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Storm Daniel struck northeastern Libya on September 10, 2023, causing severe infrastructure damage and significant human loss. Derna was the most affected city, with the University of Derna suffering extensive damage and the tragic loss of 37 medical students. Medical students face unique psychological and academic stressors, and tend to have higher rates of psychiatric disorders compared to their peers of the same age. This is the first study to investigate the storm’s psychological impact on medical students at the University of Derna. The study has a cross-sectional design and lasted from February 1 to March 1, 2024. We used the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety and the Patient Health Questionnaire-9 (PHQ-9) to assess depression, along with sociodemographic questions in our questionnaire. We included only active students enrolled in the 7-year undergraduate program at the University of Derna. Statistical tests such as the chi-square test and binary logistic regression were used in the analysis. About 225 students completed the survey. The means and standard deviations for GAD-7 and PHQ-9 scores were 9.2 (3.9) and 10.8 (5.0), respectively. The prevalence of anxiety was 42.2% for cases classified as moderate and severe (cut-off ≥10). Depression had a prevalence of 51.1% for cases classified as moderate, moderately severe and severe (cut-off ≥ 10). Suicidal ideation was reported at a rate of 48.9% for “several days” or more and at 16.5% for “more than half of the days” and “nearly every day.” Internal displacement following the storm was significantly associated with both anxiety (p = 0.033) and depression (p = 0.003). However, age, gender, year of study, monthly allowance and residence status (living with family or alone) did not show a statistically significant association with either anxiety or depression (p > 0.05 for all variables). Logistic regression analysis identified gender as the only significant predictor of anxiety (p = 0.041) and internal displacement as the sole significant predictor of depression (p = 0.023). Medical students at the University of Derna reported high rates of anxiety, depression and suicidal ideation following Storm Daniel. Internal displacement was significantly associated with both anxiety and depression. These results highlight the need for targeted interventions to address medical students’ mental health challenges and improve their overall well-being.
Moving to Edinburgh from Glasgow to study medicine at the age of 17. A brief description of teaching methods as they were then. My experience of psychiatry as a medical student, and a discussion of self-harm. Met my future husband, who was to spend a lot of his life as an agricultural economist, working in Mexico.
To determine the level of awareness of health technology assessment (HTA) and its predictors among clinical year medical students in public universities in Klang Valley, Malaysia.
Methods
A cross-sectional study using the stratified random sampling method was conducted among clinical year medical students in four public universities in Klang Valley, Malaysia. Data on the level of awareness of HTA and its associated factors were collected using a self-administered online questionnaire. Descriptive, bivariate, and multivariate analyses were performed using IBM SPSS version 27 to determine the level of awareness of HTA and its predictors.
Results
Majority (69 percent) of participants had a low level of awareness of HTA. The predictors of high-level awareness of HTA were attitude toward HTA (adjusted odds ratio (AOR) = 7.417, 95 percent confidence interval (CI): 3.491, 15.758), peer interaction on HTA (AOR = 0.320, 95 percent CI: 0.115, 0.888), and previous training on HTA (AOR = 4.849, 95 percent CI: 1.096, 21.444).
Conclusions
Most future doctors in public universities exhibit a low awareness of HTA. This study highlights the interplay between attitudes toward HTA, peer interaction, and previous training as influential predictors of HTA awareness. An integrated and comprehensive educational approach is recommended to cultivate a positive attitude and harness the positive aspects of peer interaction while mitigating the potential negative impact of misconceptions. Emphasizing early exposure to HTA concepts through structured programs is crucial for empowering the upcoming generation of healthcare professionals, enabling them to navigate HTA complexities and contribute to evidence-based healthcare practices in Malaysia and beyond.
In general, medical students perceive themselves as inadequately prepared to assist in disasters. This study evaluated the impact of a disaster preparedness curriculum and medical students’ views toward required preparedness education for health care professionals.
Methods:
A comprehensive disaster preparedness curriculum was evaluated on its effect on medical students’ views on preparedness education requirements, preparedness, and prior disaster training using self-report survey methodology.
Results:
Results provide evidence to support curricular effectiveness in significantly increasing initial participant views of health professionals’ education requirements, perceived preparedness for integrating professional roles into the emergency response system, and confidence in exposure risk assessment and triage skills. Most participants possessed limited recent prior disaster training and drill experience. Most interestingly, the majority consistently believed throughout the study that disaster preparedness training should be a medical license mandate.
Conclusions:
For those instructing current medical students in disaster preparedness, it is suggested that a curriculum be chosen that can create participant initial anticipation, awareness, and belief in the importance of and need for disaster preparedness training. Further investigation is recommended into the relationship between students’ perceived training importance and any future curriculum delivery efforts on behalf of required or mandatory preparedness offerings in continuing professional development.
Research is an important aspect of many students’ training. However, formal research training is rarely included in curricula. Thus, we developed an online, asynchronous series of modules to introduce trainees to multiple topics that are relevant to the conduct of research.
Methods:
Research 101 was utilized by first-year medical students and undergraduate students conducting mentored research projects. Students’ knowledge, confidence, and satisfaction were assessed using pre- and post-module surveys with five-point Likert scaled questions, open-ended text responses, and a final quiz.
Results:
Pre-module survey results showed that learners felt most confident with the Conducting a literature search and Race and racism in medicine modules and least confident with the Submitting an Institutional Review Board protocol at UC module. Post-module survey responses were significantly increased compared to pre-module results for all modules and questions (p < 0.0001). The response to “The content of this module met my needs” was endorsed across all modules (84.9% “yes” responses). A final quiz of 25 multiple-choice questions was completed by 92 participants who received a median score of 21. Content analysis of open-ended post-module survey responses identified several strengths and opportunities for improvement in course content and instructional methods.
Conclusions:
These data demonstrate that significant learning resulted from completion of Research 101, as post-module survey scores were significantly higher than pre-module survey scores for all modules and questions. Final quiz scores were positive but also highlighted opportunity for additional trainee learning and will guide evolution of future modules.
Studies on patient-student relationships have to date largely focused on student attitudes. This study explores attitudes of patients with psychiatric illness in Ireland, towards medical students. Patients’ experience of consent for student involvement is an area of concern in previous studies and is also quantified here.
Methods:
This was a mixed-methods cross-sectional survey of Irish adult psychiatric patients. Quantitative analysis was carried out using SPSS 22 (Statistical Product and Service Solutions, Version 22, IBM). Differences on Likert score between groups (male/female, hospital site, past experience with students/ no experience) were analysed using ordinal logistic regression with a p-value below 0.05 being significant. Qualitative data were analysed by thematic analysis using OpenCode 4.03
Results:
A total of 340 patients completed the survey. The mean age (sd) was 44.8 (16.3). 52.8% were female, 75.2% were outpatients. 24.3% had never met a medical student. Most patients were comfortable seeing students, but preferred students being passive observers. Patients with previous student experience had higher comfort levels and more positive attitudes. Although most patients (63.7%) strongly agreed they had been asked for consent, only 49.3% felt they had been given sufficient information. Qualitative data revealed preference for adequate information and notice of involvement. Patients felt pressured by student presence in certain circumstances.
Conclusions:
Psychiatric patients are comfortable with students but many feel inadequately informed. Patients recognise the benefits of interacting with students. More information is needed regarding circumstances in which patients give consent to involvement with students
Mental illness stigma is the most significant obstacle impeding the wellbeing of individuals with such conditions. Thus, research on determinants of mental illness stigma may be of crucial importance in avoiding these attitudes. Affective temperaments are thought to be present in up to 20% of the healthy general population. However, there are very few studies addressing the relationship between temperament and mental health-related stigma.
Objectives
Evaluate attitudes and behavioral responses of medical students towards individuals with a mental illness. Explore factors associated with stigma including temperament.
Methods
A cross-sectional study was conducted among students in medical universities.
All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.
Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA). Students were also asked to complete the TEMPS-A Scale.
Results
The sample consisted of 1028 respondents (9.3% of the total population). Females represented 78,3% of the study sample. A dominant affective temperament was found in 17% of the cases under study, represented mainly by depressive and irritable temperaments. Bivariate correlations performed to assess the association between temperament and mental illness stigma revealed that a positive relationship was identified between the MICA scale and hyperthymic temperament( p=0,04). There were no significant associations between the other type of temperaments and The MICA scale.
Conclusions
Students’ temperament should be considered in developing anti-stigma programs in undergraduate education. Further researches should be undertaken to disentangle the complex relationship among demographic features, personality traits, and attitudes toward people with a mental illness.
Psychiatry is still considerably ‘young’ compared to other positive sciences. Thus, it holds a huge potential for improvement of the current diagnostic and classification systems and modes of treatment particularly. For instance, the Research Domain Criteria Project will certainly generate novel research questions that will shed a light upon mechanisms, and processes for the expression of psychiatric phenomenology and develop psychiatric treatments. The new era of Digital Psychiatry/Telepsychiatry and real-time mobile monitoring are other approaches that have a lot to offer to advance the field of psychiatry. Despite these developments, the stigma around psychiatry is still a big obstacle to tackle with. Addressing and reducing stigma during medical education should benefit from training and experience co-facilitated by people living with mental illness ideally starting from the early years in medical school. Besides clinic rotations, student clubs, student scientific congresses, and clinical research that facilitate contact with the patients may be potential platforms to attract medical students’ attention to the work of psychiatry. The speaker will touch upon some examples and implementations from the medical schools in Turkey.
Stigma and discrimination can disrupt the lives of individuals with a mental illness, preventing their opportunities to become productive citizens. These Individuals must also face either an avoidant attitude by healthcare professionals or prejudices about their adherence to medications and the psychological nature of their physical symptoms.
Objectives
Assess stigma in terms of explicit and implicit attitudes among medical school students and junior doctors. Evaluate academic factors and interfering with these attitudes.
Methods
A cross-sectional study was conducted among students from medical schools in Tunisia.
All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.
Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA).
Results
The sample consisted of 1028 respondents. The respondents’ mean age was 24.54 years (SD=3.7). Post-clinical students scored higher than pre-clinical students in questions 2, 6, and 12 on the rating scale. A positive significant relationship was identified with specialization in psychiatry. Residents who were specialized in family medicine, emergency, and intensive care had a higher stigma level compared to other residents (Mean score>0.51). The completion of a psychiatry clerkship did not significantly reduce the level of stigma toward people with a mental illness ( p=0.8).
Conclusions
A combination of medical school experiences of psychiatry’s theoretical learning and clerkship are important factors that shape students. Awareness of this will enable educators to develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students’ attitudes towards psychiatry as a discipline and mental illness in general.
The COVID-19 pandemic has impacted medical students in many ways. They are not exempt from personal struggles caused by the health crisis, and many have faced similar challenges adapting to a new learning experience. The University of East Anglia (UEA) has initiatives in place to support medical students including the society Headucate UEA and the Wellbeing Champions scheme established by Norwich Medical School (NMS).
Objectives
Headucate aims to improve mental wellbeing by educational online webinars and social events aimed at university students. NMS Wellbeing Champions offer support and signpost students to resources and the wider student support system at the UEA.
Methods
Headucate was established in 2012 by NMS students that began running workshops at local secondary schools. Their work has expanded to include wellbeing workshops, social events for students and mental health first aid training, so members can provide peer support. Wellbeing Champions are medical student representatives responsible for completing mental health first aid training, communication between students and faculty, providing resources and signposting, creating mental health bulletin newsletters, and running socials exclusively for medical students.
Results
100% of Headucate workshop attendees who completed anonymous feedback agreed that they enjoyed it and that it was useful. No feedback has been collected regarding the success of the Wellbeing Champions. This should be carried out to assess and enhance the project further.
Conclusions
More data is needed to establish the success of the initiatives at NMS and their impact on medical student’s wellbeing.
Research is an important aspect of many medical students’ training. However, many medical students are not required to complete a scholarly project, and formal research training is often fragmented across the medical school curriculum. Thus, we developed an online, structured, asynchronous set of modules to introduce trainees to multiple topics relevant to the conduct of research.
Methods:
Research 101 was piloted by 27 first-year medical students at the University of Cincinnati College of Medicine. Students’ knowledge, confidence, and satisfaction were assessed using a final quiz and pre- and post-module surveys with five-point Likert-scaled questions and open-ended text responses.
Results:
Pre-module survey results showed that learners felt most confident in Conducting a literature search and least confident in Submitting an Institutional Review Board (IRB) protocol at UC. Post-module mean scores were significantly increased compared to pre-module results for all modules and questions (P < 0.05). The response to “The content of this module met my needs” was high across all modules with 236 (84.0%) “yes” responses. Thematic analysis of open-ended text responses from post-module surveys identified several improvements to individual modules and to the overall structure of Research 101. A final quiz of 25 multiple choice questions covering content from all required modules was required. The median score was 21.
Conclusions:
Comparison of post-module to pre-module survey scores provided clear evidence of improved learning across all topics. The modules developed were responsive to the students’ needs, and students provided additional improvements for subsequent iterations of Research 101.
This study seeks the opinions of qualified doctors on what they feel medical students should learn about otolaryngology. It aims to identify both the content deemed relevant and the performance levels for medical students in otolaryngology.
Methods
A national survey developed from a content analysis of undergraduate otolaryngology curricula from the UK was undertaken, accompanied by a review of the literature and input from an expert group. Data were collected from a wide range of doctors.
Results
Participants felt that graduating students should be able to: recognise, assess and initiate management for common and life-threatening acute conditions; take an appropriate patient history; and perform an appropriate examination for the majority of otolaryngology clinical conditions but manage only a select few.
Conclusion
This study reports performance levels for otolaryngology topics at an undergraduate level. Participating doctors felt that a higher level of performance should be expected of students treating life-threatening, acute and common otolaryngology conditions.
Edited by
Uta Landy, University of California, San Francisco,Philip D Darney, University of California, San Francisco,Jody Steinauer, University of California, San Francisco
In Ethiopia, graduates of the health profession lack the competencies required to provide reproductive health services before they entering practice. Since 2015 the Center for International Reproductive Health Training (CIRHT) supported ten higher teaching institutions to implement a new model that assures acquisition of competencies for reproductive health services focused on comprehensive abortion (CAC) and contraceptive care (CC) in pre-service (medical student and residency) education settings. A direct link with the departments of Gynecology and Obstetrics (GYNOBS) and schools of midwifery was established. The program included all levels of providers but targeted medical students, interns, residents and midwives. The multipronged approach of CIRHT focused on: 1) faculty development: ensuring up-to-date clinical knowledge and skills to teach and assess clinical andresearch skills; 2) establishing clinical simulation labs and comprehensive Sexual and Reproductive Health(SRH) (Michu)clinics 3) empowering students to become self-learners through the Peer Assisted Learning (PAL) program and engage in collaborative learning 4) strengthening systems support: work with the Ministry of Health(MOH), Ministry of education(MOE) and Professional societies in designingcompetency based curricula.
The 2019 coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a pandemic in need of controlling. The disease has taken its toll on universities; as a consequence, universities must prepare their campuses in such a way that will reduce the spread of SARS-CoV-2 and COVID-19 and ensure the safety of their students. This is why it is necessary to critically assess the risks involved in reopening university campuses. This letter to the editor highlights the importance of the social side of student life on campus and how it might affect the precautions put in place to reduce SARS-CoV-2 transmission. Furthermore, this letter is proposing potential courses of action for universities to take during the pandemic for the forthcoming academic year. The ability of universities to contain the spread of the virus is limited, as they lack control over social interactions outside of campus. We discuss the multifaceted approach needed to educate students about off-campus transmission to prevent SARS-CoV-2 transmission.
We describe the establishment and evaluation of a career-based mentoring scheme (PsychStart) for medical students interested in psychiatry. Medical students reported multiple benefits of mentoring, including enhanced personal and professional development, increased career and clinical knowledge, and broadened exposure to psychiatry. The mentoring scheme was also found to promote and sustain interest in the specialty. Further evaluation is required to determine the long-term effects of mentoring and how this may compare with other undergraduate enrichment activities. We conclude that mentoring in psychiatry could offer innovative solutions for improving recruitment and retention, and for supporting and valuing medical students who demonstrate an early interest in the specialty.
The role of medical students in the current coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving. The aim of this review is to explore the involvement of medical students in past global health emergencies, to help inform current and future scenarios.
Methods:
A rapid systematic review was undertaken, including articles from online databases discussing the roles, willingness and appropriateness of medical student involvement in global health emergencies. Data were extracted, appraised and written up as a narrative synthesis. This study was registered with PROSPERO (CRD42020177231).
Results:
Twenty-eight articles were included. Medical students played a wide variety of clinical and nonclinical roles including education and logistics, although medical assistance was the most commonly reported role. Challenges included a lack of preparedness and negative mental health impacts. A total of 91.7% of included articles about willingness found medical students were more willing to be involved than not.
Conclusions:
This review shows medical students are capable and willing to be involved in global health emergencies. However, there should be clear protocols for the roles that they play, taking into account the appropriateness. As a rapid review, there were study limitations and more research is required regarding the impact of these roles on medical students and the system.
We describe a novel 10-week summer research program aimed at developing academic emergency medicine (EM) interest among medical students. A cohort of students was recruited to participate in the Summer Training and Research in Emergency Medicine (STAR-EM) program with the primary goal of completing and disseminating a scholarly project. Curriculum development and program evaluation were informed by Kern's model and Kirkpatrick's hierarchy, respectively. Students and faculty demonstrated interest in academic EM and research productivity during the curriculum. This program provides a model for other emergency departments seeking to foster the development of academic EM at their institution.
COVID-19 or ‘Coronavirus’ has become a global pandemic since its initial report in Wuhan, China, on November 17, 2020. It is highly infectious and poses significant health risks for those in vulnerable populations. This article aims to provide perspective into an Irish experience, through the eyes of a practicing psychiatric nurse, who has recently graduated medical school and intends to work as an intern doctor.
Introduction: For many years, Emergency Medicine (EM) educators have used narrative comments to assess their learners on each shift, either in isolation or combined with some type of Likert scale ranking. Competency based medical education (CBME), soon to be fully implemented throughout Canadian EM educational programs, encourages this type of frequent low-stakes narrative assessment. It is important to understand what information is currently garnered from existing narrative assessments in order to successfully and smoothly transition to the CBME system. The purpose of this study was to explore how one Canadian undergraduate EM program's narrative assessment comments mapped to two competency frameworks: one traditional CanMEDS-based and one competency-based, built on entrustable professional activities (EPAs). Methods: A qualitative and quantitative content analysis of 1925 retrospective, narrative assessments was conducted for the 2015/2016 and 2016/2017 academic years. The unprompted comments were mapped to the Royal College CanMEDS framework and the Association of Faculties of Medicine of Canada EPA Framework. Using an iterative coding process as per accepted qualitative methodologies, additional codes were generated to classify comments and identify themes that were not captured by either framework. Results: 93% and 85% of the unprompted narrative assessments contained comments that mapped to at least one CanMEDS role or EPA competency, respectively. The most common CanMEDS role commented upon was Medical Expert (86%), followed by Communicator, Collaborator and Scholar (all at 23%). The most common EPA competency mentioned related to history and physical findings (62%) followed by management plan (33%), and differential diagnosis (33%). However, 75% of narrative comments contained within the assessments, included ideas that did not fall into either framework but were repeated with frequency to suggest importance. The experiential characteristics of working with a learner were commented upon by 22% of preceptors. Other unmapped themes included contextual information, generalities and platitudes, and directed feedback for next steps to improve. Conclusion: While much of the currently captured data can be mapped to established frameworks, important information for both learner and assessor may be lost by limiting comments to the competencies described within a particular framework, suggesting caution when transitioning to a CBME assessment program.
The objective of this study was to assess medical students' knowledge of and attitudes toward the two Canadian emergency medicine (EM) residency programs (Fellow of the Royal College of Physicians of Canada [FRCPC] and Certificant of the College of Family Physicians-Emergency Medicine [CCFP-EM]). Additionally, medical students interested in EM were asked to select factors affecting their preferred choice of residency training program and their intended future practice.
Methods:
Medical students enrolled at The University of Western Ontario for the 2008–2009 academic year were invited to complete an online 47-item questionnaire pertaining to their knowledge, opinions, and attitudes toward EM residency training.
Results:
Of the 563 students invited to participate, 406 (72.1%) completed the survey. Of the respondents, 178 (43.8%) expressed an interest in applying to an EM residency training program, with 85 (47.8%) most interested in applying to the CCFP-EM program.
The majority of respondents (54.1%) interested in EM believed that there should be two streams to EM certification, whereas 18.0% disagreed. Family life and control over work schedule appeared to be common priorities seen as benefits of any career in EM. Other high-ranking factors influencing career choice differed between the groups interested in CCFP-EM and FRCPC. The majority of students interested in the CCFP-EM residency program (78%) reported that they intend to blend their EM with their family medicine practice. Only 2% of students planned to practice only EM with no family medicine.
Conclusions:
This is the first survey of Canadian medical students to describe disparities in factors influencing choice of EM residency stream, perceptions of postgraduate work life, and anticipated practice environment.