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Kodikara K, Seneviratne T, Premaratna R. Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023:10.1007/s10459-023-10293-0. [PMID: 37878118 DOI: 10.1007/s10459-023-10293-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/01/2023] [Indexed: 10/26/2023]
Abstract
Simulation is accepted as an effective method of learning procedural skills. However, the translational outcomes of skills acquired through simulation still warrants investigation. We designed this study to assess if skills laboratory training in addition to bedside learning (intervention group [IG]) would provide better learning results than bedside learning alone (control group [CG]) in the context of venipuncture training. This prospective, cluster-randomized, single-blind study took place at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Seventeen clusters of second-year medical students were randomly assigned to either IG or CG. The IG trained on venipuncture in the skills laboratory, receiving instruction after modified Payton's Four Step Method. Following the training, students of both IG and CG underwent bedside learning for one month. Afterward, students of both groups performed venipuncture on actual patients in a clinical setting. An independent, blinded assessor scored students' performance using the Integrated Procedural Protocol Instrument (IPPI) and a checklist. Patients assessed students' performance with the Communication Assessment Tool (CAT). Eight and nine clusters were randomized to the intervention and control groups, respectively. IG completed significantly more single steps of the procedure correctly (IG: 19.36 ± 3.87 for checklist items; CG: 15.57 ± 4.95; p < 0.001). IG also scored significantly better on IPPI ratings (median: IG: 27 (12) vs. CG: 21 (8); p < 0.001). Rated by patients, students' communication skills did not significantly differ between the two groups. Simulation-based venipuncture training enabled students to perform the procedure on actual patients with a higher technical accuracy than students who learned venipuncture at the bedside. Students were able to transfer the skills acquired through venipuncture training at the skill laboratory to the bedside.
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Affiliation(s)
- Kaumudee Kodikara
- Department of Medical Education, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
| | - Thilanka Seneviratne
- Department of Pharmacology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Ranjan Premaratna
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Ayu Eka NG, Rumerung CL, Tahulending PS. Role Modeling of Professional Behavior in Nursing Education During the COVID-19 Pandemic: A Mixed Method Study. J Holist Nurs 2023:8980101231179300. [PMID: 37291999 DOI: 10.1177/08980101231179300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to examine professional behavior as role models in nursing education during the COVID-19 pandemic perceived by nursing students. This study applied a mixed-method design using a sequential explanatory approach. A total of 120 nursing students participated in the self-reported questionnaire, and 10 were involved in semistructured individual interviews. The Professional Nurse Educator Role-Model questionnaire developed by the authors was used to collect quantitative data, and four open-ended questions modified from a previous study as the guideline in qualitative data collection. Quantitative data were analyzed using descriptive quantitative analysis. Open-ended questions were analyzed using thematic analysis. Quantitatively, students reported that excellent professional behaviors as role models were prevalent in nursing education (Mean 3.61 out of 4). Four themes from qualitative findings were revealed to complement the quantitative data, including teaching by example, altruism, efficiently performing, and effective communication. In conclusion, nurses as educators and clinicians could be students' professional role models, particularly in clinical settings during the COVID-19 pandemic. It is essential for nurse educators and clinicians to actively create a culture of professional nursing care for self and others during the pandemic to be present in wholeness and provide holistic care.
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Affiliation(s)
- Ni Gusti Ayu Eka
- Head of Research and Community Service, Faculty of Nursing, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Christie Lidya Rumerung
- Department of Management & Leadership in Nursing, Faculty of Nursing, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Peggy Sara Tahulending
- Department of Management & Leadership in Nursing, Faculty of Nursing, Universitas Pelita Harapan, Tangerang, Indonesia
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Koh EYH, Koh KK, Renganathan Y, Krishna L. Role modelling in professional identity formation: a systematic scoping review. BMC MEDICAL EDUCATION 2023; 23:194. [PMID: 36991373 PMCID: PMC10052869 DOI: 10.1186/s12909-023-04144-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Role modelling's pivotal part in the nurturing of a physician's professional identity remains poorly understood. To overcome these gaps, this review posits that as part of the mentoring spectrum, role modelling should be considered in tandem with mentoring, supervision, coaching, tutoring and advising. This provides a clinically relevant notion of role modelling whilst its effects upon a physician's thinking, practice and conduct may be visualised using the Ring Theory of Personhood (RToP). METHODS A Systematic Evidence Based Approach guided systematic scoping review was conducted on articles published between 1 January 2000 to 31 December 2021 in the PubMed, Scopus, Cochrane, and ERIC databases. This review focused on the experiences of medical students and physicians in training (learners) given their similar exposure to training environments and practices. RESULTS 12,201 articles were identified, 271 articles were evaluated, and 145 articles were included. Concurrent independent thematic and content analysis revealed five domains: existing theories, definitions, indications, characteristics, and the impact of role modelling upon the four rings of the RToP. This highlights dissonance between the introduced and regnant beliefs and spotlights the influence of the learner's narratives, cognitive base, clinical insight, contextual considerations and belief system on their ability to detect, address and adapt to role modelling experiences. CONCLUSION Role modelling's ability to introduce and integrate beliefs, values and principles into a physician's belief system underscores its effects upon professional identity formation. Yet, these effects depend on contextual, structural, cultural and organisational influences as well as tutor and learner characteristics and the nature of their learner-tutor relationship. The RToP allows appreciation of these variations on the efficacy of role modelling and may help direct personalised and longitudinal support for learners.
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Affiliation(s)
- Eugene Yong Hian Koh
- Singapore Armed Forces, 303 Gombak Drive, Singapore, 669645, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Kai Kee Koh
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Yaazhini Renganathan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Lalit Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK.
- Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- Duke-NUS Medical School, National University of Singapore, College Rd, Singapore, 169857, Singapore.
- Centre of Biomedical Ethics, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore.
- The Palliative Care Centre for Excellence in Research and Education, PalC, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Aslam F, Mahboob U, Zahra Q, Zohra S, Malik R, Khan RA. The Drudgery of a Doctor's Disciple: Exploring the effects of Negative Role Modelling on medical students' professional development. MEDICAL TEACHER 2022; 45:1-7. [PMID: 36272400 DOI: 10.1080/0142159x.2022.2133690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Role modelling is considered an essential component of teaching in various educational settings and impact students' professional development. Most studies found in the literature have explored the influence of positive role models and limited data is available about the negative role modelling. This study explores the effects of negative role modelling of teachers on the professional development of future doctors. METHODS A qualitative exploratory study was done in three medical colleges of Lahore, Pakistan. Fifteen, telephonic, semi-structured interviews were done with fifth-year MBBS students. A thematic analysis was done through manual coding of transcribed interviews. RESULTS A total of 374 codes were generated in the first cycle of coding, that was merged to 42 in the second cycle. These codes led to 4 subthemes that finally emerged as two themes. The first theme was "Students & patients: In the same boat" highlighting the damaging effects of negative role modelling. The second theme was "Taking the bad with the good" focusing on the ambivalent response of students towards the unprofessional behaviours of their role models. CONCLUSION Negative role modelling exponentially affects the attitude and behaviour of medical students especially in informal settings and have detrimental effects on patient care. Students lose some degree of humanism while unconsciously observing the unethical behaviours, to become a part of hospital culture whereas some students show determination to channelize their resentment to reforms.
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Affiliation(s)
- Fatima Aslam
- Department of Psychiatry & Behavioural Sciences, Avicenna Medical College & Hospital, Lahore, Pakistan
| | - Usman Mahboob
- Institute of Health Professions Education (IHPE&R), Khyber Medical University, Peshawar, Pakistan
| | - Qundeel Zahra
- Department of Ophthalmology, Azra Naheed Medical College & Hospital, Lahore, Pakistan
| | | | - Rabia Malik
- Department of Medical Education, Muhammad Islam Medical & Dental College, Gujranwala, Pakistan
| | - Rehan Ahmed Khan
- Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
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Sharma S, Sharma R, Khyalappa RK, Sharma S, Kandoth S. Student perceptions: Background to a new ethics curriculum in Indian medical colleges. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:284. [PMID: 34667784 PMCID: PMC8459876 DOI: 10.4103/jehp.jehp_982_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/07/2020] [Indexed: 06/08/2023]
Abstract
BACKGROUND Ethic education as a part of medical school curriculum is one which requires constant re-evaluation and re-emphasis. The medical regulatory body of India has, in recent times, introduced a revised module of the same, which is implemented across the country in all medical schools. Medical students' perception of ethics education is an important variable which will influence the validity of this module. This study attempts to evaluate the same. MATERIALS AND METHODS A peer-validated questionnaire was distributed to 150 undergraduate and postgraduate medical students (response rate: 74.4%) with the aim to evaluate their attitude toward knowledge of ethics, and their perceptions of contents and methods of learning ethics. RESULTS A significant number of students recognize the importance of medical ethics knowledge and its positive impact on their career (P < 0.05). They accept material taught as per planned curriculum as a source of learning and favor interactive methods of teaching (P < 0.05). Research projects and didactic lectures were rejected as learning methods (P < 0.05). CONCLUSION "Deliberate teaching" has been accepted as a source of learning ethics by all students, though undergraduate students also favored learning about ethics "during practice." Perceptions have been identified that need to be addressed. The study reveals a need to further explore the purpose and contribution of role models in this context and to identify ways of strengthening their related perceptions by students.
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Affiliation(s)
- Shimpa Sharma
- Department of General Medicine, D Y Patil Medical College, DY Patil Education Society Deemed University, Kolhapur, Maharashtra, India
| | - Rakesh Sharma
- Department of Obstetrics & Gynecology D Y Patil Medical College, DY Patil Education Society Deemed University, Kolhapur, Maharashtra, India
| | - Rajesh K. Khyalappa
- Department of General Medicine, D Y Patil Medical College, DY Patil Education Society Deemed University, Kolhapur, Maharashtra, India
| | - Shweta Sharma
- Intern, MGM Medical College, Navi Mumbai, Maharashtra, India
| | - Samin Kandoth
- Intern, MGM Medical College, Navi Mumbai, Maharashtra, India
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Ethics and Health Communication in English: Tackling the Consequences of Colonial Era Linguicism and Racism. Asian Bioeth Rev 2021; 13:245-253. [PMID: 33968214 DOI: 10.1007/s41649-021-00172-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022] Open
Abstract
Sri Lanka, once a colony of Britain, gained independence in 1948. However, especially the health sector continues to use English as its main medium of communication. Such language bias leads to marginalization of those less fluent in English, and hinders achieving a higher level of health literacy. Discrimination of people or social groups based on their language is termed linguicism. Tackling linguicism requires an understanding of its historic roots and an exploration of potential links to colonial racial prejudices. Published literature presents evidence that traces linguicism to language policies of the British colonial government (1815-1948). Though an exhaustive survey of historical records is not presented, there is reasonable evidence to suggest a close link. British colonial rule derived its justification from supremacist and racist ideology. As a result, English became the medium in all forms of official communications, a situation that persisted after independence. A similar situation exists in many parts of the worlds. We should recognize language-based discrimination and linguicism as public health issues. They are detrimental to health of vulnerable groups and have the potential to worsen health disparities.
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Mohammadi E, Mortaz Hejri S, Sohrabpour AA, Mirzazadeh A, Shahsavari H. Exploring clinical educators' perceptions of role modeling after participating in a role modeling educational program. MEDICAL TEACHER 2021; 43:397-403. [PMID: 33226884 DOI: 10.1080/0142159x.2020.1849590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Role modeling significantly affects medical students' values, attitudes, and professional behaviors. Role modeling is a complex and multidimensional process that necessitates accurate perception and adequate knowledge and skills. However, most clinical educators do not have adequate awareness and knowledge about the positive and negative effects of role modeling. We aimed to explore clinical educators' perceptions of role modeling after participating in a role modeling educational program. METHODS This qualitative study was conducted on eighteen clinical educators who were voluntarily participated in a three-month role modeling educational program. Data were collected using reflection paper writing and were analyzed through conventional content analysis. RESULTS Data analysis resulted in the development of three main categories, namely closer attention to role modeling and effort for its promotion, deliberate effort to display role modeling, and creating a positive environment to increase the effectiveness of role modeling. CONCLUSIONS Clinical educators have limited role modeling knowledge and skills, and hence, educational programs are required to improve their role modeling knowledge, attitudes, and skills. Role modeling educational programs should aim at developing educators' awareness and knowledge about role modeling, develop their reflection and self-control abilities, and sensitize them to the importance of deliberate use of role modeling.
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Affiliation(s)
- Elaheh Mohammadi
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Mortaz Hejri
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Sohrabpour
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azim Mirzazadeh
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Internal Medicine, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Shahsavari
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Duan Q, Zhuo N, Sun T, Zhang X. Clinical Study of Ultrasound Elastography in Qualitative Diagnosis of Breast Masses. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Breast mass is one of the clinical signs of breast lesions. Clinically, breast tumors can occur in breast cancer, breast tuberculosis, breast duct dilatation, breast cysts, breast fibroadenoma, and breast hyperplasia. Its pathogenesis is not clear. The occurrence of breast lesions is
related to many factors, such as diet, trauma, genetic mutations, inheritance, endocrine disorders, breast development, and chronic stimuli. With the continuous improvement of examination equipment and continuous improvement of the treatment level, the incidence of breast masses is increasing.
For a long time, clinicians have mostly used hand palpation methods to complete the diagnosis of breast masses based on the relatively hard properties of breast masses and adjacent tissues. It is more difficult to diagnose patients based on their clinical symptoms and signs, and it is easy
to miss the diagnosis. Choosing the appropriate diagnostic method to confirm breast mass disease has become the first task for the diagnosis and treatment of breast mass. Ultrasound elastography is a new ultrasound examination method. It diagnoses the elasticity and hardness of breast masses
by using corresponding characteristics. The imaging principle is to apply pressure to the tissue at the lesion site to determine its elasticity and hardness to identify the nature of the tumor. This article explores the clinical value of ultrasound elastography in the effective diagnosis of
breast masses. Compared with the diagnosis results of ordinary ultrasound, the parameters such as the position, shape, size, boundary, internal echo, and rear echo of the focused mass were observed. Facts have proved that elastography can be used to make a qualitative differential diagnosis
of benign and malignant breast masses from another angle according to the different characteristics of the hardness of the tissue being examined. It is non-invasive, non-radiative, low-cost, and easy for patients to accept. Provide valuable clinical diagnosis basis for early detection and
treatment of breast masses.
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Affiliation(s)
- Qing Duan
- The Second Hospital of Tianjin Medical University, Hexi District, Tianjin 300211 China
| | - Na Zhuo
- The Second Hospital of Tianjin Medical University, Hexi District, Tianjin 300211 China
| | - Tong Sun
- The Second Hospital of Tianjin Medical University, Hexi District, Tianjin 300211 China
| | - Xuening Zhang
- The Second Hospital of Tianjin Medical University, Hexi District, Tianjin 300211 China
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Safari Y, Khatony A, Khodamoradi E, Rezaei M. The role of hidden curriculum in the formation of professional ethics in Iranian medical students: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:180. [PMID: 32953908 PMCID: PMC7482700 DOI: 10.4103/jehp.jehp_172_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/04/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Professionalism and medical ethics are a vital quality for doctors, which has been taken into account seriously in recent years. Perception of the factors affecting professionalism may help develop more efficient approaches to promote this quality in medical education. This study was aimed to explain the role of hidden curriculum in the formation of professional ethics in Iranian medical students. MATERIALS AND METHODS This qualitative study was performed on 15 medical interns of Kermanshah University of Medical Sciences in 2019, using grounded theory. Sampling was started by purposive sampling and continued through theoretical sampling until complete data saturation. Data collection and analysis were done simultaneously. Data were interpreted by a constant comparative method according to Strauss and Corbin's approach. RESULTS The analysis of the participants' interviews and reduction of findings using common themes yielded one class and four categories as well as a number of concepts as the role of hidden curriculum in the formation of professional ethics in medical students. The categories included the role of modeling in the formation of professional ethics, role of education in the formation of professional ethics, role of environmental factors in the formation of professional ethics, and role of personal and inherent attributes in the formation of professional ethics. CONCLUSION Curriculum developers and medical education authorities need to proceed in line with the findings of the present study to provide a proper learning environment, in which the modeling, learning, and teaching conditions and supportive environmental atmosphere are taken into account in accordance with the inherent and individual characteristics of the learners in order to guarantee the formation of professional ethics in medical students.
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Affiliation(s)
- Yahya Safari
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Khodamoradi
- Department of Radiology and Nuclear Medicine, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics and Epidemiology, Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Ong YT, Kow CS, Teo YH, Tan LHE, Abdurrahman ABHM, Quek NWS, Prakash K, Cheong CWS, Tan XH, Lim WQ, Wu J, Tan LHS, Tay KT, Chin A, Toh YP, Mason S, Radha Krishna LK. Nurturing professionalism in medical schools. A systematic scoping review of training curricula between 1990-2019. MEDICAL TEACHER 2020; 42:636-649. [PMID: 32065016 DOI: 10.1080/0142159x.2020.1724921] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Introduction: Professionalism is an evolving, socioculturally informed multidimensional construct that influences doctor-patient relationships, patient satisfaction and care outcomes. However, despite its clinical significance there is little consistency in how professionalism is nurtured amongst medical students. To address this gap a systemic scoping review of nurturing professionalism in medical schools, is proposed.Methods: Levac's framework and the PRISMA-P 2015 checklist underpinned a 6-stage systematic review protocol. Concurrent use of Braun and Clarke's approach to thematic analysis and directed content analysis was used to identify the key elements in nurturing professionalism.Results: 13921 abstracts were identified from six databases, 854 full-text articles reviewed, and 162 full-text included articles were included. The 4 themes identified through thematic analysis are consistent with findings of the directed content analysis. These were the definition of professionalism, the approaches, content, barriers and enablers to teaching professionalism.Conclusion: Informed by a viable definition of professionalism and clear milestones nurturing professionalism nurturing professionalism begins with culturally appropriate training in clinical competence, humanistic qualities and reflective capacity. This process requires effective evaluations of professional identity formation, and the impact of the learning environment underlining the need for longitudinal assessments of the training process.
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Affiliation(s)
- Yun Ting Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheryl Shumin Kow
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yao Hao Teo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lorraine Hui En Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ahmad Bin Hanifah Marican Abdurrahman
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicholas Wei Sheng Quek
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kishore Prakash
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Clarissa Wei Shuen Cheong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiu Hui Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Qiang Lim
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jiaxuan Wu
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Laura Hui Shuen Tan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kuang Teck Tay
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Annelissa Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore, Singapore
| | - Ying Pin Toh
- Family Medicine Residency, National University Health System, Singapore, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, Liverpool, England
| | - Lalit Kumar Radha Krishna
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, Liverpool, England
- Education Department, Duke-NUS Graduate Medical School, Singapore, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore
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Mansoorian MR, Jalili M, Khosravan S, Shariati M. Exploring undergraduate medical students' perception of learning procedural skills and its outcomes in clinical settings. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2019; 7:175-182. [PMID: 31750355 PMCID: PMC6820010 DOI: 10.30476/jamp.2019.74866.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 06/03/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Learning procedural skills is one of the essential aspects of undergraduate medical education. However, learning procedural skills in clinical settings is less widely considered. This study aimed to explore the Iranian undergraduate medical students' perception of learning procedural skills and its outcomes in three universities of medical sciences in Iran. METHODS A descriptive exploratory qualitative methodology with an in-depth unstructured, face-to-face interview, and content analysis was used in this study. Sixteen students in clinical phases of general medical education programs from educational hospitals were selected using purposive sampling. According to the preferences of the participants, the interviews were conducted in medical schools or in hospitals. RESULTS The students participating in this study included 7 females and 9 males (totally 16 people) with a mean age of 23.7 years old with a range of 21-27 years. The three main themes of this study were "the gap of transferring formal teaching from skill lab to clinical placement", "learning self-leading procedural skills in clinical settings", and "students' dissatisfaction with patients' vulnerability" with 8 subthemes which were extracted and explained based on the students' perception. CONCLUSION Unsupervised and self-learning by medical students and weakness in controlling the learning process have undesirable results for patients and students.
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Affiliation(s)
- Mohammad Reza Mansoorian
- Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jalili
- Emergency Medicine, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahla Khosravan
- Management and Community Health Nursing Department, Social Determinants of Health Research Centre, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohammad Shariati
- Department of Community Medicine, Medical Education Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Bazrafkan L, Hayat AA, Tabei SZ, Amirsalari L. Clinical teachers as positive and negative role models: an explanatory sequential mixed method design. J Med Ethics Hist Med 2019; 12:11. [PMID: 32328224 PMCID: PMC7166239 DOI: 10.18502/jmehm.v12i11.1448] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/07/2019] [Indexed: 11/24/2022] Open
Abstract
Today, role modeling is an essential component of medical education that facilitates the students' learning and affects their attitudes and behaviors. Hence, this study aimed to examine the characteristics of positive and negative role models using a mixed method approach. In the quantitative part, data were collected using a questionnaire with 24 items. The research population included medical students who were in their clinical period between May 2017 and December 2018 at Shiraz University of Medical Sciences (n = 750). A total of 282 questionnaires were completed by these students, and in the qualitative part, 26 semi-structured interviews were conducted with them. The most important components of role modeling for students included: individual characteristics, clinical skills and competence, teaching skills and professionalism, in that order. The qualitative analysis confirmed the results of the quantitative analysis. The findings showed that the characteristics of a negative role model can also be classified in four main components. The results demonstrated that 46.8% of the students identified one or more medical teachers as negative models. Students paid attention to not only the positive characteristics of their teachers, but also their negative features, stating that they had been influenced by both. Therefore, it can be concluded that clinical teachers should improve their performance as positive role models through reducing these negative effects and reinforcing positive characteristics.
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Affiliation(s)
- Leila Bazrafkan
- Assistant Professor, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asghar Hayat
- Assistant Professor, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ziaaddin Tabei
- Professor, Department of Medical Ethics and Philosophy in Health Care, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Amirsalari
- Researcher, Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Riveros-Perez E, Jimenez E, Cheriyan T, Varela N, Rodriguez J, Rocuts A. Approach to learning and educational environment: time to rethink measurement tools in postgraduate medical training? INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2019; 10:62-67. [PMID: 30927542 PMCID: PMC6773370 DOI: 10.5116/ijme.5c88.029d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To assess the correlation between perception of the learning environment and the approach to learning adopted by anesthesiology residents throughout training in an academic institution in the United States. METHODS This is a cross-sectional study involving forty-one anesthesiology residents who completed electronic forms of the Revised Two-Factor Study Process Questionnaire to assess learning approaches, and the Dundee Ready Educational Environment Measure questionnaire to assess learning environment. Convenience sampling was used with the current anesthesiology residents. Learning approaches were analyzed with a multiple regression model for correlation between total score, domains, and training level. Analysis of variance was used to assess differences in perception of the learning environment based on training level. Multivariate logistic regression was used to assess the correlation between domains of learning the environment and approaches questionnaires. Cronbach α was used to evaluate the internal consistency of responses within each domain of both questionnaires. RESULTS Forty-one residents completed the questionnaires. Cronbach α varied between 0.604 and 0.76 among the domains in the Study Process Questionnaire and was greater than 0.60 for the Dundee questionnaire. There was a moderate correlation between total deep approach scores and the total subjective perception of teachers scores (R2= - 0.507, p <0.01). There was no significant association between specific domains of Dundee and study process questionnaires and resident year of training. CONCLUSIONS The learning approaches adopted by anesthesiology residents and the perception of the educational environment are not correlated with years of training. The DREEM and R-SPQ-2F questionnaires should not be recommended for evaluation of anesthesiology residents.
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Affiliation(s)
- Efrain Riveros-Perez
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, USA
| | - Enow Jimenez
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, USA
| | - Thomas Cheriyan
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, USA
| | - Nicole Varela
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, USA
| | | | - Alexander Rocuts
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, USA
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Woodward A, McLernon-Billows D. Undergraduate medical education in Sierra Leone: a qualitative study of the student experience. BMC MEDICAL EDUCATION 2018; 18:298. [PMID: 30526576 PMCID: PMC6286603 DOI: 10.1186/s12909-018-1397-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sierra Leone, a low-income and post-conflict country, has an extreme shortage of qualified medical doctors. Given the complex challenges facing medical education in this country and the need for context-specific knowledge, the aim of this paper is to explore the undergraduate medical education experience in Sierra Leone through qualitative interviews with recent graduates. METHODS In-depth interviews were conducted with purposively sampled junior doctors (n = 15) who had graduated from the only medical school in Sierra Leone. Additionally, semi-structured interviews were held with senior teaching staff at the School (n = 7). Interviews were conducted in October 2013. Results were thematically analysed. RESULTS The analytical framework consisted of four themes. Medical school experiences (Theme 1) were described as 'stressful and tedious' but also 'interesting and enjoyable'. Various constraints were experienced linked to the Medical school capacity (Theme 2), including human (limited number of teachers, teaching skills), organisational (departmental differences, curriculum related challenges), physical (lacking teaching facilities on campus, transportation problems) and financial capacity (inadequate remunerations for teachers, most students receive scholarships). Medical school culture (Theme 3) was by some participants perceived as fearful and unfair. Findings suggest various coping strategies (Theme 4) were used at school ('creatively' hire extra teaching staff, teaching schedule upon availability of staff), staff (juggle multiple roles, teach flexibly), and student levels (comply with 'hidden' rules, negotiate teaching support from less qualified health personnel). CONCLUSIONS This study has provided an insight into the student perspective on medical education in Sierra Leone. Numerous capacity related concerns were identified; which are unsurprising for an educational institution in a low-income and conflict affected country. While the School, staff and students have found creative ways to deal with these constraints, participants' accounts of stress imply more is needed. For example, findings suggest that: students could be better supported in their self-directed learning, more effort is required to ensure basic needs of students are met (like shelter and food), and the power imbalance between staff and students could be addressed. Also better alignment amongst learning objectives and assessment methods will likely diminish student distress and may, consequently, reduce exam failure and possibly drop-out.
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Gardeshi Z, Amini M, Nabeiei P. The perception of hidden curriculum among undergraduate medical students: a qualitative study. BMC Res Notes 2018; 11:271. [PMID: 29728132 PMCID: PMC5935913 DOI: 10.1186/s13104-018-3385-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives The effect of hidden curriculum on student learning has not been sufficiently recognized in most of the revised curriculums. This study is a qualitative study that measures the students’ perception of hidden curriculum through semi-structured interviews. All of the interviews were recorded and then converted into scripts. These scripts were divided to sentences and phrases and named as units. Units aggregated with similar groups and named as codes, then the similar codes were aggregated into themes. Results Four main themes emerged, role modeling, personal attitude and beliefs, hierarchy, social and ethical culture. The results of the present study showed that it is necessary to discuss the hidden curriculum. We are unaware of the hidden curriculum, but even when were are aware of it, we are unwilling to act. Information about issues related to the hidden and informal curriculum, as well as knowing the viewpoints of students is necessary. It seems necessary to provide data to students about the hidden curriculum and encouraging patient centered curriculums early in training, such as integrated curriculum.
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Affiliation(s)
- Zahra Gardeshi
- Clinical Education Research Center, Shiraz University of Medical Sciences, Neshat Street Sina Sadra Hall, Shiraz, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Neshat Street Sina Sadra Hall, Shiraz, Iran.
| | - Parisa Nabeiei
- Clinical Education Research Center, Shiraz University of Medical Sciences, Neshat Street Sina Sadra Hall, Shiraz, Iran
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Liu YP, Sun L, Wu XF, Yang Y, Zhang CT, Zhou HL, Quan XQ. Use of humour in medical education: a survey of students and teachers at a medical school in China. BMJ Open 2017; 7:e018853. [PMID: 29187417 PMCID: PMC5719277 DOI: 10.1136/bmjopen-2017-018853] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Humour is a powerful resource in medical education. The purpose of this study is to investigate what students and teachers think about the use of humour. What challenges do teachers face in using humour and how they address them are also the subject of the present study. DESIGN Separate cross-sectional questionnaire surveys. SETTING Tongji Medical College and Tongji Hospital in China. PARTICIPANTS 327 students at Tongji Medical College and 165 physician teachers at Tongji Hospital in China. MAIN OUTCOME MEASURES The primary study outcome was assessed by proportion. RESULTS 87% of student and teacher respondents agreed with using humour in the didactic setting. They felt humour fostered a positive didactic atmosphere. Interesting clinical case was the most frequently used humour type by teachers and considered the most effective by students. Lack of humorous materials related to the lecture subject was the main challenge to humour use cited by teachers. Collecting humorous materials in teacher's daily work and life, observing teachers with a reputation for successfully using humour, and efficiently using the internet-enhanced humour use ability. CONCLUSION The present study confirms that most medical students and physician teachers support the use of humour in medical didactics, with particular strategies aiding its use and positive impact.
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Affiliation(s)
- Yan-Ping Liu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Sun
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Fen Wu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Yang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cun-Tai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Lian Zhou
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Qing Quan
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Bhagat V, Haque M, Simbak NB, Jaalam K. Study on personality dimension negative emotionality affecting academic achievement among Malaysian medical students studying in Malaysia and overseas. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2016; 7:341-6. [PMID: 27354836 PMCID: PMC4910681 DOI: 10.2147/amep.s108477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism) on the medical students' academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student's academic achievement regardless of the fact whether they study in their own country or overseas.
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Affiliation(s)
- Vidya Bhagat
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, Kuala Terengganu, Malaysia
- Correspondence: Vidya Bhagat, Unit of Psychological Medicine, Faculty of Medicine (FP), Medical Campus, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu, Malaysia, Email
| | - Mainul Haque
- Faculty of Medicine and Defense Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Nordin Bin Simbak
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, Kuala Terengganu, Malaysia
| | - Kamarudin Jaalam
- USM-KLE International Medical Program, Belgaum, Karnataka, India
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