology for a medical school second-year organ system module.
In American medical schools, the period of time between the announcement of internships and graduation is known as FYBIGMI, for "Fuck You Brother I Got My Internship." At University Medical School (pseudonym), as at most American medical schools, this period culminates in an elaborate musical comedy (attended by faculty and relatives) in which faculty are abused, patients are represented in terms of stigmatized stereotypes, and the students demonstrate a profane familiarity with cultural taboos. Using the analytic methods of cultural anthropology, this examination of the FYBIGMI performance at U.M.S. focuses primarily on the seniors' presentation of their newly acquired professional identity, which is constituted in the skits by recurring oppositions to socially stigmatized, medically self-destructive patients. In this oppositional logic, racial stereotypes play a particularly large role. In addition, the seniors establish their new social status by inverting their relationship to their (former) supervisors on a personal basis, and by confronting the audience with their professional ability to treat cultural taboos with profane familiarity. The FYBIGMI theatrical, and its representation of professional identity, is analyzed in relation to a proposed model of the underlying structure of the process of medical education, that is, an escalating dialectic of intimidation and self-congratulation.
Khan, Aamer Zaman
To identify the non-academic attributes developed during 5 years of training in medical school. Sequential mixed method. The study was conducted on final year medical students of four medical colleges in the city of Lahore, from March to September 2010. Probability random sampling was employed to identify public sector medical colleges for inclusion in the study through Lottery method. In the first phase, survey was done with the help of questionnaires, distributed amongst 280 students, selected on the basis of convenience sampling. It was triangulated with data collected by in-depth structured interviews on 46 students selected using purposive sampling after formal informed consent. For quantitative data percentages of the categorical variables were calculated through SPSS version 10. For qualitative data, themes and patterns were identified using Content Analysis technique. Majority of the medical students (80%) learn the attributes of integrity, self-reliance, tolerance and independence during their schooling. Sixty five percent students thought that the values of humanity, forbearance, righteous attitude in face of adversities and sympathetic behaviour towards peers and patients helped them in being better medical students. Thirty five percent said they faced the negative influences of gender bias and gender discrimination which has led to their impaired professional growth. Eighty percent of the students believe that the teaching methodology employed is teacher centric which does not let them become problem solvers, team players, reflective learners and hampers development of effective communication skills. Medical schooling in our part of the world helps in developing untaught attributes such as integrity, selfreliance, tolerance, independence, sympathetic attitude and good communication skills which are the same as are developed in the medical students of advanced countries, which can be fostered further by formally addressing them in the curriculum.
Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin
Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors' FCOI declarations in guidelines from the Canadian Medical Association (CMA) Infobase. We also assess the financial relationships between guideline-affiliated organizations and drug companies. Using a population approach, we extracted first-line drug recommendations and authors' FCOI disclosures in guidelines from the CMA Infobase. We contacted the corresponding authors on guidelines when FCOI disclosures were missing for some or all authors. We also extracted guideline-affiliated organizations and searched each of their websites to determine if they had financial relationships with drug companies. We analyzed 350 authors from 28 guidelines. Authors were named on one, two, or three guidelines, yielding 400 FCOI statements. In 75.0 % of guidelines at least one author, and in 21.4 % of guidelines all authors, disclosed FCOI with drug companies. In 54.0 % of guidelines at least one author, and in 28.6 % of guidelines over half of the authors, disclosed FCOI with manufacturers of drugs that they recommended. Twenty of 48 authors on multiple guidelines reported different FCOI in their disclosures. Eight guidelines identified affiliated organizations with financial relationships with manufacturers of drugs recommended in those guidelines. This is the first study to systematically describe FCOI disclosures by authors of Canadian guidelines and financial relationships between guideline-affiliated organizations and pharmaceutical companies. These financial relationships are common. Because authoritative value is assigned to guidelines distributed by
Hardy, S P
Published histories of bacteriology concentrate on the scientific concepts, exemplified by Louis Pasteur and Robert Koch. Arguably, the early British bacteriological studies are headed by Lord Lister, whereas other notables such as Ronald Ross, Robert Bruce and Patrick Manson are honoured for their discoveries of 'tropical' microbes, accomplished abroad. What then was happening in Great Britain? The introduction of bacteriology into the medical school curriculum is examined according to the published lectures in The Lancet between 1889 and 1901 and the dates are reviewed in light of other published sources. The names of the people delivering bacteriology at the medical schools in Great Britain and Ireland provide a guide to the relevance of crediting Lister as the leading light for microbiology in the UK. The diversity of names and backgrounds suggests that a critical reassessment of the perceived late and limited start of UK medical bacteriology is needed.
Neeley, Brandon C; Golden, Daniel W; Brower, Jeffrey V; Braunstein, Steve E; Hirsch, Ariel E; Mattes, Malcolm D
Delivering a cohesive oncology curriculum to medical students is challenging due to oncology's multidisciplinary nature, predominantly outpatient clinical setting, and lack of data describing effective approaches to teaching it. We sought to better characterize approaches to oncology education at US medical schools by surveying third and fourth year medical students who serve on their institution's curriculum committee. We received responses from students at 19 schools (15.2% response rate). Key findings included the following: (1) an under-emphasis of cancer in the curriculum relative to other common diseases; (2) imbalanced involvement of different clinical subspecialists as educators; (3) infrequent requirements for students to rotate through non-surgical oncologic clerkships; and (4) students are less confident in their knowledge of cancer treatment compared to basic science/natural history or workup/diagnosis. Based on these findings, we provide several recommendations to achieve robust multidisciplinary curriculum design and implementation that better balances the clinical and classroom aspects of oncology education.
Chertoff, Jason; Wright, Ashleigh; Novak, Maureen; Fantone, Joseph; Fleming, Amy; Ahmed, Toufeeq; Green, Marianne M; Kalet, Adina; Linsenmeyer, Machelle; Jacobs, Joshua; Dokter, Christina; Zaidi, Zareen
We sought to investigate the number of US medical schools utilizing portfolios, the format of portfolios, information technology (IT) innovations, purpose of portfolios and their ability to engage faculty and students. A 21-question survey regarding portfolios was sent to the 141 LCME-accredited, US medical schools. The response rate was 50% (71/141); 47% of respondents (33/71) reported that their medical school used portfolios in some form. Of those, 7% reported the use of paper-based portfolios and 76% use electronic portfolios. Forty-five percent reported portfolio use for formative evaluation only; 48% for both formative and summative evaluation, and 3% for summative evaluation alone. Seventy-two percent developed a longitudinal, competency-based portfolio. The most common feature of portfolios was reflective writing (79%). Seventy-three percent allow access to the portfolio off-campus, 58% allow usage of tablets and mobile devices, and 9% involve social media within the portfolio. Eighty percent and 69% agreed that the portfolio engaged students and faculty, respectively. Ninety-seven percent reported that the portfolios used at their institution have room for improvement. While there is significant variation in the purpose and structure of portfolios in the medical schools surveyed, most schools using portfolios reported a high level of engagement with students and faculty.
Green, Emily P; Borkan, Jeffrey M; Pross, Susan H; Adler, Shelley R; Nothnagle, Melissa; Parsonnet, Julie; Gruppuso, Philip A
Many medical curricula now include programs that provide students with opportunities for scholarship beyond that provided by their traditional, core curricula. These scholarly concentration (SC) programs vary greatly in focus and structure, but they share the goal of producing physicians with improved analytic, creative, and critical-thinking skills. In this article, the authors explore models of both required and elective SC programs. They gathered information through a review of medical school Web sites and direct contact with representatives of individual programs. Additionally, they discuss in-depth the SC programs of the Warren Alpert Medical School of Brown University; the University of South Florida College of Medicine; the University of California, San Francisco; and Stanford University School of Medicine. The authors describe each program's focus, participation, duration, centralization, capstone requirement, faculty involvement, and areas of concentration. Established to address a variety of challenges in the U.S. medical education system, these four programs provide an array of possible models for schools that are considering the establishment of an SC program. Although data on the impact of SC programs are lacking, the authors believe that this type of program has the potential to significantly impact the education of medical students through scholarly, in-depth inquiry and longitudinal faculty mentorship.
Nassar, Usama; Fairbanks, Connor; Flores-Mir, Carlos; Kilistoff, Alan; Easton, Rick
Comprehensive data on the characteristics and opinions of graduating dental students in Canada are lacking. Specifically, only minimal information is available on graduates' immediate career plans and factors that may influence their decisions regarding these plans. Our aim was to gather such data to allow better understanding of this issue and improve the design of future studies on this topic. The Career Development Committee at the school of dentistry, University of Alberta, designed a short survey to be administered to graduating students over 5 years to gain insight into their immediate career plans and opinions on career services at the school. Preliminary results from 2012-2014 are reported here. With a response rate of close to 90% (n = 99/111), the data reveal considerable differences in immediate career plans between the surveyed students and those in other schools in Canada and the United States. Of the students, 89% were planning to work in a general dental practice and only 9% were planning to enroll in advanced education, including general practice residency training. More research is needed to better understand the factors affecting career path decisions of students.
Olopade, Funmilayo Eniola; Adaramoye, Oluwatosin Adekunle; Raji, Yinusa; Fasola, Abiodun Olubayo; Olapade-Olaopa, Emiola Oluwabunmi
The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the "old" curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula successfully. The modifications to the teaching and assessment of the core basic medical science subjects have resulted in improved learning and performance at the final examinations.
Romano, Elisa; Babchishin, Lyzon; Pagani, Linda S; Kohen, Dafna
In this article we replicate and extend findings from Duncan et al. (2007). The 1st study used Canada-wide data on 1,521 children from the National Longitudinal Survey of Children and Youth (NLSCY) to examine the influence of kindergarten literacy and math skills, mother-reported attention, and mother-reported socioemotional behaviors on 3rd-grade math and reading outcomes. Similar to Duncan et al., (a) math skills were the strongest predictor of later achievement, (b) literacy and attention skills predicted later achievement, and (c) socioemotional behaviors did not significantly predict later school achievement. As part of extending the findings, we incorporated a multiple imputation approach to handle missing predictor variable data. Results paralleled those from the original study in that kindergarten math skills and Peabody Picture Vocabulary Test-Revised scores continued to predict later achievement. However, we also found that kindergarten socioemotional behaviors, specifically hyperactivity/impulsivity, prosocial behavior, and anxiety/depression, were significant predictors of 3rd-grade math and reading. In the 2nd study, we used data from the NLSCY and the Montreal Longitudinal-Experimental Preschool Study (MLEPS), which was included in Duncan et al., to extend previous findings by examining the influence of kindergarten achievement, attention, and socioemotional behaviors on 3rd-grade socioemotional outcomes. Both NLSCY and MLEPS findings indicated that kindergarten math significantly predicted socioemotional behaviors. There were also a number of significant relationships between early and later socioemotional behaviors. Findings support the importance of socioemotional behaviors both as predictors of later school success and as indicators of school success.
Eickmeyer, Sarah M; Do, Kim D; Kirschner, Kristi L; Curry, Raymond H
To determine the nature and frequency of impairments and related underlying conditions of medical students with physical and sensory disabilities (PSDs), and to assess medical schools' use of relevant publications in setting admission criteria and developing appropriate accommodations. A 25-item survey addressed schools' experiences with students known to have PSDs and their related policies and practices. The survey instrument was directed to student affairs deans at all 163 accredited American and Canadian medical schools. The authors limited the survey to consideration of PSDs, excluding psychiatric, cognitive, and learning disabilities. Eighty-six schools (52.8%) responded, representing an estimated 83,327 students enrolled between 2001 and 2010. Of these students, 0.56% had PSDs at matriculation and 0.42% at graduation. Although 81% of respondents were familiar with published guidelines for technical standards, 71% used locally derived institutional guidelines for the admission of disabled applicants. The most commonly reported accommodations for students with PSDs included extra time to complete tasks/exams (n = 62), ramps, lifts, or accessible entrances (n = 43), and dictated/audio-recorded lectures (n = 40). All responding schools required students' demonstration of physical examination skills; requirements for other technical skills, with or without accommodations, varied considerably. The matriculation and graduation rates of medical students with PSDs remain low. The most frequent accommodations reported were among those required of any academic or clinical setting by the Americans with Disabilities Act. There is a lack of consensus regarding technical standards for admission, suggesting a need to reexamine this critical issue.
Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik
Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism. Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Medical tourism is creating new challenges for
Daugherty, R M
The magnitude and pace of change in the health care environment demand that medical schools change. Leading in a time of great change is difficult, and it is ironic that just when stability in leadership is most needed, the average tenure of deans is dropping. Indeed, the path to leadership in academic medicine is strewn with inherent ironies, paradoxes, and idiosyncrasies. For example, few people who become leaders in academic medicine aspire to, plan for, or seek training for leadership, yet leadership skills are essential to meet today's complex institutional demands. Also, most medical school deans were once medical students, and were selected and trained to be assertive, independent physicians, not to collaborate. For faculty, the medical school environment traditionally values individual autonomy and rewards individual achievement, not behavior that supports a larger community interest. Yet today's deans must be skilled at collaborative behavior, since they must have a vision for their schools and find ways to offer direction to the faculty and others to realize that vision. The author offers ideas about leadership and its development, and stresses that good leaders must above all curtail their egos in order to do what is best for their institutions. What a dean does as an individual is not nearly as important as what a dean enables others to do. The author also provides a checklist of dean's characteristics and responsibilities to help deans-to-be understand the job and current deans to think about how to succeed and thrive. He concluded by reiterating that the culture of individual faculty success based on individual entrepreneurism is passé. To operate in the new collaborative culture, today's successful dean must meld persuasion with educational statesmanship, always informed by a vision of how the school can prosper and serve.
The Universidad Austral de Chile Medical School was created in 1966. Its general goal was to train a general physician with capacities to integrate biological, psychological and social issues, to deal with prevalent diseases as well as with the non referable casualties, to analyze health situations and to manage health teams. From its beginning, it incorporated anthropological and the public health contents to medical curriculum. Moreover, the formal teaching formation was reduced to 5 years, increasing the internship cycle to 2 years, with an important practice on primary health care in regional hospitals, that included a research project on health administration. A revision of the School curriculum showed the need of a better horizontal and vertical integration of medical education. Consequently, global courses were organized to gather knowledge that, until now, was delivered in a fragmented form. Our Medical School has a major impact in the southern region of the country and over 60% of its graduates have settled in this zone, improving its physician/inhabitant relationship and the number of specialists.
Coria, Alexandra; McKelvey, T Greg; Charlton, Paul; Woodworth, Michael; Lahey, Timothy
The acquisition of skills to recognize and redress adverse social determinants of disease is an important component of undergraduate medical education. In this article, the authors justify and define "social justice curriculum" and then describe the medical school social justice curriculum designed by the multidisciplinary Social Justice Vertical Integration Group (SJVIG) at the Geisel School of Medicine at Dartmouth. The SJVIG addressed five goals: (1) to define core competencies in social justice education, (2) to identify key topics that a social justice curriculum should cover, (3) to assess social justice curricula at other institutions, (4) to catalog institutionally affiliated community outreach sites at which teaching could be paired with hands-on service work, and (5) to provide examples of the integration of social justice teaching into the core (i.e., basic science) curriculum. The SJVIG felt a social justice curriculum should cover the scope of health disparities, reasons to address health disparities, and means of addressing these disparities. The group recommended competency-based student evaluations and advocated assessing the impact of medical students' social justice work on communities. The group identified the use of class discussion of physicians' obligation to participate in social justice work as an educational tool, and they emphasized the importance of a mandatory, longitudinal, immersive, mentored community outreach practicum. Faculty and administrators are implementing these changes as part of an overall curriculum redesign (2012-2015). A well-designed medical school social justice curriculum should improve student recognition and rectification of adverse social determinants of disease.
Chur-Hansen, Anna; Carr, John E; Bundy, Christine; Sanchez-Sosa, Juan Jose; Tapanya, Sombat; Wahass, Saeed H
The behavioral sciences are taught in medical curricula around the world. In the current paper psychologists teaching in medical schools in Australia, Mexico, Saudi Arabia, Thailand, the United Kingdom and the United States share their experience and reflections. Whilst direct comparisons between countries are not made, the themes that are evident within and between accounts are instructive. As behavioral scientists around the globe are struggling to maintain a presence in medical education many of the reasons behind this are shared, regardless of the country. Challenges discussed include those related to the impact of unrealized potential contributions of psychologists as health care professionals, teaching of behavioral sciences by other professions, domination of the biomedical model without a corresponding recognition of psychology as science, and modern medical pedagogies such as problem-based learning, which favor biomedicine. Systemic and political barriers over which we as a discipline may have little control are also highlighted.
Bruns, Florian; Chelouche, Tessa
Nazi medicine and its atrocities have been explored in depth over the past few decades, but scholars have started to examine medical ethics under Nazism only in recent years. Given the medical crimes and immoral conduct of physicians during the Third Reich, it is often assumed that Nazi medical authorities spurned ethics. However, in 1939, Germany introduced mandatory lectures on ethics as part of the medical curriculum. Course catalogs and archival sources show that lectures on ethics were an integral part of the medical curriculum in Germany between 1939 and 1945. Nazi officials established lecturer positions for the new subject area, named Medical Law and Professional Studies, at every medical school. The appointed lecturers were mostly early members of the Nazi Party and imparted Nazi political and moral values in their teaching. These values included the unequal worth of human beings, the moral imperative of preserving a pure Aryan people, the authoritarian role of the physician, the individual's obligation to stay healthy, and the priority of public health over individual-patient care. This article shows that there existed not only a Nazi version of medical ethics but also a systematic teaching of such ethics to students in Nazi Germany. The findings illustrate that, from a historical point of view, the notion of "eternal values" that are inherent to the medical profession is questionable. Rather, the prevailing medical ethos can be strongly determined by politics and the zeitgeist and therefore has to be repeatedly negotiated.
L.C. Urlings-Strop (Louise); A.P.N. Themmen (Axel); K.M. Stegers-Jager (Karen)
textabstractSeveral medical schools include candidates’ extracurricular activities in their selection procedure, with promising results regarding their predictive value for achievement during the clinical years of medical school. This study aims to reveal whether the better achievement in clinical
Brooks, Lucy; Bell, Dominic
To evaluate the UK undergraduate medical ethics curricula against the Institute of Medical Ethics (IME) recommendations; to identify barriers to teaching and assessment of medical ethics and to evaluate perceptions of ethics faculties on the preparation of tomorrow's doctors for clinical practice. Questionnaire survey of the UK medical schools enquiring about content, structure and location of ethics teaching and learning; teaching and learning processes; assessment; influences over institutional approach to ethics education; barriers to teaching and assessment; perception of student engagement and perception of student preparation for clinical practice. The lead for medical ethics at each medical school was invited to participate (n=33). Completed responses were received from 11/33 schools (33%). 73% (n=8) teach all IME recommended topics within their programme. 64% (n=7) do not include ethics in clinical placement learning objectives. The most frequently cited barrier to teaching was lack of time (64%, n=7), and to assessment was lack of time and suitability of assessments (27%, n=3). All faculty felt students were prepared for clinical practice. IME recommendations are not followed in all cases, and ethics teaching is not universally well integrated into clinical placement. Barriers to assessment lead to inadequacies in this area, and there are few consequences for failing ethics assessments. As such, tomorrow's patients will be treated by doctors who are inadequately prepared for ethical decision making in clinical practice; this needs to be addressed by ethics leads with support from medical school authorities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Wright, William S; Baston, Kirk
The National Board of Medical Examiners® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination® (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME®) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated "yes" or "no" to the initial question "Does your institution administer the NBME CBSE prior to the USMLE Step 1?". A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools.
Full Text Available Introduction: Physicians have to visit, diagnose and refer patients with genetic disorders, so they need to be familiar with the basics and indications of genetic tests. In other words, they should have effective theoretical and practical knowledge about medical genetics before they do their job. Medical genetics courses at Medical Universities of Iran are generally presented as a theoretical subject in the first period of medical education. Methods: In this descriptive research, the results of interviews with teachers of medical genetics in 30 medical schools in Islamic Republic of Iran and responses to a questionnaire by 125 medical students of Ahvaz Jundishapur University of medical sciences, about presentation time, curricula and also efficacy of medical genetics courses were analyzed. The interviews with teachers were done on phone and the students’ comments were collected by a researcher-made questionnaire. The data were analyzed, using SPSS software, version 14. Results: In two thirds of medical universities, medical genetics is taught in the third or fourth semester and in 5 universities in the fifth semester. 86% of the students believed that the quality of genetics courses is moderate and such courses are same as clinical manifestation of genetic disorders are benefitial to medical students. Conclusion: This article suggests that medical genetics be offered in the second or third period of medical education (physiopathology or stagger period. Furthermore, in teaching such courses advanced educational methods (animation presentation, case-based learning, problem-based learning, etc. should be used, together with simple genetic tests in laboratories, the visit of genetic patients in hospitals, and the genetics consult.
Zhang, Ming-ya; Wang, Guang; Cheng, Xin; Yang, Xuesong
A great number of overseas students have studied medicine at Jinan University Medical School over the past decade. Statistics from the past ten years show that these students' test scores on diagnosis and medicine I & II are lower than those of their classmates from mainland China. To address the underlying causes of this phenomenon, we…
Commander, Clayton W; Pabon-Ramos, Waleska M; Isaacson, Ari J; Yu, Hyeon; Burke, Charles T; Dixon, Robert G
To determine if there was a difference in the level of knowledge about interventional radiology (IR) between medical students in preclinical years of training compared with medical students in clinical years of training at two medical schools and to compare awareness of IR based on the curriculum at each school: one with required radiology education and one without such a requirement. An anonymous survey was distributed to students at two medical schools; the survey assessed knowledge of IR, knowledge of training pathways, and preferred methods to increase exposure. Responses of the preclinical and clinical groups were compared, and responses from the clinical groups at each school were compared. "Poor" or "fair" knowledge of IR was reported by 84% (n = 217 of 259) of preclinical students compared with 62% of clinical students (n = 110 of 177; P lack of knowledge" (65%, n = 136 of 210 preclinical; 20%, n = 32 of 162 clinical). Students in the clinical group at the institution with a required radiology rotation reported significantly better knowledge of IR than clinical students from the institution without a required clerkship (P = .017). There are significant differences in knowledge of IR between preclinical and clinical students. Required radiology education in the clinical years does increase awareness of IR. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.
Grbic, Douglas; Jones, David J; Case, Steven T
Socioeconomic status (SES) impacts educational opportunities and outcomes which explains, in part, why the majority of medical students come from the upper two quintiles of family income. A two-factor SES indicator based on parental education (E) and occupation (O) has recently been established by the Association of American Medical Colleges (AAMC). This study validates this two-factor indicator as applicable to the national pool of medical school applicants. The AAMC SES EO indicator classifies applicants into five ordered groups (EO-1 through EO-5) based on four aggregated categories of parental education and two aggregated categories of occupation. The EO indicator was applied to the 2012 American Medical College Application Service applicant pool. The authors examined the associations that the EO category had with six additional and independent indicators of socioeconomic (dis)advantage, as well as with demographic and educational characteristics and life experiences. The EO indicator could be applied to 89% of the 2012 applicants. The lower the EO category, the stronger the association with each of the six indicators of socioeconomic disadvantage. Other notable, but weaker, associations with the EO indicator were differences by age, race/ethnicity, performance on the Medical College Admission Test, community college attendance, and certain self-reported life experiences. The EO indicator provides a simple, intuitive, widely applicable, and valid means for identifying applicants from socioeconomically disadvantaged backgrounds. This affords admissions committees an additional factor to consider during the holistic review of applicants in order to further diversify the medical school class.
Schweller, Marcelo; Costa, Felipe Osorio; Antônio, Maria Ângela R G M; Amaral, Eliana M; de Carvalho-Filho, Marco Antonio
To examine the impact of simulated medical consultations using standardized patients (SPs) on the empathy levels of fourth- and sixth-year students at the Unicamp medical school in Brazil. Throughout 2011 and 2012, the authors conducted this study with two classes of fourth-year (n = 124) and two classes of sixth-year (n = 123) medical students. Students completed the medical student version of the Jefferson Scale of Physician Empathy before and after simulated medical consultations with SPs, followed by an in-depth debriefing dealing with the feelings of the patient about the disease, such as fear, guilt, anger, and abandonment; the feelings of the doctor towards the patient; and other topics as they arose. The simulation activity increased the empathy scores of the fourth-year students (from 115.8 to 121.1, P students (from 117.1 to 123.5, P consultations with SPs may improve medical students' empathy levels. One unexpected result was that this activity, during the debriefing, became a forum for debating topics such as the doctor-patient relationship, the hidden curriculum, negative role models, and emotionally significant experiences of students in medical school. This kind of activity in itself may influence young doctors to become more empathetic and compassionate with their patients and foster a more meaningful way of practicing medicine.
Jacque, Berri; Malanson, Katherine; Bateman, Kathleen; Akeson, Bob; Cail, Amanda; Doss, Chris; Dugan, Matt; Finegold, Brandon; Gauthier, Aimee; Galego, Mike; Roundtree, Eugene; Spezzano, Lawrence; Meiri, Karina F
Medical schools, although the gatekeepers of much biomedical education and research, rarely engage formally with K-12 educators to influence curriculum content or professional development. This segregation of content experts from teachers creates a knowledge gap that limits inclusion of current biomedical science into high school curricula, affecting both public health literacy and the biomedical pipeline. The authors describe how, in 2009, scientists from Tufts Medical School and Boston public school teachers established a partnership of formal scholarly dialogue to create 11th- to 12th-grade high school curricula about critical health-related concepts, with the goal of increasing scientific literacy and influencing health-related decisions. The curricula are based on the great diseases (infectious diseases, neurological disorders, metabolic disease, and cancer). Unlike most health science curricular interventions that provide circumscribed activities, the curricula are comprehensive, each filling one full term of in-class learning and providing extensive real-time support for the teacher. In this article, the authors describe how they developed and implemented the infectious disease curriculum, and its impacts. The high school teachers and students showed robust gains in content knowledge and critical thinking skills, whereas the Tufts scientists increased their pedagogical knowledge and appreciation for health-related science communication. The results show how formal interactions between medical schools and K-12 educators can be mutually beneficial.
William S Wright,1 Kirk Baston2 1Department of Biomedical Sciences, 2Department of Pathology, University of South Carolina School of Medicine Greenville, Greenville, SC, USA Purpose: The National Board of Medical Examiners® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination® (USMLE) Step 1 in new schools and sch...
Olstad, Dana Lee; Campbell, Elizabeth J; Raine, Kim D; Nykiforuk, Candace I J
Few children meet physical activity (PA) recommendations, and are therefore at increased risk for overweight/obesity and adverse health outcomes. To increase children's opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. The purpose of this study was to understand the processes underlying adoption and diffusion of Canadian DPA policies, and to review evidence regarding their implementation and impact. We adopted a multiple case history methodology in which we traced the chronological trajectory of DPA policies among Canadian provinces by compiling timelines detailing key historical events that preceded policy adoption. Publicly available documents posted on the internet were reviewed to characterize adopter innovativeness, describe the content of their DPA policies, and explore the context surrounding policy adoption. Diffusion of Innovations theory provided a conceptual framework for the analyses. A systematic literature search identified studies that had investigated adoption, diffusion, implementation or impact of Canadian DPA policies. Five of Canada's 13 provinces and territories (38.5%) have DPA policies. Although the underlying objectives of the policies are similar, there are clear differences among them and in their various policy trajectories. Adoption and diffusion of DPA policies were structured by the characteristics and capacities of adopters, the nature of their policies, and contextual factors. Limited data suggests implementation of DPA policies was moderate but inconsistent and that Canadian DPA policies have had little to no impact on school-aged children's PA levels or BMI. This study detailed the history and current status of Canadian DPA policies, highlighting the conditional nature of policy adoption and diffusion, and
Huang, Lei; Cai, Qiaoling; Cheng, Liming; Kosik, Russell; Mandell, Greg; Wang, Shuu-Jiun; Xu, Guo-Tong; Fan, Angela P
A comprehensive search of the literature published between 2001 and 2010 was performed to gain a greater understanding of curricular reform practices at Chinese medical schools. There were 10,948 studies published between 2001 and 2010 that were retrieved from the database. Following preliminary screening, 76 publications from 49 different medical schools were selected. Thirty-one publications regarding clinical medicine curricular reforms were analyzed further. Of the 76 studies, 53 described curricular reforms that were instituted in theoretical courses, 22 described curricular reforms that were instituted in experimental courses, and 1 described curricular reforms that were instituted in a clinical skills training course. Of the 31 clinical medicine publications, 2 described reforms that were implemented for 3-year program medical students, 12 described reforms that were implemented for 5-year program medical students, 6 described reforms that were implemented for 7-year program medical students, and 2 described reforms that were implemented for 8-year program medical students. Currently, the majority of medical schools in China use the discipline-based curriculum model. Thirteen studies described transition to an organ-system-based curriculum model, 1 study described transition to a problem-based curriculum model, and 3 studies described transition to a clinical presentation-based curriculum model. In 7 studies educators decided to retain the discipline-based curriculum model while integrating 1 or several new courses to remedy the weaker aspects of the traditional curriculum, in 7 studies educators decided to integrate the preclinical courses with the clinical courses by using the systemic-integrating curricular system that dilutes classical disciplines and integrates material based on organ systems, and in 2 studies educators limited reforms to clinical courses only. Eight studies discussed the implementation of a formative evaluation system, 4 studies
Ng, C L; Tambyah, P A; Wong, C Y
Medical tuition fees have been rising in many countries, including in Singapore. No formal study has been conducted to evaluate the financial situation of medical students in relation to the cost of medical education in Singapore. This study was conducted to determine the financial profile of Singaporean medical students and the financial expenses they incur over the five-year duration of their undergraduate medical course. A questionnaire study was conducted among Year one to Year five medical students in the Yong Loo Lin School of Medicine, National University of Singapore. The following quantifiable parameters were analysed: monthly household income, financial assistance, monthly allowances and expenses. 64.3 percent (735) of the 1,143 undergraduates completed the survey. 21.9 percent came from families with a monthly income of less than S$3,000, with another 26.2 percent from families with monthly incomes of S$3,000-S$5,000. The total tuition fees for a five-year medical course amounted to S$87,450. The average annual expenditure of medical students amounted to S$4,470. 31.1 percent of respondents were on loans. 14.6 percent received scholarships or bursaries. A five-year medical course can cost more than S$100,000 and pose a significant financial burden for students. The proportion of students who came from lower-income families was lower in medical school than at the national level, while the proportion from high-income families was significantly higher than at the national level. A significant proportion of students took loans to pay for tuition, and a smaller percentage was under scholarships and bursaries. More substantial financial assistance is required, particularly for students from lower-income families.
Bardes, Charles L; Best, Peggy Carey; Kremer, Sara J; Dienstag, Jules L
Medical schools use a variety of criteria in selecting applicants for admission, attempting to assess both the academic preparation and the personal characteristics suitable for a career in medicine. While assessing academic preparation is fairly straightforward, assessing applicants' personal characteristics is difficult and controversial. The possibility of implementing standardized testing of personal characteristics, so-called "noncognitive testing," has been proposed as part of the admissions process. Such a proposal, however, raises numerous questions about the validity, fairness, and cost of such testing and the impact of commercial test-preparation services on test performance and reliability. Therefore, before noncognitive testing is adopted for screening applicants to medical school, open discussion among all stakeholders in the admissions process is critically important.
Gangata, Hope; Ntaba, Phatheka; Akol, Princess; Louw, Graham
The study of gross Anatomy through the use of cadaveric dissections in medical schools is an essential part of the comprehensive learning of human Anatomy, and unsurprisingly, 90% of the surveyed medical schools in Africa used cadaveric dissections. Donated cadavers now make up 80% of the total cadavers in North American medical schools and all…
Crooks, Valorie A; Turner, Leigh; Cohen, I Glenn; Bristeir, Janet; Snyder, Jeremy; Casey, Victoria; Whitmore, Rebecca
Objectives Medical tourism involves patients’ intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism. Design We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically. Participants Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated. Results Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making. Conclusions Concern was expressed that medical tourism might have unintended and undesired effects upon patients’ home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose
Park, H W
Kwang Hye Won(Je Joong Won), the first western hospital in Korea, was founded in 1885. The first western Medical School in Korea was open in 1886 under the hospital management. Dr. O. R. Avison, who came to Korea in 1893, resumed the medical education there, which was interrupted for some time before his arrival in Korea. He inaugurated translating and publishing medical textbooks with the help of Kim Pil Soon who later became one of the first seven graduates in Severance Hospital Medical School. The first western medical textbook translated into Korean was Henry Gray's Anatomy. However, these twice-translated manuscripts were never to be published on account of being lost and burnt down. The existing early anatomy textbooks, the editions of 1906 and 1909, are not the translation of Gray's Anatomy, but that of Japanese anatomy textbook of Gonda. The remaining oldest medical textbook in Korean is Inorganic Materia Medica published in 1905. This book is unique among its kind that O. R. Avison is the only translator of the book and it contains the prefaces of O. R. Avison and Kim Pil Soon. The publication of medical textbook was animated by the participation of other medical students, such as Hong Suk Hoo and Hong Jong Eun. The list of medical textbooks published includes almost all the field of medicine. The medical textbooks in actual existence are as follows: Inorganic Materia Medica (1905), Inorganic Chemistry (1906), Anatomy I (1906), Physiology (1906), Diagnostics I (1906), Diagnostics II (1907), Obstetrics (1908), Organic Chemistry (1909), Anatomy (1909), and Surgery (1910).
Sen Gupta, T K; Hays, R B; Kelly, G; Buettner, P G
As medical education becomes more decentralised, and greater use is made of rural clinical schools and other dispersed sites, attention is being paid to the quality of the learning experiences across these sites. This article explores this issue by analysing the performance data of 4 cohorts of students in a dispersed clinical school model across 4 sites. The study is set in a newly established medical school in a regional area with a model of dispersed education, using data from the second to fifth cohorts to graduate from this school. Summative assessment results of 4 graduating cohorts were examined over the final 2 years of the course. Two analyses were conducted: an analysis of variance of mean scores in both years across the 4 sites; and an analysis of the effect of moving to different clinical schools on the students' rank order of performance by use of the Kruskal-Wallis test. Analysis revealed no significant difference in the mean scores of the students studying at each site, and no significant differences overall in the median ranking across the years. Some small changes in the relative ranking of students were noticed, and workplace-based assessment scores in the final year were higher than the examination-based scores in the previous year. The choice of clinical school site for the final 2 years of an undergraduate rural medical school appears to have no effect on mean assessment scores and only a minor effect on the rank order of student scores. Workplace-based assessment produces higher scores but also has little effect on student rank order. Further studies are necessary to replicate these findings in other settings and demonstrate that student learning experiences in rural sites, while popular with students, translate into required learning outcomes, as measured by summative assessments.
Maria Cristina Pereira Lima
The students’ relationships with one another and their teachers can become difficult at different times. However, entrance into the university seems to be a particularly tense moment, due to the hazing suffered this stage of their academic lives. This study presents a review of the literature on the hazing, especially that have happen in medical schools, trying to identify the characteristics and maintaining factors of those ritual. In parallel, constructs a metaphor of the vampire myth, prop...
Schweller, Marcelo; Costa, Felipe Osorio; Antônio, Maria Ângela R.G.M.; Amaral, Eliana M.
Purpose To examine the impact of simulated medical consultations using standardized patients (SPs) on the empathy levels of fourth- and sixth-year students at the Unicamp medical school in Brazil. Method Throughout 2011 and 2012, the authors conducted this study with two classes of fourth-year (n = 124) and two classes of sixth-year (n = 123) medical students. Students completed the medical student version of the Jefferson Scale of Physician Empathy before and after simulated medical consultations with SPs, followed by an in-depth debriefing dealing with the feelings of the patient about the disease, such as fear, guilt, anger, and abandonment; the feelings of the doctor towards the patient; and other topics as they arose. Results The simulation activity increased the empathy scores of the fourth-year students (from 115.8 to 121.1, P empathy levels. One unexpected result was that this activity, during the debriefing, became a forum for debating topics such as the doctor–patient relationship, the hidden curriculum, negative role models, and emotionally significant experiences of students in medical school. This kind of activity in itself may influence young doctors to become more empathetic and compassionate with their patients and foster a more meaningful way of practicing medicine. PMID:24556779
Quinlivan, Julie A; Lam, Lawrence T; Wan, Siu hong; Petersen, Rodney W
To evaluate whether the four criteria used by the University of Notre Dame Australia (UNDA) to select medical students are successful in selecting for graduates with the desired outcomes of academic excellence and Catholic "mission fit". Prospective cohort study of medical students selected for 2008 and 2009 entry to UNDA in Sydney, New South Wales. The statistical association between the two academic selection criteria of the Graduate Australian Medical School Admissions Test (GAMSAT) and grade point average (GPA) compared with the outcome of medical school examination performance, and the two mission selection criteria of a portfolio score and interview score compared with the outcome of a positive attitude towards serving underserved communities as measured using the Medical Student Attitudes Toward the Underserved (MSATU) test. A total of 223 students were enrolled. GAMSAT section 3, GPA and the interview scores were significantly positively associated with academic performance (P attitude towards serving underserved communities, as measured by the MSATU score. None of the four selection tools used were significantly associated with medical students who had a positive attitude towards serving underserved communities.
Reutzel, Thomas J.; Desai, Archana; Workman, Gloria; Atkin, John A.; Grady, Sarah; Todd, Timothy; Nguyen, Nhu; Watkins, Melissa; Tran, Kim; Liu, Nian; Rafinski, Michelle; Dang, Thanh
An increasing number of students are taking medications while they are in school or are under the influence of medication during school hours. In a novel effort, clinical pharmacists and mental health therapists worked together to provide "mini-in-service" educational programs on psychological disorders and medications used to treat…
Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah
Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended.
Oda, Yasutomo; Koizumi, Shunzo
In Japan, problem-based learning (PBL) is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums) to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors). Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum) is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including "silent tutors" and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan.
Full Text Available In Japan, problem-based learning (PBL is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors. Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including “silent tutors” and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan.
O'Ferrall, Ilse; Hoare, Samuel; Caroline, Bulsara; Mak, Donna B.
Objectives This study explores how medical graduates and their workplace supervisors perceive the value of a structured clinical audit program (CAP) undertaken during medical school. Methods Medical students at the University of Notre Dame Fremantle complete a structured clinical audit program in their final year of medical school. Semi-structured interviews were conducted with 12 Notre Dame graduates (who had all completed the CAP), and seven workplace supervisors (quality and safety staff and clinical supervisors). Purposeful sampling was used to recruit participants and data were analysed using thematic analysis. Results Both graduates and workplace supervisors perceived the CAP to be valuable. A major theme was that the CAP made a contribution to individual graduate’s medical practice, including improved knowledge in some areas of patient care as well as awareness of healthcare systems issues and preparedness to undertake scientifically rigorous quality improvement activities. Graduates perceived that as a result of the CAP, they were confident in undertaking a clinical audit after graduation. Workplace supervisors perceived the value of the CAP beyond an educational experience and felt that the audits undertaken by students improved quality and safety of patient care. Conclusions It is vital that health professionals, including medical graduates, be able to carry out quality and safety activities in the workplace. This study provides evidence that completing a structured clinical audit during medical school prepares graduates to undertake quality and safety activities upon workplace entry. Other health professional faculties may be interested in incorporating a similar program in their curricula. PMID:28692425
Full Text Available Funmilayo Eniola Olopade,1 Oluwatosin Adekunle Adaramoye,2 Yinusa Raji,3 Abiodun Olubayo Fasola,4 Emiola Oluwabunmi Olapade-Olaopa5 1Department of Anatomy, 2Department of Biochemistry, 3Department of Physiology, 4Department of Oral Pathology, 5Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria Abstract: The College of Medicine of the University of Ibadan recently revised its MBBS and BDS curricula to a competency-based medical education method of instruction. This paper reports the process of revising the methods of instruction and assessment in the core basic medical sciences directed at producing medical and dental graduates with a sound knowledge of the subjects sufficient for medical and dental practice and for future postgraduate efforts in the field or related disciplines. The health needs of the community and views of stakeholders in the Ibadan medical and dental schools were determined, and the “old” curriculum was reviewed. This process was directed at identifying the strengths and weaknesses of the old curricula and the newer competences required for modern-day medical/dental practice. The admission criteria and processes and the learning methods of the students were also studied. At the end of the review, an integrated, system-based, community-oriented, person-centered, and competency-driven curriculum was produced and approved for implementation. Four sets of students have been admitted into the curriculum. There have been challenges to the implementation process, but these have been overcome by continuous faculty development and reorientation programs for the nonteaching staff and students. Two sets of students have crossed over to the clinical school, and the consensus among the clinical teachers is that their knowledge and application of the basic medical sciences are satisfactory. The Ibadan medical and dental schools are implementing their competency-based medical education curricula
Full Text Available Abstract Background Today, there is a trend towards establishing the medical humanities as a component of medical education. However, medical humanities programs that exist within the context of a medical school can be problematic. The aim of this study was to explore problems that can arise with the establishment of a medical humanities curriculum in a medical school program. Methods Our theoretical approach in this study is informed by derridean deconstruction and by post-structuralist analysis. We examined the ideology of the Humanities and Medicine program at Lund University, Sweden, the practical implementation of the program, and how ideology and practice corresponded. Examination of the ideology driving the humanities and medicine program was based on a critical reading of all available written material concerning the Humanities and Medicine project. The practice of the program was examined by means of a participatory observation study of one course, and by in-depth interviews with five students who participated in the course. Data was analysed using a hermeneutic editing approach. Results The ideological language used to describe the program calls it an interdisciplinary learning environment but at the same time shows that the conditions of the program are established by the medical faculty's agenda. In practice, the "humanities" are constructed, defined and used within a medical frame of reference. Medical students have interesting discussions, acquire concepts and enjoy the program. But they come away lacking theoretical structure to understand what they have learned. There is no place for humanities students in the program. Conclusion A challenge facing cross-disciplinary programs is creating an environment where the disciplines have equal standing and contribution.
Full Text Available Abstract Background Learning environment in any medical school is found to be important in determining students' academic success. This study was undertaken to compare the perceptions of first year and clinical phase students regarding the learning environment at Melaka Manipal Medical College (MMMC (Manipal Campus and also to identify the gender wise differences in their perceptions. Methods In the present study, the Dundee Ready Education Environment Measure (DREEM inventory was used. DREEM was originally developed at Dundee and has been validated as a universal diagnostic inventory for assessing the quality of educational environment. In the present study, DREEM was administered to undergraduate medical students of first year (n = 118 and clinical phase (n = 108 and the scores were compared using a nonparametric test. Results Among the two batches, first year students were found to be more satisfied with the learning environment at MMMC (as indicated by their higher DREEM score compared to the clinical batch students. Gender wise, there was not much difference in the students' perceptions. Conclusion The present study revealed that both groups of students perceived the learning environment positively. Nevertheless, the study also revealed problematic areas of learning environment in our medical school which enabled us to adopt some remedial measures.
Villavicencio, J Leonel; Merrill, Daniel M; Rich, Norman M
It is a historical fact that warfare and surgery have been linked together as far back as military history has been recorded. In the 18th century, the tendency of most armies to dismiss their medical services at the end of every major conflict resulted in higher mortality at the beginning of the next war. This became evident in the French and British Armies during the Battle of Waterloo. These countries went to great efforts to mobilize their civilian reserve physicians, only to discover that more than half of the medical personnel declined to serve. The scarcity of physicians and the inexperience of those caring for the wounded resulted in a high casualty rate. The current armed conflicts throughout the world with their high number of victims are living evidence of the need for preparedness of the military medical personnel. In this article, we review the systems of military medical education in several countries, and offer the example of the Escuela Medico Militar (Military Medical School) of Mexico, a prestigious source of military medical physicians for the Mexican armed forces.
Walker-Bartnick, L A; Berger, J H; Kappelman, M M
For the past several years, the University of Maryland School of Medicine has operated a successful and efficient basic science peer tutorial program through the management of the Office of Medical Education. During the 1981-82 and 1982-83 academic years, 122 tutoring dyads were formed to take advantage of the tutoring program in nine of the 10 basic science courses encountered during the first two years of medical training. The success of the program is evident in that tutored students received passing grades in 102 (84 percent) of the courses in which they were tutored. In this paper, the authors discuss the systematic procedure of managing a peer tutorial program and the potential positive effects the program has on student tutors as well as on the medical student in academic difficulty.
Full Text Available Audrey Menezes,1,2 Annette Burgess,1 Antonia J Clarke,1,3 Craig Mellis1 1Central Clinical School, Sydney Medical School, The University of Sydney; 2Hornsby Ku-ring-gai Hospital; 3Royal Prince Alfred Hospital, Sydney, NSW, Australia Purpose: Peer tutoring offers a valuable method of enhancing students’ learning experience in medical school. Junior students learn from senior peers to reinforce curriculum content in an engaging community environment. The aim of our study was to assess tutees’ perceptions of a formal peer tutoring program at the Central Clinical School of Sydney Medical School. We used the learning theory of the community of practice in order to understand tutees’ perspectives. Patients and methods: All Year 1 and Year 2 students within the Central Clinical School were invited to be tutored by Year 3 and Year 4 students, respectively. Tutor pairs taught a group of three to four tutees fortnightly, and the tutorials were largely clinically based. A questionnaire containing 13 closed items and four open-ended questions regarding their experiences in the program was distributed to the tutees. Descriptive statistics were used to analyze the data. Results: A total of 66 of 101 (65% Year 1 and Year 2 students took part as tutees and 42 of 106 (40% students as tutors. The tutees' response rate was 53% (35/66. Results were largely positive, with 97% of the tutees enjoying the program, 90% showing interest in tutorial topics, 91% feeling a sense of community, 100% wanting to take part next year, 97% finding small groups effective, and 97% and 91% feeling an improved understanding of medical concepts and clinical skills, respectively. Tutees perceived the most useful aspects to be learning and revision and advice from experienced peers. The most frequent suggestion for improvement was to resolve scheduling conflicts. Conclusion: Tutees found the peer tutoring program to be valuable in learning and revision, establishing a community, and
Simmenroth-Nayda, Anne; Görlich, Yvonne
Admission candidates especially in medicine do not represent the socio-demographic proportions of the average population: children of parents with an academic background are highly overrepresented, and those with parents who are medical doctors represent quite a large and special group. At Göttingen University Medicine, a new admission procedure was established with the intention to broaden the base of applicants towards including candidates with previous medical training or lower final school grades. With a view to family background, we wished to know whether candidates differ in the test scores in our admission procedure. In February 2014 we asked all admission candidates of Göttingen University Medicine by questionnaire (nine closed, four open questions) about the academic background in their families, specifically, the medical background, school exam grades, and previous medical training as well as about how they prepared for the admission test. We also analysed data from admission scores of this group (semi-structured interview and four multiple mini-interviews). In addition to descriptive statistics, we used a Pearson correlation, means comparisons (t-test, analysis of variance), ANOVA, and a Scheffé test. In February 2014 nearly half of the applicants (44%) at Göttingen University Medicine had a medical background, most frequently, their parents were physicians. This rate is much higher than reported in the literature. Other socio-demographic baseline data did not differ from the percentages given in the literature. Of all applicants, 20% had previous medical training. The group of applicants with parents who were medical doctors did not show any advantage in either test-scoring (MMI and interview), their individual preparation for the admission test, or in receiving or accepting a place at medical school. Candidates with parents who were medical doctors had scored slightly lower in school exam grades. Our results suggest that there is a self
Jang Hee Park
Full Text Available lt has been an issue whether the current medical examination system can evaluate medical students' competencies efficiently. This study was performed to survey on the satisfaction for the current medical examination system and present situation for clinical skill test in medical schools. We conducted a survey for this research and the subjects of this study were deans, medical professors, resident and medical students. We met with interesting results. First, most respondents answered the current medical examination system couldn't evaluate the medical students' competencies efficiently. Second, many residents thought preparing for paper-pencil test was not helpful for training, while experiencing clinical skill test was helpful for it. Third, the current contents and methods to evaluate clinical skill in the medical schools were variable and desirable. We concluded it was high time to change our medical examination system for evaluating the clinical skill performance of medical students.
Bridges, Terry James
This qualitative case study explores the use of lesson study over a ten-week period with six Ontario middle school science teachers. The research questions guiding this study were: (1) How does participation in science-based lesson study influence these teachers': (a) science subject matter knowledge (science SMK), (b) science pedagogical content knowledge (science PCK), and (c) confidence in teaching science?, and (2) What benefits and challenges do they associate with lesson study? Data sources for this study were: teacher questionnaires, surveys, reflections, pre- and post- interviews, and follow-up emails; researcher field notes and reflections; pre- and post- administration of the Science Teaching Efficacy Belief Instrument; and audio recordings of group meetings. The teachers demonstrated limited gains in science SMK. There was evidence for an overall improvement in teacher knowledge of forces and simple machines, and two teachers demonstrated improvement in over half of the five scenarios assessing teacher science SMK. Modest gains in teacher science PCK were found. One teacher expressed more accurate understanding of students' knowledge of forces and a better knowledge of effective science teaching strategies. The majority of teachers reported that they would be using three-part lessons and hands-on activities more in their science teaching. Gains in teacher pedagogical knowledge (PK) were found in four areas: greater emphasis on anticipation of student thinking and responses, recognition of the importance of observing students, more intentional teaching, and anticipated future use of student video data. Most teachers reported feeling more confident in teaching structures and mechanisms, and attributed this increase in confidence to collaboration and seeing evidence of student learning and engagement during the lesson teachings. Teacher benefits included: learning how to increase student engagement and collaboration, observing students, including video data
Do differentials in the support and advice available at UK schools and colleges influence candidate performance in the medical school admissions interview? A survey of direct school leaver applicants to a UK medical school.
Lambe, Paul; Waters, Catherine; Bristow, David
To our knowledge, nothing is known about whether differentials in support and advice during preparation for the interview influence candidate performance and thereby contribute to bias in selection for medical school. To assess if differences in advice and support with preparation for the medical school admissions interview given type of school last attended influence interview score achieved by direct school leaver applicants to study on an undergraduate UK medical degree course. Confidential self-completed on-line questionnaire survey. Interview performance was positively related to whether a teacher, tutor or career advisors at the School or College last attended had advised a respondent to prepare for the interview, had advised about the various styles of medical interview used and the types of questions asked, and what resources were available to help in preparation. Respondents from Private/Independent schools were more likely than those from State schools to have received such advice and support. Differentials in access to advice on and support with preparation for the medical school interview may advantage some candidates over others. This inequity would likely be ameliorated by the provision of an authoritative and comprehensive guide to applying to medical school outlining admission requirements and the preparation strategy applicants should use in order to best meet those requirements. The guide could be disseminated to the Principals of all UK schools and colleges and freely available electronic versions signposted in medical school prospectuses and the course descriptor on the Universities and Colleges Admissions Service.
Miller, G D; Frank, D; Franks, R D; Getto, C J
In 1986 the authors mailed a one-page questionnaire to 135 North American medical schools requesting information about written expectations for students that contain noncognitive criteria. Eighty-eight questionnaires (65.2%) were returned, and 48 schools (54.5%) indicated they possessed written noncognitive criteria. Those schools having noncognitive criteria were asked to submit the criteria for review and were questioned about their reasons for establishing such criteria. Those schools not having noncognitive criteria were asked whether they perceived a need for such criteria and had plans for developing them. The study showed an increasing trend to create criteria that assist in administrative actions when problems arise. In the 31 sets of noncognitive criteria submitted for the study, the rank order of specific expectations was, from most to least frequently mentioned: honesty, professional behavior, dedication to learning, appearance, respect for law, respect for others, confidentiality, aid to others, substance abuse, and financial responsibility. The authors make recommendations for schools wishing to create noncognitive criteria and explain why they feel such criteria should receive the recognition and importance given to cognitive criteria.
Jerant, Anthony; Srinivasan, Malathi; Bertakis, Klea D; Azari, Rahman; Pan, Richard J; Kravitz, Richard L
Favorable primary care (PC) experiences might encourage more medical students to pursue generalist careers, yet academicians know little about which attributes influence the medical school PC experience. The authors sought to identify such attributes and weight their importance. Semistructured interviews with 16 academic generalist leaders of family medicine, general internal medicine, and general pediatrics led to the development of a Web-based survey, administered to a national sample of 126 generalist faculty. Survey respondents rated (on a nine-point Likert-like scale) the importance of each interview-generated PC medical school attribute and indicated (yes/no) whether outside experts' assessment of the attributes would be valid. The authors assessed interrater agreement. Interview thematic analysis generated 58 institutional attributes in four categories: informal curriculum (23), institutional infrastructure (6), educational/curricular infrastructure (6), and specific educational experiences (23). Of these 58, 31 (53%) had median importance ratings of >7 (highly important). For 14 of these (45%), more than two-thirds of respondents indicated external expert surveys would provide a valid assessment. Of the 23 informal curriculum attributes, 20 (87%) received highly important ratings; however, more than two-thirds of respondents believed that external expert survey ratings would be valid for only 4 (20%) of them. Strong agreement occurred among respondents across the generalist fields. Academic generalist educators identified several attributes as highly important in shaping the quality of the medical school PC experience. Informal curriculum attributes appeared particularly influential, but these attributes may not be validly assessed via expert surveys, suggesting the need for other measures.
Abedini, Nauzley C; Danso-Bamfo, Sandra; Moyer, Cheryl A; Danso, Kwabena A; Mäkiharju, Heather; Donkor, Peter; Johnson, Timothy R B; Kolars, Joseph C
International medical electives typically represent a unidirectional flow of students from economically advantaged countries in the global "North" to resource-poor nations in the global "South." Little is known about the impact of bilateral exchanges on students from less affluent nations. Since 2007, students from the University of Michigan Medical School (UMMS) and medical schools in Ghana have engaged in a bilateral clinical exchange program. A 45-item online survey was distributed to all 73 Ghanaian medical students who had rotated at UMMS from 2008 to 2010 to assess perspectives on the value and impact of their participation. Incoming Ghanaian students outnumbered outgoing UMMS students 73 to 33 during the study period. Of eligible Ghanaian students, 70% (51/73) participated in the survey, with 40 of 51 providing valid data on at least 50% of questions. Ninety-seven percent (37/38) reported that the UMMS rotation was valuable to their medical training, 90% (35/39) reported changes in how they approach patient care, and 77% (24/31) reported feeling better equipped to serve patients in their home community. Eighty-five percent of students (28/33) felt more inclined to pursue training opportunities outside of their home country after their rotation at UMMS. More studies are needed to determine the feasibility of bidirectional exchanges as well as the short-term and long-term impact of rotations on students from underresourced settings and their hosts in more resource-rich environments.
The increasing globalisation of medicine, as manifested in the migration rate of medical doctors and in the growth of cross-border education providers, has inflicted a wave of quality assurance efforts in medical education, and underlined the need for definition of standards and for introduction of effective and transparent accreditation systems. In 2004, reflecting the importance of the interface between medical education and the healthcare delivery sector, a World Health Organization (WHO)/World Federation for Medical Education (WFME) Strategic Partnership to improve medical education was formed. In 2005, the partnership published Guidelines for Accreditation of Basic Medical Education. The WHO/WFME Guidelines recommend the establishment of proper accreditation systems that are effective, independent, transparent and based on medical education-specific criteria. An important prerequisite for this development was the WFME Global Standards programme, initiated in 1997 and widely endorsed. The standards are now being used in all 6 WHO/WFME regions as a basis for quality improvement of medical education throughout its continuum and as a template for national and regional accreditation standards. Promotion of national accreditation systems will have a pivotal influence on future international appraisal of medical education. Information about accreditation status - the agencies involved and the criteria and procedure used - will be an essential component of new Global Directories of Health Professions Educational Institutions. According to an agreement between the WHO and the University of Copenhagen (UC), these Directories (the Avicenna Directories) will be developed and published by the UC with the assistance of the WFME, starting with renewal of the WHO World Directory of Medical Schools, and sequentially expanding to cover educational institutions for other health professions. The Directories will be a foundation for international meta-recognition ("accrediting the
Boelen, Charles; Dharamsi, Shafik; Gibbs, Trevor
There is growing interest worldwide in social accountability for medical and other health professional schools. Attempts have been made to apply the concept primarily to educational reform initiatives with limited concern towards transforming an entire institution to commit and assess its education, research and service delivery missions to better meet priority health needs in society for an efficient, equitable an sustainable health system. In this paper, we clarify the concept of social accountability in relation to responsibility and responsiveness by providing practical examples of its application; and we expand on a previously described conceptual model of social accountability (the CPU model), by further delineating the parameters composing the model and providing examples on how to translate them into meaningful indicators. The clarification of concepts of social responsibility, responsiveness and accountability and the examples provided in designing indicators may help medical schools and other health professional schools in crafting their own benchmarks to assess progress towards social accountability within the context of their particular environment.
Benotmane, Ilies; Glatz, Nicolas; Bihan, Solenn; Legrand, Fanny; Gosset, Didier; Boulanger, Eric
The purpose of this study was to determine the future, in terms of scientific publication, of medical thesis (MT) defended in the Medical School of Lille 2 University (MSL2U) between January 1st, 2001 and December 31st, 2007. The collection of MT published as a corresponding scientific article was realized from PubMed(®). For every corresponding article, we determined the journal Impact Factor (IF), the language of publication and the rank of the student and his MT director in the author list. Analyses were also realized according to the group of speciality of the TM. In all, 11.3% of the 2150 MT defended in the MSL2U were followed up by a scientific publication. The average IF was 2.32 with a median at 1.75 and extreme values from 0 to 14.78. Seventy percent of the articles were published in English. The rank of the student was placed before his MT director (2.06 vs. 3.15). The MT defended by students in the field of medical specialities presented the highest rate of publication (25.1%). The general medicine was the second speciality the most productive in term of number of published articles (n=49) after medical specialities (n=103). The MT director and the PhD students must be more motivated to publish their results. The value of 11.3% could be considered as weak but, because of a huge lack of references, it is impossible to compare our results to those of other French medical schools. It remains important to reform the objectives and the modalities of the writing of a MT: should we not have to turn to thesis called "on article"? Copyright © 2012. Published by Elsevier Masson SAS.
Frey, Melissa K; Biewald, Mollie A; Worley, Michael J.; Taylor, Jolyn S; Lin, Stephanie N; Holcomb, Kevin
Introduction: Lynch syndrome was first described in the 1950s however until recently it was rarely included in medical school curricula. As a result, many practicing physicians have limited exposure, potentially contributing to significant under diagnosis. As identification of Lynch syndrome prior to malignancy allows for intensified screening, prophylactic surgery and improved patient outcomes, all physicians should be aware of the characteristics of affected families. We aim to determine th...
Härtl, Anja; Berberat, Pascal; Fischer, Martin R; Forst, Helmuth; Grützner, Stefanie; Händl, Thomas; Joachimski, Felix; Linné, Renate; Märkl, Bruno; Naumann, Markus; Putz, Reinhard; Schneider, Werner; Schöler, Claus; Wehler, Markus; Hoffmann, Reinhard
Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills. Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung) into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks "Movement," "Balance" and "Contact." The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men's-women's-children's medicine, the senses, the nervous system and the mind, and general medicine) which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments), block practicums, and two scientific projects. Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum and the impact of the new
Full Text Available Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum.Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills.Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks “Movement,” “Balance” and “Contact.” The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men’s-women’s-children’s medicine, the senses, the nervous system and the mind, and general medicine which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments, block practicums, and two scientific projects.Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum
Garcia, C D; Barboza, A P; Goldani, J C; Neumann, J; Chem, R; Camargo, J; Lucchese, F; Marcon, I; Marcon, A; Brandão, A; Kalil, A; Vitola, S P; Bittencourt, V; Hausen, S; Todeschini, D; Elbern, L; Castro, E; Garcia, V D
A favorable attitude of health professionals to organ donation can positively influence the decision of families of potential donors. By increasing health professionals knowledge about donation and transplantation and qualifying them to disseminate information, education has produced a positive response to increase the insufficient number of donors. Educating students early in their careers may become crucial in this setting. In order to supply the necessary information about the process of donation and transplantation, a medical school in association with the Hospital Transplant Coordination Department created an educational program of organ donation and transplantation. This course is intended for medical, biomedical, and nutrition students. The objective of our program is to supply basic knowledge about organ donation and transplantation to students of medicine, nutrition, and biomedicine and to enhance their commitment to this process. Each semester, 50 to 90 students are enrolled in the course, which involves a total of 25 hours. Various aspects are approached such as brain death, donor management, political and legal aspects of donation, and skin, lung, bone marrow, heart, pancreas, liver, and kidney transplantation. Between March 2006 and June 2007, three courses were carried out and 200 students were trained. The students evaluated the course and rated it as excellent, concluding that it contributed to their education. Their attitude toward organ donation and transplantation was strongly positive at the end of the course. This project aims to educate and stimulate students in the process of organ donation and transplantation and should be implemented in other medical schools.
Kiguli-Malwadde, Elsie; Talib, Zohray M; Wohltjen, Hannah; Connors, Susan C; Gandari, Jonathan; Banda, Sekelani S; Maggio, Lauren A; van Schalkwyk, Susan C
Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability. In-depth interviews were conducted with the heads or directors of the four medical education departments using a structured interview protocol developed by the study group. An inductive approach to analysis of the interview transcripts was adopted as the texts were subjected to thematic content analysis. Medical education departments, also known as units or centers, were established for a range of reasons including: to support curriculum review, to provide faculty development in Health Professions Education, and to improve scholarship in learning and teaching. The reporting structures of these departments differ in terms of composition and staff numbers. Though the functions of departments do vary, all focus on improving the quality of health professions education. External and internal funding, where available, as well as educational innovations were key enablers for these departments. Challenges included establishing and maintaining the legitimacy of the department, staffing the departments with qualified individuals, and navigating dependence on external funding. All departments seek to expand the scope of their services by offering higher degrees in HPE, providing assistance to other universities in this domain, and developing and maintaining a medical education research agenda. The establishment of
Day, Charles S; Yeh, Albert C; Franko, Orrin; Ramirez, Miguel; Krupat, Edward
To assess medical students' knowledge and clinical confidence in musculoskeletal medicine as well as their attitudes toward the education they receive in this specialty. A cross-sectional survey of students in all four years of Harvard Medical School was conducted during the 2005-2006 academic year. Participants were asked to fill out a 30-question survey and a nationally validated basic competency exam in musculoskeletal medicine. The response rate was 74% (449/608). Medical students rated musculoskeletal education to be of major importance (3.8/5) but rated the amount of curriculum time spent on musculoskeletal medicine as poor (2.1/5). Third-year students felt a low to adequate level of confidence in performing a musculoskeletal physical examination (2.7/5) and failed to demonstrate cognitive mastery in musculoskeletal medicine (passing rate on competency exam: 7%), whereas fourth-year students reported a similar level of confidence (2.7/5) and exhibited a higher passing rate (26%). Increasing exposure to the subject by taking clinical electives resulted in greater clinical confidence and enhanced performance on the exam (P Students' feedback suggested that musculoskeletal education can be better integrated into the preclinical curriculum, more time should be spent in the field, and more focus should be placed on common clinical conditions. These findings, which are consistent with those from other schools, suggest that medical students do not feel adequately prepared in musculoskeletal medicine and lack both clinical confidence and cognitive mastery in the field. Implementing a four-year integrated musculoskeletal curriculum is one way that medical schools can address this concern.
Eley, Diann S; Zhang, Jianzhen; Wilkinson, David
The doctor shortage in Australia generally, and the rural shortage in particular, has led to an increase in medical schools, medical places and rural training. If effective, these strategies will first impact on the intern workforce. We studied the source of interns in Queensland. Analysis of number, source and location of interns by Rural, Remote and Metropolitan Area (RRMA) classification (an index of remoteness) from university and health department records (2003-2008). Odds ratios compared the likelihood of intern supply from Queensland universities and rural clinical schools. Most interns in Queensland graduated from Queensland universities in 2007 (287 [72%]) and 2008 (344 [84%]). Proportions increased across all three RRMA groups from: 82% to 93% in RRMA1; 56% to 68% in RRMA2 and 67% to 79% in RRMA3. The University of Queensland (UQ) provides most interns in all RRMA locations including RRMA3, and this increased from 2007 (n = 33 [35%]) to 2008 (n = 57 [58%]). Interns from interstate decreased from 61 (15%) in 2007 to 40 (10%) in 2008. Interns from overseas fell from 53 (13%) in 2007 to 27 (7%) in 2008. Rural clinical schools compared with traditional urban-based schools were more likely to supply interns to RRMA3 than RRMA1