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Marima P, Chidaushe JT, King S, Chibhabha F. Historical trends and current experiences of anatomical body donation in two Zimbabwean medical schools. Ann Anat 2024; 254:152243. [PMID: 38460856 DOI: 10.1016/j.aanat.2024.152243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Body donation is integral to anatomy education, but procurement can be ethically fraught. While voluntary donation is preferred, the use of unclaimed bodies, although considered unethical, is a primary means for body procurement in some countries. This mixed methods study examined historical trends and anatomy technical staff perspectives on body donation in two Zimbabwean medical schools. METHODOLOGY AND MAIN FINDINGS In Phase 1, 194 cadaver paper records from January 1984 to January 2021 were reviewed. Unclaimed bodies accounted for 67% while 33% (all white Zimbabweans) were voluntarily donated. Most cadavers were black Africans (62.4%) followed by white Zimbabweans (34.0%). Race was not indicated in seven (3.6%) records. In Phase 2, semi-structured interviews were conducted with seven technicians responsible for sourcing cadavers at the two institutions. Data were thematically analysed resulting in the development of eight themes, arranged into three domains. Cadaver procurement themes related to (1) cadaver source, (2) adherence to procurement guidelines, (3) screening for suitability, and (4) cultural and religious beliefs. Cadaver embalmment focused on (5) embalming practices, and (6) hospital mortuary-based embalming. Finally, (7) disposal processes and (8) resource constraints were found to influence cadaver disposal practices. CONCLUSIONS Contrary to best practice, there is continued reliance on the use of unclaimed bodies to support anatomy education in the two Zimbabwean medical schools. Improving the ethical sourcing of bodies requires increased efforts to educate all Zimbabweans, especially the black majority, about the role and importance of voluntary body donation in medical education. Additionally, well-structured, and well-resourced body donation programs could enhance ethical procurement.
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Affiliation(s)
- Phillipa Marima
- Department of Anatomy, Faculty of Medicine and Health Sciences, Midlands State University, Zimbabwe
| | | | - Svetlana King
- Prideaux Discipline of Clinical Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Fidelis Chibhabha
- Department of Anatomy, Faculty of Medicine and Health Sciences, Midlands State University, Zimbabwe; Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, United Kingdom.
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Wilkins CH, Williams M, Kaur K, DeBaun MR. Academic Medicine's Journey Toward Racial Equity Must Be Grounded in History: Recommendations for Becoming an Antiracist Academic Medical Center. Acad Med 2021; 96:1507-1512. [PMID: 34432719 PMCID: PMC8542070 DOI: 10.1097/acm.0000000000004374] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The harsh realities of racial inequities related to COVID-19 and civil unrest following police killings of unarmed Black men and women in the United States in 2020 heightened awareness of racial injustices around the world. Racism is deeply embedded in academic medicine, yet the nobility of medicine and nursing has helped health care professionals distance themselves from racism. Vanderbilt University Medical Center (VUMC), like many U.S. academic medical centers, affirmed its commitment to racial equity in summer 2020. A Racial Equity Task Force was charged with identifying barriers to achieving racial equity at the medical center and medical school and recommending key actions to rectify long-standing racial inequities. The task force, composed of students, staff, and faculty, produced more than 60 recommendations, and its work brought to light critical areas that need to be addressed in academic medicine broadly. To dismantle structural racism, academic medicine must: (1) confront medicine's racist past, which has embedded racial inequities in the U.S. health care system; (2) develop and require health care professionals to possess core competencies in the health impacts of structural racism; (3) recognize race as a sociocultural and political construct, and commit to debiologizing its use; (4) invest in benefits and resources for health care workers in lower-paid roles, in which racial and ethnic minorities are often overrepresented; and (5) commit to antiracism at all levels, including changing institutional policies, starting at the executive leadership level with a vision, metrics, and accountability.
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Affiliation(s)
- Consuelo H. Wilkins
- C.H. Wilkins is senior vice president and senior associate dean for health equity and inclusive excellence, Office of Health Equity, and professor of medicine, Division of Geriatric Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mamie Williams
- M. Williams is senior director of nurse diversity, equity, and inclusion, Nursing Administration, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Karampreet Kaur
- K. Kaur is a first-year resident, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. At the time of writing, the author was a fourth-year medical student, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Michael R. DeBaun
- M.R. DeBaun is professor of pediatrics and medicine, J.C. Peterson Endowed Chair in Pediatrics, Department of Pediatrics, and director, Vanderbilt-Meharry Sickle Cell Disease Center of Excellence, Vanderbilt University Medical Center, Nashville, Tennessee
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3
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Affiliation(s)
- Philip R Fischer
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN.
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Price S. Testing Boundaries COVID-19 made the USMLE, Clerkships a Moving Target for Med Students. Tex Med 2020; 116:34. [PMID: 32866275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Medical schools typically have predictable schedules. The timing of lectures, clerkships, exams, and even extracurricular activities tend to follow in the same grooves year after year. Students can reliably block out even minor events months ahead of time and be confident they'll take place. All that changed with COVID-19. Since March, when the pandemic began closing down schools, businesses, and other institutions across the state, figuring out what comes next in medical school has been anything but predictable.
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Affiliation(s)
- Sally A Santen
- From Virginia Commonwealth University School of Medicine, Richmond (S.A.S., R.R.H.); Baylor School of Medicine, Houston (J.C.); and Oregon Health and Science University School of Medicine, Portland (G.M.)
| | - Jennifer Christner
- From Virginia Commonwealth University School of Medicine, Richmond (S.A.S., R.R.H.); Baylor School of Medicine, Houston (J.C.); and Oregon Health and Science University School of Medicine, Portland (G.M.)
| | - George Mejicano
- From Virginia Commonwealth University School of Medicine, Richmond (S.A.S., R.R.H.); Baylor School of Medicine, Houston (J.C.); and Oregon Health and Science University School of Medicine, Portland (G.M.)
| | - Robin R Hemphill
- From Virginia Commonwealth University School of Medicine, Richmond (S.A.S., R.R.H.); Baylor School of Medicine, Houston (J.C.); and Oregon Health and Science University School of Medicine, Portland (G.M.)
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Abstract
Short-term experiences in global health (STEGHs) are common ways trainees engage in global health activities, which can be viewed by students as either altruistic or opportunistic. This article explores how STEGHs express the social contract medicine has with society, emphasizes areas of breakdown in this social contract, and calls for medical schools, licensure boards, STEGH-sponsoring organizations, and professional societies to take active roles in addressing these ethical challenges.
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Affiliation(s)
- Shailendra Prasad
- A professor of family medicine and community health in the Department of Family Medicine and Community Health at the University of Minnesota Medical School in Minneapolis, and the executive director and the Carlson Chair of Global Health at the Center for Global Health and Social Responsibility at the University of Minnesota and has worked in primary care and public health in various parts of the world
| | | | - Jessica Evert
- An assistant clinical professor in family medicine and community health at the University of California, San Francisco, School of Medicine, and also the executive director of Child Family Health International
| | - Tricia Todd
- The director of the Pre-Health Student Resource Center and an adjunct faculty member at the School of Public Health at the University of Minnesota
| | - Fred Lenhoff
- The director since 2012 of the Academic Physicians Section at the American Medical Association (AMA) in Chicago, Illinois, where he also serves as staff to the medical education committee that recommends potential policy to the AMA House of Delegates
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Affiliation(s)
- Miriam A Knoll
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey.
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Ellaway RH, Malhi RL, Woloschuk W, de Groot JM, Doig CJ, Myhre D. An Axiological Analysis of One Medical School's Admissions Process: Exploring Individual Values and Value Systems. Acad Med 2019; 94:1229-1236. [PMID: 30870149 DOI: 10.1097/acm.0000000000002698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Values and value systems are fundamental to medical school admissions processes. An axiological analysis was carried out to explore the individual values and value systems found within the University of Calgary's Cumming School of Medicine's undergraduate admissions process. METHOD A mixed-methods case study methodology was developed with a focus on applicant characteristics viewed as desirable, the relative value ascribed to applicant characteristics, the values that participants in admissions processes brought to bear, the values that were reflected in the artifacts and procedures used in support of admissions processes, and the values that were expressed at a system, program, or institutional level. The study employed a descriptive audit of admissions processes, a stakeholder survey, stakeholder interviews, and a discourse analysis of admissions materials (all carried out between June and September 2017). RESULTS The study found that, despite a general sense of satisfaction with the rigor of the admissions process, there was less satisfaction with the final selection it produced. Participants wanted to see more attention paid to responsibilities to patients and society than to gender and ethnic balance. CONCLUSIONS Those involved with medical school admissions need to be mindful of their value systems and use them to align intent with process and outcomes in selecting tomorrow's physicians. Axiological analysis of medical education processes can play a central role in reviewing and refocusing efforts on meeting an institution's social mission and medical education's social contract.
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Affiliation(s)
- Rachel H Ellaway
- R.H. Ellaway is professor, Department of Community Health Sciences, and director, Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. R.L. Malhi is research associate, Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. W. Woloschuk is program evaluation consultant, Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. J.M. de Groot is associate professor, Departments of Psychiatry and Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. C.J. Doig is professor, Departments of Critical Care Medicine and Community Health Sciences, and current chair, Admissions Committee, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. D. Myhre is professor, Department of Family Medicine, and associate dean, Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Mian O, Hogenbirk JC, Marsh DC, Prowse O, Cain M, Warry W. Tracking Indigenous Applicants Through the Admissions Process of a Socially Accountable Medical School. Acad Med 2019; 94:1211-1219. [PMID: 30730368 DOI: 10.1097/acm.0000000000002636] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE To describe the admissions process and outcomes for Indigenous applicants to the Northern Ontario School of Medicine (NOSM), a Canadian medical school with the mandate to recruit students whose demographics reflect the service region's population. METHOD The authors examined 10-year trends (2006-2015) for self-identified Indigenous applicants through major admission stages. Demographics (age, sex, northern and rural backgrounds) and admission scores (grade point average [GPA], preinterview, multiple mini-interview [MMI], final), along with score-based ranks, of Indigenous and non-Indigenous applicants were compared using Pearson chi-square and Mann-Whitney tests. Binary logistic regression was used to assess the relationship between Indigenous status and likelihood of admission outcomes (interviewed, received offer, admitted). RESULTS Indigenous qualified applicants (338/17,060; 2.0%) were more likely to be female, mature (25 or older), or of northern or rural background than non-Indigenous applicants. They had lower GPA-based ranks than non-Indigenous applicants (P < .001) but had comparable preinterview-, MMI-, and final-score-based ranks across all admission stages. Indigenous applicants were 2.4 times more likely to be interviewed and 2.5 times more likely to receive an admission offer, but 3 times less likely to accept an offer than non-Indigenous applicants. Overall, 41/338 (12.1%) Indigenous qualified applicants were admitted compared with 569/16,722 (3.4%) non-Indigenous qualified applicants. CONCLUSIONS Increased representation of Indigenous peoples among applicants admitted to medical school can be achieved through the use of socially accountable admissions. Further tracking of Indigenous students through medical education and practice may help assess the effectiveness of NOSM's social accountability admissions process.
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Affiliation(s)
- Oxana Mian
- O. Mian is research associate, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada. J.C. Hogenbirk is senior research associate, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada; ORCID: http://orcid.org/0000-0003-0841-4657. D.C. Marsh is professor of clinical sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada; ORCID: https://orcid.org/0000-0002-8769-1785. O. Prowse is assistant dean for admissions, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada. M. Cain is director of admissions and recruitment, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada. W. Warry is currently director, Rural Health Initiatives, Memory Keepers Medical Discovery Team, and professor of family medicine and biobehavioral health, University of Minnesota, Duluth, Minnesota. At the time of writing, he was director, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
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Goss AL, Viswanathan VB, DeLisser HM. Not Just a Specimen: A Qualitative Study of Emotion, Morality, and Professionalism in One Medical School Gross Anatomy Laboratory. Anat Sci Educ 2019; 12:349-359. [PMID: 30739388 DOI: 10.1002/ase.1868] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students' emotional and moral responses to the experiences of dissection. The "specimen" view facilitated a technical, detached approach to dissection, while the "person" view made students engage emotionally. Further, students who intentionally cultivated a "specimen" view generally felt less moral distress about dissection than students who intentionally cultivated a "person" view. The concept of respect gave students permission to perform dissections, but "person-minded" students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. "Specimen-minded" students intentionally objectified the body to learn the emotional control physicians need, while "person-minded" students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.
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Affiliation(s)
- Adeline L Goss
- Department of Neurology, University of California San Francisco, San Francisco, California
| | - Vidya B Viswanathan
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Horace M DeLisser
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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11
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Champney TH. A Bioethos for Bodies: Respecting a Priceless Resource. Anat Sci Educ 2019; 12:432-434. [PMID: 30589510 DOI: 10.1002/ase.1855] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
The value that willed body donors provide to medical education is priceless. Their precious gift helps to teach anatomy, spatial relationships between morphological structures, anatomical variation, and professionalism to medical students in a way that plastic models, podcasts, and lectures cannot. They are also an important resource for medical research and a wide variety of postgraduate training opportunities. While many body donation programs throughout the world are nonprofit organizations, there are body donation companies in the United States that sell donors for-profit. These "body brokers" have accumulated large profits from this business. It is incongruous that others would profit from such a priceless, freely donated gift. To prevent this incongruity, it is proposed that the international anatomical community develop a normative culture (a bioethos) for body donation programs. This would involve the conscious and systematic development of ethical principles for the day-to-day policies and practices of institutions that collect and use human bodies. With the development of this bioethos, a cultural shift in how donors are treated would occur and, over time, this would become the normal practice. These principles would become fundamental and foundational for the procurement and use of priceless human tissues.
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Affiliation(s)
- Thomas H Champney
- Department of Cell Biology, University of Miami, Miller School of Medicine, Miami, Florida
- Institute for Bioethics and Health Policy, University of Miami, Miller School of Medicine, Miami, Florida
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12
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Hildebrandt S. The Role of History and Ethics of Anatomy in Medical Education. Anat Sci Educ 2019; 12:425-431. [PMID: 30580499 DOI: 10.1002/ase.1852] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient-doctor interaction, medical epistemology, self-awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.
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MESH Headings
- Anatomists/organization & administration
- Anatomists/psychology
- Anatomy/education
- Anatomy/ethics
- Anatomy/history
- Cadaver
- Clinical Competence
- Curriculum/trends
- Dissection
- Education, Medical, Undergraduate/ethics
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/trends
- Ethics, Medical/education
- Ethics, Medical/history
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- Humans
- Professional Role
- Schools, Medical/ethics
- Schools, Medical/organization & administration
- Schools, Medical/trends
- Students, Medical/psychology
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Affiliation(s)
- Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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13
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Halliday NL, Moon MB, O'Donoghue DL, Thompson BM, Crow SM. Transformation and Closure for Anatomical Donor Families that Meet Medical Students. Anat Sci Educ 2019; 12:399-406. [PMID: 31038285 DOI: 10.1002/ase.1888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 06/09/2023]
Abstract
The University of Oklahoma College of Medicine has conducted an annual Anatomical Donor Luncheon where families of the anatomical donors met anatomy dissection groups of medical students. The luncheon presented an opportunity for donor family members to share the life story of their loved one with the medical students prior to the start of the anatomy course. This study was designed to understand the impact of the Anatomical Donor Luncheon on families of the donors. Seven families in two different focus groups were included to explore the reactions and attitudes of the donor families to meeting the medical students. Conversations were digitally recorded and transcribed. Qualitative analysis of textual data were coded by three investigators using the Constant Comparative Method. To provide evidence of validity, a form of member checking was utilized. For further triangulation, an analyst not involved in conducting the focus groups or analyzing the data, re-coded all data. This analyst used categories and themes identified by the original analysts, ensuring validity of the themes and any negative cases (data not supporting or contradictory of the established categories and themes). One meta-theme and three sub-themes were identified. The meta-theme was Donor Family Participants Experience Transformation and Closure, and sub-themes were Motivators for Participation, Optimal Venue Factors, and Optimal Medical Student-Anatomical Donor Family Interactions. Study findings indicated the Anatomical Donor Luncheon facilitated closure on the death of their loved one, and transformed their apprehension about the luncheon and body donation into an attitude of gratitude and appreciation.
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Affiliation(s)
- Nancy L Halliday
- Department of Cell Biology, College of Medicine, The University of Oklahoma, Oklahoma City, Oklahoma
| | - Mary B Moon
- Department of Cell Biology, College of Medicine, The University of Oklahoma, Oklahoma City, Oklahoma
| | - Daniel L O'Donoghue
- Department of Cell Biology, College of Medicine, The University of Oklahoma, Oklahoma City, Oklahoma
- Department of Family and Preventive Medicine, College of Medicine, The University of Oklahoma, Oklahoma City, Oklahoma
| | - Britta M Thompson
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania
| | - Sheila M Crow
- Educational Development Office, University of Miami Miller School of Medicine, Miami, Florida
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14
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Caplan I, DeCamp M. Of Discomfort and Disagreement: Unclaimed Bodies in Anatomy Laboratories at United States Medical Schools. Anat Sci Educ 2019; 12:360-369. [PMID: 30586224 DOI: 10.1002/ase.1853] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 06/09/2023]
Abstract
Use of unclaimed bodies for anatomy teaching in undergraduate medical education continues, but is ethically controversial. The purposes of this study were to estimate the proportion of United States (US) medical schools using unclaimed bodies in first-year anatomy laboratories, to determine whether schools inform students of this use, and to explore anatomy course leaders' attitudes toward unclaimed body use. Anatomy course leaders from 146 US medical schools that had independent preclinical programs including anatomy were surveyed. Survey results were analyzed with descriptive statistics and statistical tests of association. Free text responses were analyzed using a thematic editing style of qualitative content analysis. Of 89 responses (response rate, 61.0%), 11 schools (12.4%) reported possible use of unclaimed bodies. Course leaders from these schools reported greater comfort with using unclaimed bodies compared to leaders from other schools (P < 0.01). Although most course leaders (49/76, or 64.5%) believed it was important or very important to inform students about use of unclaimed bodies, respondents from schools where unclaimed bodies could be used were more neutral (P < 0.01). Qualitative findings revealed deep disagreement and contradictory views about how unclaimed body use relates to ethical principles of respect for persons and justice. Continued use of unclaimed bodies, varying levels of comfort with their use, and disagreement about the practices' underlying morality suggest a need for greater ethical reflection about the permissibility of unclaimed body use in clinical anatomy and for educational interventions that teach students about its history, ethics, and contemporary practice.
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Affiliation(s)
- Ilan Caplan
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Matthew DeCamp
- Johns Hopkins Berman Institute of Bioethics, John Hopkins University, Baltimore, Maryland
- Division of General Internal Medicine, Department of Medicine, John Hopkins University, Baltimore, Maryland
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15
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Kramer B, Hutchinson EF, Brits DM, Billings BK. Making the Ethical Transition in South Africa: Acquiring Human Bodies for Training in Anatomy. Anat Sci Educ 2019; 12:264-271. [PMID: 30179313 DOI: 10.1002/ase.1814] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/13/2018] [Accepted: 06/09/2018] [Indexed: 06/08/2023]
Abstract
While dissection remains the method of choice for teaching human anatomy, ethical requirements for obtaining cadavers has made the process of acquiring human bodies more strenuous for institutions. In Africa and at the School of Anatomical Sciences in South Africa, dependence on unclaimed bodies has been prevalent. The aim of the present study was to determine whether more rigorous application of ethical consent has altered the provenance of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand. The numbers of bequeathed/donated/unclaimed cadavers received over the period 2013-2017, as well as their sex and population affinity were analyzed. The majority (96.8%) of the cadavers dissected over the period were from bequests/donations. Marginally more females than males were available. In addition, the population affinity of the cadavers had changed from a majority of South African African (unclaimed) bodies to a majority of South African White (bequest/donated) bodies. The study shows that even with ethical constraints it is possible to transition from the use of mainly unclaimed bodies to the acquisition of bequeathed/donor bodies. However, there may be challenges in relation to anatomical collections in the School as few of the bequest/donated cadavers remain in the School to be added to the collections. These changes also affect the demographics of the Schools' collections.
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Affiliation(s)
- Beverley Kramer
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Erin F Hutchinson
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Desiré M Brits
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Brendon K Billings
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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16
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Malički M, Katavić V, Marković D, Marušić M, Marušić A. Perceptions of Ethical Climate and Research Pressures in Different Faculties of a University: Cross-Sectional Study at the University of Split, Croatia. Sci Eng Ethics 2019; 25:231-245. [PMID: 29071571 PMCID: PMC6418058 DOI: 10.1007/s11948-017-9987-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
We determined the prevailing ethical climate at three different schools of a single university, in order to explore possible differences in the ethical climate related to different research fields: the School of Electrical Engineering, Mechanical Engineering, and Naval Architecture; the School of Humanities and Social Sciences; and the School of Medicine. We used the Ethical Climate Questionnaire to survey the staff (teachers and administration) at the three schools, and used the research integrity and organizational climate (RIOC) survey for early-stage researchers at the three schools. The dominant ethical climate type perceived collectively at the three university schools (response rate 49%, n = 294) was Laws and professional codes, which is associated with the cosmopolitan level of analysis and the ethical construct of principle. Individually, the same climate predominated at the schools for engineering and humanities, but the School of Medicine had the Self-interest ethical climate, which is associated with the individual level of analysis and the egoism ethical construct. In the RIOC survey (response rate 85%; n = 70), early-stage researchers from the three university schools did not differ in their perceptions of the organizational research integrity climate, or in their perceived individual, group or organizational pressures. Our study is the first, to the best of our knowledge, to show differences in perceived ethical climate at a medical school compared to other schools at a university. Further studies are needed to explore the reasons for these differences and how they translate to organizational outcomes, such as job satisfaction, commitment to the institution and dysfunctional behaviour, including research misconduct.
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Affiliation(s)
- Mario Malički
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia
- Cochrane Croatia, University of Split School of Medicine, Split, Croatia
| | - Vedran Katavić
- Department of Anatomy, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Domagoj Marković
- Department of Cardiology, University of Split Hospital Centre, Split, Croatia
| | - Matko Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia
- Cochrane Croatia, University of Split School of Medicine, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia.
- Cochrane Croatia, University of Split School of Medicine, Split, Croatia.
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Carr PL, Raj A, Kaplan SE, Terrin N, Breeze JL, Freund KM. Gender Differences in Academic Medicine: Retention, Rank, and Leadership Comparisons From the National Faculty Survey. Acad Med 2018; 93:1694-1699. [PMID: 29384751 PMCID: PMC6066448 DOI: 10.1097/acm.0000000000002146] [Citation(s) in RCA: 292] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE Prior studies have found that women in academic medicine do not advance or remain in their careers in parity with men. The authors examined a cohort of faculty from the 1995 National Faculty Survey to identify predictors of advancement, retention, and leadership for women faculty. METHOD The authors followed 1,273 faculty at 24 medical schools in the continental United States for 17 years to identify predictors of advancement, retention, and leadership for women faculty. Schools were balanced for public or private status and the four Association of American Medical Colleges geographic regions. The authors used regression models to adjust for covariates: seniority, department, academic setting, and race/ethnicity. RESULTS After adjusting for significant covariates, women were less likely than men to achieve the rank of professor (OR = 0.57; 95% CI, 0.43-0.78) or to remain in academic careers (OR = 0.68; 95% CI, 0.49-0.94). When number of refereed publications was added to the model, differences by gender in retention and attainment of senior rank were no longer significant. Male faculty were more likely to hold senior leadership positions after adjusting for publications (OR = 0.49; 95% CI, 0.35-0.69). CONCLUSIONS Gender disparities in rank, retention, and leadership remain across the career trajectories of the faculty cohort in this study. Women were less likely to attain senior-level positions than men, even after adjusting for publication-related productivity. Institutions must examine the climate for women to ensure their academic capital is fully utilized and equal opportunity exists for leadership.
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Affiliation(s)
- Phyllis L Carr
- P.L. Carr is associate physician, Department of Medicine, Massachusetts General Hospital, and associate professor, Harvard Medical School, Boston, Massachusetts. A. Raj is professor and director, Center on Gender Equity and Health, Division of Global Public Health, School of Medicine, University of California, San Diego, San Diego, California. S.E. Kaplan is assistant professor and assistant dean for diversity, Boston University School of Medicine, Boston, Massachusetts. N. Terrin is professor and director, Biostatistics, Epidemiology and Research Design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. J.L. Breeze is assistant professor and epidemiologist, Biostatistics, Epidemiology and Research Design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. K.M. Freund is professor and vice chair of medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts
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Zaidi D, Kesselheim JC. Assessment of orientation practices for ethics consultation at Harvard Medical School-affiliated hospitals. J Med Ethics 2018; 44:91-96. [PMID: 28780527 DOI: 10.1136/medethics-2016-103909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 04/28/2017] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Few studies have been conducted to assess the quality of orientation practices for ethics advisory committees that conduct ethics consultation. This survey study focused on several Harvard teaching hospitals, exploring orientation quality and committee members' self-evaluation in the American Society of Bioethics and Humanities (ASBH) ethics consultation competencies. METHODS We conducted a survey study that involved 116 members and 16 chairs of ethics advisory committees, respectively (52% and 62.5% response rates). Predictor variables included professional demographics, duration on committees and level of training. Outcome variables included familiarity with and preparedness in the ASBH competencies and satisfaction with orientations. We hypothesised that responses would be associated with both the aforementioned predictors and whether or not participants had encountered the ASBH competencies in training. RESULTS A majority of respondents found their orientation curricula to be helpful (62%), although a significant portion of respondents did not receive any orientation (24%) or were unsatisfied with their orientation (14%). Familiarity with ASBH competencies was a statistically significant predictor of respondents' self-evaluation in particular categories (54% had heard of the competencies). Standard educational materials were reported as offered during orientation, such as readings (50%) and case studies (41%); different medium resources were less evidenced such as videos on ethics consultation (19%). CONCLUSIONS Institutions should re-evaluate orientation practices for ethics committee members that perform ethics consultation. Integrating ASBH competencies and useful methods into a resourceful pedagogy will help improve both member satisfaction with orientation and preparation in consultation.
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Affiliation(s)
- Danish Zaidi
- Harvard Medical School Center for Bioethics, Boston, Massachusetts, USA
| | - Jennifer C Kesselheim
- Harvard Medical School Center for Bioethics, Boston, Massachusetts, USA
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA
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Abstract
In 2012, Loyola University Chicago's Stritch School of Medicine became the first medical school in the United States to actively recruit and accept undocumented immigrants who received protections granted under the Deferred Action for Childhood Arrivals program that was established by presidential memorandum. By 2016, sixty-one medical schools were considering applications from DACA recipients for admission, and more than 110 students applied. According to the American Association of Medical Colleges, sixty-five DACA recipients matriculated in U.S. medical schools in the 2016-2017 school year. These students contribute both diversity and talent to our medical community; they could also have a significant impact on the care of underserved and immigrant populations. The recent decision by the Trump administration to rescind DACA therefore comes with serious pragmatic and ethical ramifications, impeding our medical community's efforts to develop a diverse and representative workforce committed to improving access to quality care for all patients.
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Hessel K, DiPasco P, Kilgore L, Shelley C, Perry A, Wagner J. Have We Come as Far as We Had Hoped? Discrimination in the Residency Interview. J Surg Educ 2017; 74:939-945. [PMID: 28483440 DOI: 10.1016/j.jsurg.2017.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 03/21/2017] [Accepted: 04/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The primary objective was to use a pilot survey of fourth-year medical students at our institution to determine if female residency applicants were asked potentially illegal questions regarding family status and childbearing more frequently than male applicants. Secondary objectives included comparing the use of potentially illegal questions in surgical versus nonsurgical specialties and between community and academic residency programs. DESIGN A 20-item questionnaire was distributed to all fourth-year medical students at the University of Kansas School of Medicine. Data were analyzed in SPSS using descriptive statistics, bivariate analysis, and multivariate analysis. SETTING University of Kansas Health System, Tertiary Care Center. PARTICIPANTS Fourth-year medical students from the University of Kansas School of Medicine. RESULTS There were 57 survey respondents (51% male and 49% female). Female applicants were more likely to report being asked about their desire to have a family than male applicants (32% vs. 3%, respectively, p = 0.041). However, male and female students were equally likely to report being asked specifically if they had or intended to have children (p = 0.194). No significant differences were found in potentially illegal question-asking between surgical and nonsurgical specialties or between community-based and academic programs. CONCLUSIONS Although women now represent 47% of the applicant pool, gender discrimination in the residency interview has not been eradicated. Women are more likely to report potentially illegal questions regarding their desire to have a family on residency interviews than men. Community and academic programs appear to ask similar numbers and types of potentially illegal questions. Further study is warranted to determine if these findings apply to the entire applicant pool. Further education of interviewers is necessary regarding potentially illegal questions during the residency interview process.
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Affiliation(s)
- Kara Hessel
- Department of General Surgery, University of Kansas Medical Center, Kansas City, Kansas.
| | - Peter DiPasco
- Department of General Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Lyndsey Kilgore
- Department of General Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Casey Shelley
- Department of General Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Alvin Perry
- Department of General Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Jamie Wagner
- Department of General Surgery, University of Kansas Medical Center, Kansas City, Kansas
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Scheffer P, Guy-Coichard C, Outh-Gauer D, Calet-Froissart Z, Boursier M, Mintzes B, Borde JS. Conflict of Interest Policies at French Medical Schools: Starting from the Bottom. PLoS One 2017; 12:e0168258. [PMID: 28068362 PMCID: PMC5221756 DOI: 10.1371/journal.pone.0168258] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background 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. Methods 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] Results 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. Conclusion 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.
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Affiliation(s)
- Paul Scheffer
- Sciences of Education Department, Paris 8 University, Saint-Denis France
- * E-mail:
| | | | - David Outh-Gauer
- Faculty of Medicine Purpan, Toulouse 3 University, Toulouse, France
| | | | | | - Barbara Mintzes
- Faculty of Pharmacy, Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Atenstaedt RL. The state of ethical-legal oaths in UK medical practice today: Is it time to look at standardising? Med Leg J 2016; 84:200-202. [PMID: 27514400 DOI: 10.1177/0025817216663958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The taking of an ethical-legal oath is a "rite of passage" for many medical practitioners. A 1997 paper noted that half of medical schools in the UK administer an oath. I performed a survey of UK medical schools to see whether these are still used today. An electronic survey was sent to 31 UK medical schools, asking them whether the Hippocratic Oath (in any version) was taken by their medical students; non-respondents were followed up by telephone. Information was obtained from 21 UK medical schools, giving a response rate of 68% (21/31). A total of 18 (86%) institutions use an oath. Ethical-legal oaths are therefore taken in the vast majority of UK medical schools today. However, a great variety are used, and there are advantages in standardisation. My recommendation is that the Standard Medical Oath of the UK (SMOUK) is adopted by all medical schools, and that this is also taken regularly by doctors as part of revalidation.
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Carlat DJ, Fagrelius T, Ramachandran R, Ross JS, Bergh S. The updated AMSA scorecard of conflict-of-interest policies: a survey of U.S. medical schools. BMC Med Educ 2016; 16:202. [PMID: 27519253 PMCID: PMC4983088 DOI: 10.1186/s12909-016-0725-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 08/06/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Best practices for conflict-of-interest (COI) policies in medical schools have evolved rapidly over the past decade, in part motivated by the American Medical Student Association (AMSA) scorecard that has publicly graded schools since 2007. This report describes the methodological update and impact of revisions to the scorecard in 2014. METHODS The original AMSA scorecard (used annually from 2008 to 2013) was revised by a work group to improve its methodology and to increase the stringency of its criteria for scoring COI policies. All U.S. medical schools (both allopathic and osteopathic; n = 160) were invited to submit their COI policies to AMSA for scoring with the new scorecard; web site searches were used to acquire policy information for schools that did not submit. The authors developed a codebook and analyzed 14 distinct categories of COI policies, pertaining to activities such as industry-funded gifts, meals, educational events, site access for sales reps, and conflict-of-interest disclosure requirements. The analysis yielded four possible grades for each school: A, B, C, or I (incomplete). The authors compared 2014 grades with 2013 grades, and compared the distribution of grades of schools by type (allopathic vs. osteopathic) and geographical region. RESULTS A total of 27 (16.9 %) medical schools scored A grades, indicating that their COI policies were strong, 81 (50.6 %) scored B, 25 (15.6 %) scored C and 26 (16.3 %) policies scored I. As compared to 2013, in 2014 fewer schools qualified for A grades (17.0 % vs. 26.0 %; p = 0.05). The grade distributions of allopathic and osteopathic schools were significantly different (p < 0.0001), with osteopathic schools more likely than allopathic schools to have incomplete policies. There were no significant grade differences by geographical region. CONCLUSIONS The revised 2014 AMSA scorecard, with its more stringent criteria for evaluating COI policies, assigned fewer As and more Bs and Cs than in years past. This was the first study to identify schools with COI policies stronger than those recommended in 2008 by the Association of American Medical Colleges. Developing more stringent COI policies should be helpful in reducing the influence of pharmaceutical and device industry marketing on both trainees and faculty in American medical schools.
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Affiliation(s)
- Daniel J. Carlat
- Tufts University School of Medicine, Boston, MA USA
- P.O. Box 626, Newburyport, MA 01950, USA
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Angoff NR, Duncan L, Roxas N, Hansen H. Power Day: Addressing the Use and Abuse of Power in Medical Training. J Bioeth Inq 2016; 13:203-13. [PMID: 26979827 PMCID: PMC5539994 DOI: 10.1007/s11673-016-9714-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 02/13/2016] [Indexed: 05/20/2023]
Abstract
PROBLEM Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. APPROACH Beginning in 2001, Yale School of Medicine has held annual "Power Day" workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. OUTCOME Emerging narrative themes included the potential impact of small acts and students feeling "mute" and "complicit" in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. NEXT STEPS The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word "power" due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well.
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Affiliation(s)
- Nancy R Angoff
- Office of Student Affairs and Department of Internal Medicine, Yale University School of Medicine, 367 Cedar Street, New Haven, CT, 06510, USA.
| | - Laura Duncan
- University of California, San Francisco (UCSF) School of Medicine, San Francisco, California, USA
| | - Nichole Roxas
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Helena Hansen
- Departments of Psychiatry and Anthropology, New York University, New York, New York, USA
- Nathan Kline Institute for Psychiatry Research, Orangeburg, New York, USA
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Abstract
In this article, we discuss current perceptions of the model physician and how these perceptions conflict with stressful realities of training environments and contribute to the staggering rates of burnout and depression faced by medical students and residents. We suggest a multi-tiered interventional approach to address these problems, with innovations for individual trainees, programs, institutions, and the health care system. Finally, we discuss the medical community's ethical obligations to ensure that it is appropriately and thoughtfully investing in the wellness of medicine's next generations of practitioners.
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Affiliation(s)
- Kathryn Baker
- Clinical instructor in the Department of Psychiatry at the University of Michigan in Ann Arbor, and the director of the University of Michigan Medical Student Mental Health and House Officer Mental Health programs
| | - Srijan Sen
- Associate professor in the Department of Psychiatry and in the Molecular and Behavioral Neuroscience Institute at the University of Michigan in Ann Arbor, and the principal investigator of the Intern Health Study
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Abstract
U.S. medical education faces a threat from for-profit Caribbean medical schools which purchase clinical rotation slots for their students at U.S. hospitals. These offshore schools are monetizing a system that was previously characterized as a duty-the duty of the current generation of physicians to educate their successors. Offshore schools purchase clinical rotation slots using funds largely derived from federally subsidized student loans. This leads to pressure on U.S. schools to pay for clinical clerkships and is forcing some of them to find new clinical training sites.For-profit Caribbean schools largely escape the type of scrutiny that U.S. schools face from U.S. national accreditation organizations. They also enroll large classes of students with lower undergraduate GPAs and Medical College Admission Test scores than those of students at U.S. medical schools; their students take and pass Step 1 of the United States Medical Licensing Examination at a substantially lower rate than that of U.S. medical students; and their students match for residencies at a fraction of the rate of U.S. medical school graduates.Among the potential solutions proposed by the authors are passing laws to hold for-profit Caribbean schools to standards for board passage rates, placing restrictions on federal student loans, monitoring attrition rates, and denying offshore schools access to U.S. clinical training sites unless they meet accreditation standards equivalent to those of U.S. medical schools.
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Affiliation(s)
- Edward C Halperin
- E.C. Halperin is chancellor and chief executive officer, New York Medical College, Valhalla, New York, and provost for biomedical affairs, Touro College and University System, New York, New York. R.B. Goldberg is executive dean, Touro College of Osteopathic Medicine, New York, New York
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Yeh JS, Austad KE, Franklin JM, Chimonas S, Campbell EG, Avorn J, Kesselheim AS. Medical Schools' Industry Interaction Policies Not Associated With Trainees' Self-Reported Behavior as Residents: Results of a National Survey. J Grad Med Educ 2015; 7:595-602. [PMID: 26692972 PMCID: PMC4675417 DOI: 10.4300/jgme-d-15-00029.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/11/2015] [Accepted: 05/20/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Medical students attending schools with policies limiting industry/student interactions report fewer relationships with pharmaceutical representatives. OBJECTIVE To investigate whether associations between students' medical school policies and their more limited industry interaction behaviors persist into residency. METHODS We randomly sampled 1800 third-year residents who graduated from 120 allopathic US-based medical schools, using the American Medical Association Physician Masterfile. We surveyed them in 2011 to determine self-reported behavior and preferences for brand-name prescriptions, and we calculated the strength of their medical schools' industry interaction policies using the 2008 American Medical Student Association and Institute on Medicine as a Profession databases. We used logistic regression to estimate the association between strength of school policies and residents' behaviors with adjustments for class size, postresidency career plan, and concern about medical school debt. RESULTS We achieved a 44% survey response rate (n = 739). Residents who graduated from schools with restrictive policies were no more or less likely to accept industry gifts or industry-sponsored meals, speak with marketing representative about drug products, attend industry-sponsored lectures, or prefer brand-name medications than residents who graduated from schools with less restrictive policies. Residents who correctly answered evidence-based prescription questions were about 30% less likely to have attended industry-sponsored lectures (OR = 0.72, 95% CI 0.56-0.98). CONCLUSIONS Any effect that medical school industry interaction policies had on insulating students from pharmaceutical marketing did not persist in the behavior of residents in our sample. This suggests that residency training environments are important in influencing behavior.
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Affiliation(s)
- James S. Yeh
- Corresponding author: James S. Yeh, MD, MPH, Brigham and Women's Hospital, Division of Pharmacoepidemiology & Pharmacoeconomics, 1620 Tremont Street, Suite 3030, Boston, MA 02120, 617.278.0930, fax 617.232.8602,
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Affiliation(s)
- William Ventres
- research professor, Institute for Studies in History, Anthropology, and Archeology, University of El Salvador professor and associate dean, School of Osteopathic Medicine, University of the Incarnate Word
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Ariffin F, Chin KL, Ng C, Miskan M, Lee VK, Isa MR. Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country. BMC Res Notes 2015; 8:248. [PMID: 26082003 PMCID: PMC4470357 DOI: 10.1186/s13104-015-1220-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 06/02/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sexual history training during undergraduate education is essential for preparing future doctors to handle patients' sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools. METHODS The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to rate their attitudes and perceptions regarding training on taking sexual histories using a newly developed questionnaire with good internal consistency (Cronbach's alpha = 0.73). Ethics approval was obtained from the relevant medical schools, and the statistical analysis was conducted using SPSS, Version 20.0. RESULTS The mean age of participants was 23.58 ± 0.65 SD. Participants reported high interest in sexual health and felt it was important for doctors to know how to take a sexual history (95%). Among the participants, only half felt comfortable in taking sexual histories from patients. The participants identified cultural and religious differences between the doctor and the patient as a potential barrier for discussing sexual health. Participants were aware of their own practice and ability, as well as their limitations, in taking sexual histories. Less than half (46%) felt that the training they received adequately prepared them to take sexual histories. CONCLUSIONS This study identified gaps in sexual health training among medical schools in Malaysia. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take sexual histories from patients. The barrier caused by differences in culture or religion between a doctor and a patient may be overcome through cross cultural and cultural competency training. This is important for multi-faith, multi cultural societies such as Malaysia and other similar countries.
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Affiliation(s)
- Farnaza Ariffin
- Department of Family Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.
| | - Ken Lee Chin
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Shah Alam, Malaysia.
| | - ChirkJenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Maizatullifah Miskan
- Department of Family Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.
| | - Verna KarMun Lee
- Department of Family Medicine, Faculty of Medicine, International Medical University, Bukit Jalil, Malaysia.
| | - Mohammad Rodi Isa
- Department of Community Medicine, Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia.
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Kano M, Getrich CM, Romney C, Sussman AL, Williams RL. Costs and inconsistencies in US IRB review of low-risk medical education research. Med Educ 2015; 49:634-637. [PMID: 25989411 PMCID: PMC5698906 DOI: 10.1111/medu.12693] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/29/2014] [Accepted: 10/08/2014] [Indexed: 06/04/2023]
Abstract
CONTEXT Advances in communication technologies over the last two decades have transformed the way medical education research is conducted, creating opportunities for multi-institution national and international studies. Although these studies enable researchers to gain broader understandings of educational processes across institutions, they increase the need for multiple institutional review board (IRB) reviews to ensure the protection of human subjects. OBJECTIVES This study describes the process of obtaining multiple IRB approvals of the same protocol for a multi-site, low-risk, medical education research project in the USA. The burden of obtaining those reviews and their consistency are assessed. The associated time and costs, and implications for the research process are detailed. METHODS Following review by the investigators' parent institution IRB, the project team circulated a uniform protocol for conduct of a low-risk, medical education survey to the IRBs of 89 US medical schools for review. The processes and time required to obtain approvals were recorded to estimate associated research team personnel costs. RESULTS Approval could not be obtained from five IRBs as a result of insurmountable procedural barriers. A total of 67 IRBs eventually deferred to the parent IRB determination. The remaining IRBs required a variety of additional procedural processes before ultimately agreeing with the original determination. The personnel costs associated with obtaining the 84 approvals amounted to US$121,344. CONCLUSIONS Considering the value of multi-site designs to address a range of research questions, enhance participant diversity and develop representative findings, solutions must be found to counter inefficiencies of current IRB review processes for low-risk research, such as that usually conducted in medical education. Although we acknowledge that local review is an essential protective measure for research involving identifiable communities that are uniquely susceptible to social or economic harm, this report suggests that proposals to modernise and streamline IRB review processes for low-risk research are timely and relevant.
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Affiliation(s)
- Miria Kano
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Christina M Getrich
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Crystal Romney
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Andrew L Sussman
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Robert L Williams
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
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Burke SE, Dovidio JF, Przedworski JM, Hardeman RR, Perry SP, Phelan SM, Nelson DB, Burgess DJ, Yeazel MW, van Ryn M. Do Contact and Empathy Mitigate Bias Against Gay and Lesbian People Among Heterosexual First-Year Medical Students? A Report From the Medical Student CHANGE Study. Acad Med 2015; 90:645-51. [PMID: 25674910 PMCID: PMC4414697 DOI: 10.1097/acm.0000000000000661] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE A recent Institute of Medicine report concluded that lesbian and gay individuals face discrimination from health care providers and called for research on provider attitudes. Medical school is a critical juncture for improving future providers' treatment of sexual minorities. This study examined both explicit bias and implicit bias against lesbian women and gay men among first-year medical students, focusing on two predictors of such bias, contact and empathy. METHOD This study included the 4,441 heterosexual first-year medical students who participated in the baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, which employed a stratified random sample of 49 U.S. medical schools in fall 2010. The researchers measured explicit attitudes toward gay and lesbian people using feeling thermometer self-assessments, implicit attitudes using the Implicit Association Test, amount and favorability of contact using self-report items, and empathy using subscales of the Interpersonal Reactivity Index. RESULTS Nearly half (45.79%; 956/2,088) of respondents with complete data on both bias measures expressed at least some explicit bias, and most (81.51%; 1,702/2,088) exhibited at least some implicit bias against gay and lesbian individuals. Both amount and favorability of contact predicted positive implicit and explicit attitudes. Both cognitive and emotional empathy predicted positive explicit attitudes, but not implicit attitudes. CONCLUSIONS The prevalence of negative attitudes presents an important challenge for medical education, highlighting the need for more research on possible causes of bias. Findings on contact and empathy point to possible curriculum-based interventions aimed at ensuring high-quality care for sexual minorities.
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Affiliation(s)
- Sara E Burke
- S.E. Burke is a doctoral candidate, Department of Psychology, Yale University, New Haven, Connecticut. J.F. Dovidio is Carl Iver Hovland Professor, Department of Psychology, Yale School of Public Health, and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut. J.M. Przedworski is a doctoral student and National Cancer Institute predoctoral fellow, Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota. R.R. Hardeman is research associate, University of Minnesota Department of Medicine, and associated health postdoctoral fellow, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota. S.P. Perry is assistant professor, Department of Psychological Science, University of Vermont, Burlington, Vermont. S.M. Phelan is assistant professor, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota. D.B. Nelson is core investigator and senior statistician, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, and associate professor, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. D.J. Burgess is core investigator, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, and associate professor, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. M.W. Yeazel is associate professor, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota. M. van Ryn is professor, Health Services Research, Mayo Clinic College of Medicine, and director, Research Program on Equity and Quality of Patient-Provider Encounters, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
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de Oliveira Vidal EI, Silva VDS, Santos MFD, Jacinto AF, Boas PJFV, Fukushima FB. Why medical schools are tolerant of unethical behavior. Ann Fam Med 2015; 13:176-80. [PMID: 25755040 PMCID: PMC4369591 DOI: 10.1370/afm.1763] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 10/16/2014] [Accepted: 01/05/2015] [Indexed: 12/30/2022] Open
Abstract
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.
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Affiliation(s)
| | - Vanessa Dos Santos Silva
- Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil
| | | | | | | | - Fernanda Bono Fukushima
- Anesthesiology Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil
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Sisterhen L. A time of renewal. J Ark Med Soc 2014; 111:54. [PMID: 25255685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Zhang L, Xiao M, Gu M, Zhang Y, Jin J, Ding J. An overview of the roles and responsibilities of Chinese medical colleges in body donation programs. Anat Sci Educ 2014; 7:312-20. [PMID: 24227762 DOI: 10.1002/ase.1422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 10/14/2013] [Accepted: 10/16/2013] [Indexed: 05/24/2023]
Abstract
The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low and fraught with a number of difficulties. In the past, traditional Chinese culture focused on preserving the human body intact, which often limited body donation. In recent years, the public has become more open toward body donation. At Nanjing Medical University, only 20 bodies were donated in 2001. After the university became involved in an organized body donation program, this number increased to 70 donated bodies per year (2007 to 2012). This article describes and reviews Chinese medical colleges as a special case study among body donation programs, particularly in terms of the multiple responsibilities and roles that such institutions must assume in the course of adopting these programs. Medical colleges in China must serve as advocates, coordinators, builders, managers, educators, and beneficiaries in undertaking body donation programs. It is important for medical colleges to recognize these pluripotent roles and educate the public in order to promote body donation programs. This case study may also effectively guide and encourage Chinese medical colleges in refining their own body donation programs in the future.
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Affiliation(s)
- Luqing Zhang
- Department of Human Anatomy, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
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Persaud N. Questionable content of an industry-supported medical school lecture series: a case study. J Med Ethics 2014; 40:414-8. [PMID: 23760579 PMCID: PMC4033027 DOI: 10.1136/medethics-2013-101343] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/12/2013] [Accepted: 05/21/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Medical schools are grappling with how best to manage industry involvement in medical education. OBJECTIVE To describe a case study of industry-supported undergraduate medical education related to opioid analgesics. METHOD Institutional case study. RESULTS As part of their regular curriculum, Canadian medical students attended pain pharmacotherapy lectures that contained questionable content about the use of opioids for pain management. The lectures were supported by pharmaceutical companies that market opioid analgesics in Canada and the guest lecturer was a member of speakers bureaus of the same companies. These conflicts of interests were not fully disclosed. A reference book that reinforced some of the information in the lectures and that was paid for by a sponsoring company was made available to students. This is the first report of an association between industry sponsorship and the dissemination of potentially dangerous information to medical students. CONCLUSIONS This case demonstrates the need for better strategies for preventing, identifying and dealing with problematic interactions between the pharmaceutical industry and undergraduate medical education. These might include the avoidance of unnecessary conflicts of interest, more disclosure of conflicts, an open process for dealing with recognised problems and internationally harmonised conflict of interest policies.
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Affiliation(s)
- Navindra Persaud
- Department of Family and Community Medicine, St Michael's Hospital, Toronto, Canada
- Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
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Ritz SA, Beatty K, Ellaway RH. Accounting for social accountability: developing critiques of social accountability within medical education. Educ Health (Abingdon) 2014; 27:152-157. [PMID: 25420977 DOI: 10.4103/1357-6283.143747] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The concept of the social accountability of medical schools has garnered many followers, in response to a broad desire for greater social justice in health care. As its use has spread, the term 'social accountability' has become a meta-narrative for social justice and an inevitable and unquestionable good, while at the same time becoming increasingly ambiguous in its meaning and intent. In this article, we use the lenses of postmodernism and critical reflexivity to unpack the multiple meanings of social accountability. In our view, subjecting the concept of 'social accountability' to critique will enhance the ability to appraise the ways in which it is understood and enacted. DISCUSSION We contend that critical reflexivity is necessary for social accountability to achieve its aspirations, and hence we must be prepared to become accountable not only for our actions, but also for the ideologies and discourses underlying them.
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Affiliation(s)
- Stacey A Ritz
- Medical Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
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38
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Meland E. Better legal protection of doctoral research fellows. Tidsskr Nor Laegeforen 2014; 134:693-4. [PMID: 24721853 DOI: 10.4045/tidsskr.14.0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Abstract
Despite many efforts to increase ethics education in US medical schools, barriers continue to arise that impede the production of morally driven physicians who practice medicine with ideal empathy. Research has shown that, particularly during the clinical years, medical students lose the ability both to recognize ethical dilemmas and to approach such situations with compassionate reasoning. This article summarizes the current status of ethics education in US medical schools, described through the eyes of and alongside the story of a graduating medical student.
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Shnier A, Lexchin J, Mintzes B, Jutel A, Holloway K. Too few, too weak: conflict of interest policies at Canadian medical schools. PLoS One 2013; 8:e68633. [PMID: 23861928 PMCID: PMC3701639 DOI: 10.1371/journal.pone.0068633] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 06/05/2013] [Indexed: 12/02/2022] Open
Abstract
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.
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Affiliation(s)
- Adrienne Shnier
- Health Policy and Equity, School of Health Policy and Management, York University, Toronto, Canada
| | - Joel Lexchin
- School of Health Policy and Management, York University, Toronto, Canada
- University Health Network, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- * E-mail:
| | - Barbara Mintzes
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Annemarie Jutel
- Graduate School of Nursing Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
| | - Kelly Holloway
- Department of Sociology, York University, Toronto, Canada
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Devi S. Rights abuses linked to Irish surgical college in Bahrain. Lancet 2013; 381:1892. [PMID: 23734392 DOI: 10.1016/s0140-6736(13)61138-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kay M. Medical council asks India's Central Bureau of Investigation to investigate scam of bidding for postgraduate places. BMJ 2013; 346:f2834. [PMID: 23641045 DOI: 10.1136/bmj.f2834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Connolly KK. Addressing healthcare accountability at John A. Burns School of Medicine. Hawaii J Med Public Health 2013; 72:99-101. [PMID: 23520568 PMCID: PMC3602949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Kathleen Kihmm Connolly
- Office of Administration, Finance, and Operations, Office of the Dean, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA
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44
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Affiliation(s)
- James Rourke
- Faculty of Medicine, Memorial University of Newfoundland
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45
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Kim A, Mumm LA, Korenstein D. Routine conflict of interest disclosure by preclinical lecturers and medical students' attitudes toward the pharmaceutical and device industries. JAMA 2012; 308:2187-9. [PMID: 23212492 DOI: 10.1001/jama.2012.25315] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Azalea Kim
- Department of Medical Education, Mount Sinai School of Medicine, New York, New York, USA
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Affiliation(s)
- Georgette A Dent
- University of North Carolina School of Medicine in Chapel Hill, USA
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47
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Ncayiyana DJ. The vexed question of race-based medical school admissions. S Afr Med J 2012; 102:193. [PMID: 22464492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 03/19/2012] [Indexed: 05/31/2023] Open
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Ananthakrishnan N, Shanthi AK. Attempts at regulation of medical education by the MCI: issues of unethical and dubious practices for compliance by medical colleges and some possible solutions. Indian J Med Ethics 2012; 9:37-42. [PMID: 22319851 DOI: 10.20529/ijme.2012.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- N Ananthakrishnan
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605 006, India.
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Nepokupnaia VG, Usovich AK. [Legal regulation of work with anatomical material in the medical educational institutions of Belarus and Russia]. Morfologiia 2012; 142:96-99. [PMID: 23236900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Abstract
BACKGROUND Human dissection commonly occurs early in the undergraduate medical school curriculum, thus presenting an immediate opportunity for educators to teach and encourage humanistic qualities of respect, empathy, and compassion. PURPOSE The purpose of this study was to measure the impact of the Donor Luncheon, a unique program in which medical students meet the families of the anatomical donor prior to dissection in the anatomy course at the University of Oklahoma College of Medicine. METHODS Students were randomized into groups of 8 to attend the luncheon and either met with family of the donor or attended the luncheon with no donor family present. A questionnaire measured students' attitudes at 2 weeks, 6 weeks, and at the conclusion of the anatomy course. RESULTS Factor analysis revealed 5 scales. Analysis revealed statistically significant differences across time for Donor as Person, Dissection Process, and Donor as Patient and statistically significant differences between groups for Donor as Person and Donor as Patient. CONCLUSIONS These results suggest that this program can provide students with the opportunity to maintain more humanistic attitudes at the beginning of their medical education career.
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Affiliation(s)
- Sheila M Crow
- Department of Pediatrics, University of Oklahoma Tulsa School of Community Medicine, Tulsa, Oklahoma 74135, USA.
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