Journal of Biomedical Education The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Sources of Stress and Coping Strategies among Undergraduate Medical Students Enrolled in a Problem-Based Learning Curriculum Mon, 21 Sep 2015 11:49:25 +0000 Background. Medical education is rated as one of the most difficult trainings to endure. Throughout their undergraduate years, medical students face numerous stressors. Coping with these stressors requires access to a variety of resources, varying from personal strengths to social support. We aimed to explore the perceived stress, stressors, and coping strategies employed by medical students studying in a problem-based learning curriculum. Methodology. This is a cross-sectional study of randomly selected medical students that explored demographics, perceived stress scale, sources of stress, and coping strategies. Results. Of the 378 medical students that participated in the study, males were 59.3% and females 40.7%. Nearly 53% of the students often felt stressed, and a third felt that they could not cope with stress. Over 82% found studying stressful and 64.3% were not sleeping well. Half of the students reported low self-esteem. Perceived stress scores were statistically significantly high for specific stressors of studying in general, worrying about future, interpersonal conflict, and having low self-esteem. Coping strategies that were statistically significantly applied more often were blaming oneself and being self-critical, seeking advice and help from others, and finding comfort in religion. Female students were more stressed than males but they employ more coping strategies as well. Conclusions. Stress is very common among medical students. Most of the stressors are from coursework and interpersonal relationships. Low self-esteem coupled with self-blame and self-criticism is quite common. Samira S. Bamuhair, Ali I. Al Farhan, Alaa Althubaiti, Sajida Agha, Saeed ur Rahman, and Nadia O. Ibrahim Copyright © 2015 Samira S. Bamuhair et al. All rights reserved. Nutrition Education for the Health Care Professions Sun, 09 Aug 2015 13:38:57 +0000 Martin Kohlmeier, Caryl A. Nowson, Rose Ann DiMaria-Ghalili, and Sumantra Ray Copyright © 2015 Martin Kohlmeier et al. All rights reserved. The Rationale, Feasibility, and Optimal Training of the Non-Physician Medical Nutrition Scientist Sun, 09 Aug 2015 07:04:36 +0000 Dietary components have potential to arrest or modify chronic disease processes including obesity, cancer, and comorbidities. However, clinical research to translate mechanistic nutrition data into clinical interventions is needed. We have developed a one-year transitional postdoctoral curriculum to prepare nutrition scientists in the language and practice of medicine and in clinical research methodology before undertaking independent research. Candidates with an earned doctorate in nutrition science receive intensive, didactic training at the interface of nutrition and medicine, participate in supervised medical observerships, and join ongoing clinical research. To date, we have trained four postdoctoral fellows. Formative evaluation revealed several learning barriers to this training, including deficits in prior medical science knowledge and diverse perceptions of the role of the translational nutrition scientist. Several innovative techniques to address these barriers are discussed. We propose the fact that this “train the trainer” approach has potential to create a new translational nutrition researcher competent to identify clinical problems, collaborate with clinicians and researchers, and incorporate nutrition science across disciplines from “bench to bedside.” We also expect the translational nutrition scientist to serve as an expert resource to the medical team in use of nutrition as adjuvant therapy for the prevention and management of chronic disease. Susan E. Ettinger, Jennifer A. Nasser, Ellen S. Engelson, Jeanine B. Albu, Sami Hashim, and F. Xavier Pi-Sunyer Copyright © 2015 Susan E. Ettinger et al. All rights reserved. Working with Individuals Who Provide Nursing Care to Educate Older Adults about Foodborne Illness Prevention: The Food Safety Because You Care! Intervention Thu, 06 Aug 2015 07:03:21 +0000 Older adults are more susceptible to foodborne infections than younger adults and many older adults do not follow recommended food safety practices. This study implemented the Food Safety Because You Care! program with 88 individuals in the United States who provide nursing care to older adult patients and subsequently surveyed them. The majority of respondents had favorable opinions of the program. Following program exposure, many of the respondents advised their older adult patients about food safety. The findings from this study suggest that the program is a useful tool that can assist those who provide nursing care as they interact with their older patients and lead them to positively influence older adults’ food safety practices. However, more research is needed to examine changes in providers’ behaviors as a result of program exposure and the accompanying effect on older adults’ food safety practices. Kelly C. Wohlgenant, Sandria L. Godwin, Sheryl C. Cates, and Richard Stone Copyright © 2015 Kelly C. Wohlgenant et al. All rights reserved. Hydration: Knowledge, Attitudes, and Practices of UK Dietitians Thu, 06 Aug 2015 06:59:03 +0000 Aim. The aim of this study was to investigate dietitians’ knowledge, attitudes, and practices (KAP) regarding hydration and patient care. Methods. A cross-sectional online survey was administered to UK dietitians via the British Dietetic Association monthly newsletter and included 18 items on hydration knowledge (), attitudes (), and practices (). KAP scores were calculated by adding the total number of correct knowledge responses and by ranking attitude and practice responses on a Likert scale. Results. 97 dietitians completed the online survey and displayed varying levels of KAP regarding hydration and patient care. The mean unweighted scores were knowledge 5.0 (±1.3) out of 8; attitude 13.9 (±1.3) out of 16; practice 14.9 (±2.6) out of 24. Dietitians appeared to be guided by clinical reasoning and priorities for nutrition care. Conclusions. There may be scope to further assess and potentially enhance the KAP of dietitians regarding hydration and patient care. Innovative approaches to hydration promotion are warranted and may include focusing on dietitians’ personal hydration status, increasing communication with other healthcare professionals, and partnering with patients to take a proactive role in hydration monitoring. Pauline Douglas, Lauren Ball, Lynn McGuffin, Celia Laur, Jennifer Crowley, Minha Rajput-Ray, Joan Gandy, and Sumantra Ray Copyright © 2015 Pauline Douglas et al. All rights reserved. The State of Nutrition Education at US Medical Schools Thu, 06 Aug 2015 06:46:15 +0000 Purpose. To assess the state of nutrition education at US medical schools and compare it with recommended instructional targets. Method. We surveyed all 133 US medical schools with a four-year curriculum about the extent and type of required nutrition education during the 2012/13 academic year. Results. Responses came from 121 institutions (91% response rate). Most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition education; 43 (36%) provide less than half that much. Nutrition instruction is still largely confined to preclinical courses, with an average of 14.3 hours occurring in this context. Less than half of all schools report teaching any nutrition in clinical practice; practice accounts for an average of only 4.7 hours overall. Seven of the 8 schools reporting at least 40 hours of nutrition instruction provided integrated courses together with clinical practice sessions. Conclusions. Many US medical schools still fail to prepare future physicians for everyday nutrition challenges in clinical practice. It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school and residency training how to recognize and treat the nutritional root causes. Kelly M. Adams, W. Scott Butsch, and Martin Kohlmeier Copyright © 2015 Kelly M. Adams et al. All rights reserved. A Survey of Medical Students’ Use of Nutrition Resources and Perceived Competency in Providing Basic Nutrition Education Thu, 06 Aug 2015 06:42:29 +0000 Purpose. The aims of this study were to assess where medical students obtain their nutrition information and their self-perceived level of competency in providing basic nutrition education to patients. Methods. A survey was distributed to all first through fourth year medical students at Case Western Reserve University (). For statistical analysis, data was expressed as percentages of total responses and binomial regression was used to answer the study hypotheses. Results. The survey response rate was 47%. Forty-two percent of respondents selected a majority of professional nutrition resources () as their most commonly used nutrition resources, 38% selected a majority of consumer resources (), and 20% selected “I do not use nutrition resources” (). The most popular nutrition resource selected was consumer websites. Seventy percent of respondents reported feeling competent in their ability to provide basic nutrition education to patients (). Conclusion. Medical students seem to feel competent in their ability to give basic nutrition education to patients, but they may be obtaining nutrition information from unreliable consumer-based resources. To help increase the provision of sound nutritional guidance, medical students should be taught to use reliable nutrition resources, as well as the value of referring patients to registered dietitians. Rebecca Connor, Lynn Cialdella-Kam, and Stephanie R. Harris Copyright © 2015 Rebecca Connor et al. All rights reserved. New Zealand Medical Students Have Positive Attitudes and Moderate Confidence in Providing Nutrition Care: A Cross-Sectional Survey Thu, 06 Aug 2015 06:39:50 +0000 Throughout the world, medical students and doctors report inadequate nutrition education and subsequently lack of knowledge, attitude, and skills to include nutrition in patient care. This study described New Zealand’s students’ attitudes to and self-perceived skills in providing nutrition care in practice as well as perceived quantity and quality of nutrition education received in training. 183 medical students from New Zealand’s largest medical school (response rate 52%) completed a 65-item questionnaire, partially validated, using 5-point Likert scales. Students believed incorporating nutrition care into practice is important, yet they were less confident patients improve nutrition behaviours after receiving this care. Students were confident in skills related to nutrition in health and disease but less confident in skills related to general food knowledge. Greater quantity and quality of nutrition education received was associated with greater self-perceived skills in providing nutrition care to patients but not with attitudes towards incorporating nutrition care into practice. This cohort of New Zealand medical students places similarly high importance on nutrition care as students and doctors from other countries. Further investigations beyond graduation are required to inform whether additional nutrition education is warranted for these doctors. Jennifer Crowley, Lauren Ball, Dug Yeo Han, Bruce Arroll, Michael Leveritt, and Clare Wall Copyright © 2015 Jennifer Crowley et al. All rights reserved. Learner-Directed Nutrition Content for Medical Schools to Meet LCME Standards Wed, 05 Aug 2015 14:25:55 +0000 Deficiencies in medical school nutrition education have been noted since the 1960s. Nutrition-related non-communicable diseases, including heart disease, stroke, cancer, diabetes, and obesity, are now the most common, costly, and preventable health problems in the US. Training medical students to assess diet and nutritional status and advise patients about a healthy diet, exercise, body weight, smoking, and alcohol consumption are critical to reducing chronic disease risk. Barriers to improving medical school nutrition content include lack of faculty preparation, limited curricular time, and the absence of funding. Several new LCME standards provide important impetus for incorporating nutrition into existing medical school curriculum as self-directed material. Fortunately, with advances in technology, electronic learning platforms, and web-based modules, nutrition can be integrated and assessed across all four years of medical school at minimal costs to medical schools. Medical educators have access to a self-study nutrition textbook, Medical Nutrition and Disease, Nutrition in Medicine© online modules, and the NHLBI Nutrition Curriculum Guide for Training Physicians. This paper outlines how learner-directed nutrition content can be used to meet several US and Canadian LCME accreditation standards. The health of the nation depends upon future physicians’ ability to help their patients make diet and lifestyle changes. Lisa A. Hark, Darwin D. Deen, and Gail Morrison Copyright © 2015 Lisa A. Hark et al. All rights reserved. Nutrition Knowledge, Attitudes, and Confidence of Australian General Practice Registrars Wed, 05 Aug 2015 13:29:18 +0000 Nutrition knowledge, attitudes, and confidence were assessed in General Practice Registrars (GPRs) throughout Australia. Of approximately 6,000 GPRs invited to complete a nutrition survey, 93 respondents (2%) completed the online survey, with 89 (20 males, 69 females) providing demographic and educational information. Fifty-one percent had graduated from medical school within the last two years. From a list of 11 dietary strategies to reduce cardiovascular risk, respondents selected weight loss (84%), reducing saturated fats (90%), a maximum of two alcoholic drinks/day (82%), and increasing vegetables (83%) as “highly appropriate” strategies, with only 51% indicating that salt reduction was “highly appropriate.” Two-thirds of registrars felt “moderately” (51%) or “very” confident (16%) providing nutrition advice. Most of them (84%) recalled receiving information during training, but only 34% recalled having to demonstrate nutritional knowledge. The results indicate that this group of Australian GPRs understood most of the key dietary recommendations for reducing cardiovascular risk but lacked consensus regarding the recommendation to reduce salt intake and expressed mixed levels of confidence in providing nutritional advice. Appropriate nutrition education before and after graduation is recommended for GPRs to ensure the development of skills and confidence to support patients to make healthy dietary choices and help prevent chronic diseases. Caryl A. Nowson and Stella L. O’Connell Copyright © 2015 Caryl A. Nowson and Stella L. O’Connell. All rights reserved. Student Perceptions of Nutrition Education at Marshall University Joan C. Edwards School of Medicine: A Resource Challenged Institution Wed, 05 Aug 2015 13:28:18 +0000 Nutrition education is an essential component of medical education if new physicians are to be equipped to address common chronic diseases, including obesity and the associated diabetes, cardiovascular disease, and cancer. Most medical students recognize this need and desire nutrition education; however, finding time in a medical school curriculum and funding are challenging. Available, free online resources and small group exercises can be utilized to provide basic, up-to-date nutrition information to medical students. W. Elaine Hardman, Bobby L. Miller, and Darshana T. Shah Copyright © 2015 W. Elaine Hardman et al. All rights reserved. Nutri One-on-One: The Assessment and Evaluation of a Brief One-on-One Nutritional Coaching in Patients Affected by Metabolic Syndrome Wed, 05 Aug 2015 13:26:22 +0000 Nutri One-on-One was a program with the aim to positively modify medical clinic patients’ nutritional habits and lifestyles through a brief one-on-one health coaching session. Each session was conducted by utilizing motivational interviewing techniques to allow for tailored nutrition education and goal setting. These sessions were followed by a phone call to participants at 1 month following the session. The outcomes assessed were participant perception of achieving personal nutrition and lifestyle goals, retention of knowledge, and participants’ satisfaction with the program. Physicians working in the clinic were assessed for satisfaction with the program. Most of the physicians were generally satisfied with the program and found it to be an asset to their practice. Participants perceived that they achieved their goals, were pleased with the program, and retained knowledge. Jennifer King, Jeffrey E. Harris, David Kuo, and Farzaneh Daghigh Copyright © 2015 Jennifer King et al. All rights reserved. Enabling Valuation of Nutrition Integration into MBBS Program Wed, 05 Aug 2015 13:26:09 +0000 Good nutrition is the foundation for good health. While basic nutritional assessment is part of many medical consultations, it remains underutilized despite becoming increasingly recognized as important for chronic disease prevention and management. Many studies identify shortfalls in physicians’ knowledge and attitudes toward nutrition as a result of inadequate emphasis in medical school. Additional teaching about nutrition and nutritional assessment procedures was integrated within a first year module of a MBBS program. Blended learning techniques were employed to facilitate student engagement and sessions were evaluated via student response system technology (clickers) or minute paper feedback. The initial survey to all medical students documented that less than half (45%) felt they could discuss nutrition with patients. The majority regularly consulted the internet for nutrition information, while only 163 utilised peer-reviewed journals. With the first year cohort “clickers” revealed that 91% felt nutrition important to health care and 82% felt it important in general practice. 71% found using clickers an interesting enhancement, whilst 70% noted the nutrition content informative. Early nutrition teaching was well received by students. Long-term increases in nutritional information dissemination, particularly by influential health care workers, might benefit not only economies but also the health of society as a whole. Niikee Schoendorfer and Jennifer Schafer Copyright © 2015 Niikee Schoendorfer and Jennifer Schafer. All rights reserved. University Education in Human Nutrition: The Italian Experience—A Position Paper of the Italian Society of Human Nutrition Wed, 05 Aug 2015 13:23:50 +0000 As a broad range of professionals in clinical and nonclinical settings requires some expertise in human nutrition, the university system must offer academic courses tailored to these different specific needs. In the Italian university system there is still uncertainty with regard to the learning objectives regarding human nutrition. In the ministerial decrees defining the criteria for establishing university courses, the indications about education in human nutrition are rather inconsistent, sometimes detailed, but often just mentioned or even only implied. Education in human nutrition requires both an appropriate duration (number of university credits included in the degree format for different disciplines) and course units that are designed in order to achieve specific expertise. The university system should appropriately design and distinguish the nutritional competencies of the different types of graduates. Physiology and biochemistry are the academic disciplines mostly involved in teaching fundamentals of human nutrition, while the discipline sciences of applied nutrition and dietetics more strictly focuses on applied nutrition and clinical nutrition. Other academic disciplines that may contribute to education in human nutrition, depending on the type of degree, are internal medicine (and its subspecialties), hygiene, endocrinology, food technologies, food chemistry, commodity science, and so forth. Luca Scalfi, Furio Brighenti, Nino Carlo Battistini, Alessandra Bordoni, Alessandro Casini, Salvatore Ciappellano, Daniele Del Rio, Francesca Scazzina, Fabio Galvano, and Nicolò Merendino Copyright © 2015 Luca Scalfi et al. All rights reserved. Developing Research Competence in Undergraduate Students through Hands on Learning Wed, 05 Aug 2015 13:23:37 +0000 Evidence-based practice is the foundation of nutrition and dietetics. To effectively apply evidence-based practice, health professionals must understand the basis of research. Previous work has identified the lack of involvement of dietitians in research. As part of a curriculum redevelopment in undergraduate nutrition and dietetics courses, research skill teaching was enhanced. This study evaluated the effect of a new, year two level nutrition research methods unit on the perceived research skills of students. The unit consisted of two key components: a student-led class research project and a small group systematic literature review. Prior to commencement and on completion of the course, students completed a modified version of the Research Skills Questionnaire. Results demonstrated that self-perceived competence increased by a small degree in a set of specific research skills as well as in broader skills such as information gathering and handling, information evaluation, ability to work independently, and critical thinking. The new research unit was also evaluated highly on a student satisfaction survey. Despite these positive findings, students indicated that their general feelings towards research or a career in research were unchanged. In summary, this unit enhanced students’ perceived research skills. Further exploration of students’ attitude towards research is warranted. Zoe E. Davidson and Claire Palermo Copyright © 2015 Zoe E. Davidson and Claire Palermo. All rights reserved. Making an IMPACT: The Story of a Medical Student-Designed, Peer-Led Healthy Eating and Physical Activity Curriculum Wed, 05 Aug 2015 13:20:47 +0000 Despite the importance of healthful dietary choices in combating the childhood obesity epidemic, neither primary and secondary schools nor medical schools provide adequate nutrition education. In 2005, two medical students at the University of North Carolina started the Improving Meals and Physical Activity in Children and Teens (IMPACT) program, which utilized a peer-educator model to engage medical students and high school students in teaching 4th graders about healthy eating and physical activity. Over the years, medical student leaders of IMPACT continued the program, orienting the curriculum around the 5-2-1-0 Let’s Go campaign, aligning the IMPACT curriculum with North Carolina state curricular objectives for 4th graders and engaging and training teams of health professional students to deliver the program. The IMPACT project demonstrates how medical and other health professional students can successfully promote nutrition and physical activity education for themselves and for children through community-based initiatives. Ongoing efforts are aimed at increasing family participation in the curriculum to maximize changes in eating and physical activity of IMPACT participants and ensuring sustainability of the organization by engaging health professional student participants in continuing to improve the program. Avik Chatterjee, Thomas N. Rusher, Julia Nugent, Kenneth W. Herring, Lindsey M. Rose, Dean Nehama, and Natalie D. Muth Copyright © 2015 Avik Chatterjee et al. All rights reserved. A Novel Method of Increasing Medical Student Nutrition Awareness and Education Wed, 05 Aug 2015 13:15:26 +0000 Medical nutrition education in most US medical schools is lacking, despite an epidemic of lifestyle related chronic conditions and high rates of malnutrition in hospitals. In a unique response to this deficit, students at Boston University School of Medicine have created a novel student interest group entitled Student Nutrition Awareness and Action Council (SNAAC). This student group is unique in that it focuses on interprofessional collaboration and development of concrete practice skills and works to fill educational gaps. The goal of SNAAC is to increase medical student knowledge, attitude, and skills in medical nutrition through providing extracurricular activities and partnering with official medical school curriculum committees. To accomplish this, SNAAC has developed a multipartite group overseen by a mentoring team composed of a physician nutrition specialist, registered dietitian, and a mental health provider. SNAAC provides nutrition oriented opportunities for members and the student body at large. Participation is high because it fills an educational gap, offers a unique focus on expanding nutrition awareness and education, and provides opportunities for student leadership and professional development. We encourage other medical schools to use the SNAAC student involvement model to increase nutrition awareness and facilitate the incorporation of medical nutrition in their curriculum. Cynthia L. Schoettler, Jennifer N. Lee, Kathy A. Ireland, and Carine M. Lenders Copyright © 2015 Cynthia L. Schoettler et al. All rights reserved. Analysis of Nutrition Education in Osteopathic Medical Schools Wed, 05 Aug 2015 12:59:40 +0000 Purpose. Describe nutrition education at US colleges of osteopathic medicine; determine if it meets recommended levels. Method. We surveyed 30 US colleges of osteopathic medicine (US COM) with a four-year curriculum about the amount and form of required nutrition education during the 2012/13 academic year. The online survey asked about hours of required nutrition across all 4 years and also in what types of courses this instruction occurred. We performed descriptive statistics to analyze the data. Results. Twenty-six institutions (87% response rate) completed the survey. Most responding US COM (22/26, 85%) do not meet the recommended minimum 25 hours of nutrition education; 8 (31%) provide less than half as much. Required nutrition instruction is largely confined to preclinical courses, with an average of 15.7 hours. Only 7 of the 26 responding schools report teaching clinical nutrition practice, providing on average 4.1 hours. Conclusions. Most US COM are inadequately preparing osteopathic physicians for the challenges they will face in practice addressing the nutritional concerns of their patients. Doctors of osteopathy cannot be expected to properly treat patients or guide the prevention of cardiovascular disease, obesity, cancer, diabetes, and metabolic syndrome if they are not trained to identify and modify the contributing lifestyle factors. Kathaleen Briggs Early, Kelly M. Adams, and Martin Kohlmeier Copyright © 2015 Kathaleen Briggs Early et al. All rights reserved. A Collaborative Project to Bridging the Gap between Basic and Clinical Teachers: The Opinion of Medical Students Thu, 28 May 2015 11:45:45 +0000 The organization of medical curricula with a clear distinction between basic and clinical subjects makes it difficult for teachers to collaborate and teach students in an integrated way. We designed a new subject, Integrated Medicine, to overcome such limitations. Here, we describe the evaluation of the first three years of running the experience, as well as the opinion of the first group of students in their sixth year. Three cohorts of first-year medical students and eight teachers, as well as a group of students of sixth year , participated in the experiment. Students worked following the problem-based learning approach. Their satisfaction, their subjective improvement of content knowledge in basic and clinical fields, and their belief about the accomplishment of educational objectives were evaluated. The results showed a high level of satisfaction, increased content knowledge, and improvement in solving problems, searching for relevant information, team working, and oral and written communication skills. Students of sixth year agreed that the subject helped them to better understand the clinical manifestations of disease, the diagnosis process, and therapeutic approaches. In conclusion, experiences such as Integrated Medicine may enhance the integration of knowledge by the joint work of basic and clinical teachers. Mariano Sentí, Ramon Miralles, Joan Bigorra, Meritxell Girvent, Joan Minguella, Enric Samsó, José-F. Solsona, and Josep-E. Baños Copyright © 2015 Mariano Sentí et al. All rights reserved. Confidence and Attitudes of Doctors and Dietitians towards Nutrition Care and Nutrition Advocacy for Hospital Patients in Kolkata, India Mon, 04 May 2015 12:26:40 +0000 Malnutrition results in increased duration of patient stay and increases hospital costs. However, few studies address this issue in the Indian context. A recent UK study showed that intensive nutrition training was effective in increasing awareness of health professionals. In order to inform such educational interventions in India, a needs assessment was conducted in Kolkata by measuring doctors’ and dietitians’ attitudes and confidence regarding nutrition care, advocacy, and leadership. A total of 123 doctors (including general medicine, endocrinology, and critical care) and 56 dietitians completed a questionnaire. Doctors displayed moderate confidence in providing nutrition care but were less confident in their skills relating to advocacy and leadership. Dietitians displayed greater confidence than doctors in providing nutrition care but similarly lacked confidence in skills relating to advocacy and leadership. Overall, doctors and dietitians displayed equally positive attitudes towards nutrition in patient care. The greater confidence of dietitians compared to doctors in providing nutrition care may be the result of specialised training. Despite the limitations of this study, this paper provides a first glance at the gaps in nutritional practice within the doctors and dietitians community of Kolkata such that targeted future studies can now be planned. Sumantra Ray, Minha Rajput-Ray, Lauren Ball, Jennifer Crowley, Celia Laur, Suchismita Roy, Shweta Agarwal, and Sabyasachi Ray Copyright © 2015 Sumantra Ray et al. All rights reserved. Near-Peer Teaching and Exam Results: The Acceptability, Impact, and Assessment Outcomes of a Novel Biological Sciences Revision Programme Taught by Senior Medical Students Sun, 30 Nov 2014 00:10:06 +0000 Background. Near-peer teaching is becoming increasingly popular as a learning methodology. We report the development of a novel near-peer biological sciences revision course and its acceptability and impact on student confidence and exam performance. Methods. A cross-sectional analysis of tutee-completed evaluation forms before and after each session was performed, providing demographic details, quality scores, and self-rating of confidence in the topic taught on a 0 to 100 mm visual analogue scale (VAS). The confidence data was examined using analysis of means. Exam performance was examined by analysis of variance and canonical correlation analysis. Results. Thirty-eight sessions were delivered to an average of 69.9 (±27.1) years 1 and 2 medical students per session generating 2656 adequately completed forms. There was a mean VAS gain of 19.1 (5.3 to 27.3) in self-reported confidence. Looking at relationship between attendance and exam scores, only two topics showed significant association between number of sessions attended and exam performance, fewer than hypothesised. Conclusion. The present study demonstrates that near-peer teaching for biological sciences is feasible and is associated with improved self-reported confidence in the sessions taught. The outcome data, showing significant effect for only a small number of items, demonstrates the difficulty of outcome related research. Jake Mann, Majd B. Protty, John Duffy, Mohammed Mohammed, and Connie Wiskin Copyright © 2014 Jake Mann et al. All rights reserved. Computer-Based Learning: The Use of SPSS Statistical Program for Improving Biostatistical Competence of Medical Students Wed, 22 Oct 2014 12:30:42 +0000 Background. We changed the biostatistics curriculum for our medical students and have created a course entitled “Multivariate analysis of statistical data, using the SPSS package.” Purposes. The aim of this course was to develop students’ skills in computerized data analysis, as well as enhancing their ability to read and interpret statistical data analysis in the literature. Methods. In the current study we have shown that a computer-based course for biostatistics and advanced data analysis is feasible and efficient, using course specific evaluation questionnaires. Results. Its efficacy is both subjective (our subjects felt better prepared to do their theses, as well as to read articles with advanced statistical data analysis) and objective (their knowledge of how and when to apply statistical procedures seemed to improve). Conclusions. We showed that a formal evaluative process for such a course is possible and that it enhances the learning experience both for the students and their teachers. In the current study we have shown that a computer-based course for biostatistics and advanced data analysis is feasible and efficient. Zvi H. Perry, Aricha-Tamir Barak, Lily Neumann, and Amalia Levy Copyright © 2014 Zvi H. Perry et al. All rights reserved. Frequency in Usage of Terminologia Anatomica Terms by Clinical Anatomists Thu, 18 Sep 2014 06:54:10 +0000 Almost 16 years since the publishing of Terminologia Anatomica (TA) by the Federative Committee on Anatomical Terminology (FCAT), there has yet to be a unified adoption of TA-recommended anatomical terms by anatomists. A survey was sent to members of the American Association of Clinical Anatomists (AACA) to determine the frequency of TA term usage. Most respondents (70.3%) received their terminal degrees in anatomy, with 23.4% in clinical and anthropological areas. Academically ranked, most respondents were professors (38.4%) and most were from North America (81.1%). Almost 40% of respondents were textbook authors. Overall results indicate that the TA preferred term had the highest frequency of usage in only 53% of the anatomical structures/features surveyed. Compliance with TA preferred terms ranged from 98.2% to 3.6% usage. Almost 25% of AACA anatomists were not familiar with the FCAT and over 75% were concerned about synonymity in anatomical terminology. Data demonstrates that clinical anatomists of the AACA are not consistent in how they use anatomical terminology, as well as how they conform to TA terminology. Bradford D. Martin, Donna Thorpe, Vanessa DeLuna, Trish Howard, Josh Hagemeyer, and Nicholas Wilkins Copyright © 2014 Bradford D. Martin et al. All rights reserved. Self-Assessment of Problem Solving Disposition in Medical Students Mon, 18 Aug 2014 11:26:43 +0000 Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 experts in medical education and applied to 135 registered students on the sixth year of the M.D. Physician Surgeon program at a private medical school. Cronbach’s alpha indicated an internal consistency of 0.751. The findings suggest that selected items have both homogeneity and validity. The factor analysis resulted in components that were associated with three problem-solving subcategories. The students’ perceptions are higher in the pattern recognition and application of general strategies for problem solving subcategories of the Problem solving disposition model. Silvia Lizett Olivares-Olivares and Mildred Vanessa López-Cabrera Copyright © 2014 Silvia Lizett Olivares-Olivares and Mildred Vanessa López-Cabrera. All rights reserved. Proactive Student Engagement with Fitness to Practise Tue, 15 Jul 2014 11:10:07 +0000 Fitness to practise (FTP) is fundamental to health professional education and health service delivery, impacting on both practitioner and client wellbeing. Literature exploring FTP support policies primarily identifies retrospective student support and management. This study describes student perceptions of an innovative FTP policy which supports students and staff to proactively identify FTP management strategies prior to entering the clinical environment. Forty-nine final year physiotherapy students were surveyed regarding their perceptions of self-declaring FTP. Ordinal data from Likert scales were reported using descriptive statistics. Thematic analysis was undertaken for open text responses. The response rate was 88%. Forty-two percent of students stated that they had experienced FTP concerns during the course. Concerns included physical and mental impairment and clinical competence issues. The majority of students (80%) indicated that they were “comfortable” or “very comfortable” in self-declaring FTP issues. Confidentiality, positive relationships with staff and a supportive environment enhanced likelihood of declaration. Eight students (19%) met with university staff to develop management strategies and all rated these meetings as “helpful” or “very helpful.” Students had positive perceptions of self-declaring their FTP to enable early development of management strategies. This strategy successfully navigates sensitive ethicolegal issues, empowering students to take responsibility for their own FTP. Kristin Lo, Stephen Maloney, Margaret Bearman, and Prue Morgan Copyright © 2014 Kristin Lo et al. All rights reserved. Integrating Contemplative Tools into Biomedical Science Education and Research Training Programs Wed, 02 Jul 2014 00:00:00 +0000 Academic preparation of science researchers and/or human or veterinary medicine clinicians through the science, technology, engineering, and mathematics (STEM) curriculum has usually focused on the students (1) acquiring increased disciplinary expertise, (2) learning needed methodologies and protocols, and (3) expanding their capacity for intense, persistent focus. Such educational training is effective until roadblocks or problems arise via this highly-learned approach. Then, the health science trainee may have few tools available for effective problem solving. Training to achieve flexibility, adaptability, and broadened perspectives using contemplative practices has been rare among biomedical education programs. To address this gap, a Cornell University-based program involving formal biomedical science coursework, and health science workshops has been developed to offer science students, researchers and health professionals a broader array of personal, contemplation-based, problem-solving tools. This STEM educational initiative includes first-person exercises designed to broaden perceptional awareness, decrease emotional drama, and mobilize whole-body strategies for creative problem solving. Self-calibration and journaling are used for students to evaluate the personal utility of each exercise. The educational goals are to increase student self-awareness and self-regulation and to provide trainees with value-added tools for career-long problem solving. Basic elements of this educational initiative are discussed using the framework of the Tree of Contemplative Practices. Rodney R. Dietert Copyright © 2014 Rodney R. Dietert. All rights reserved. Mobile Learning in a Rural Medical School: Feasibility and Educational Benefits in Campus and Clinical Settings Sun, 29 Jun 2014 11:04:02 +0000 Students in a new medical school were provided with laptops. This study explored the feasibility and educational benefits of mobile learning for two cohorts of students learning in two settings—university campus (first-year students) and rural clinical placements (second-year students). Evaluation involved questionnaires, focus groups (faculty and students), and document analysis. Descriptive statistics were computed. Focus groups were audio-recorded, transcribed, and analysed thematically. Response rates for questionnaires exceeded 84%. Compared with second-year students, significantly more first-year students (60%) took their laptops to campus daily () and used their laptops for more hours each day (). All students used laptops most frequently to access the internet (85% and 97%) and applications (Microsoft Word (80% and 61%) and Microsoft PowerPoint (80% and 63%)). Focus groups with students revealed appreciation for the laptops but frustration with the initial software image. Focus groups with faculty identified enthusiasm for mobile learning but acknowledged its limitations. Physical infrastructure and information technology support influenced mobile learning. Document analysis revealed significant costs and issues with maintenance. If adequately resourced, mobile learning through university-issued laptops would be feasible and have educational benefits, including equitable access to learning resources, when and where they are needed. However, barriers remain for full implementation. Debra Nestel, Katherine Gray, Andre Ng, Matthew McGrail, George Kotsanas, and Elmer Villanueva Copyright © 2014 Debra Nestel et al. All rights reserved. Faculty Development Effectiveness: Insights from a Program Evaluation Mon, 23 Jun 2014 07:57:54 +0000 Background. Faculty development programs are often time and resource intensive. In order to accommodate time constrained clinicians a limited time commitment faculty development program was developed and was shown to be effective in improving participant’s scholarly productivity. Objectives. The objective of this study was to assess participants’ perceptions of why the faculty development program was effective in promoting scholarship in education. Methods. In-depth semistructured interviews of course participants were conducted a year after completing a faculty development program. The interviews were audiotaped and transcribed verbatim. The transcriptions were coded independently by the investigators for dominant themes. The investigators held coding meetings to further refine the themes and discrepancies were handled by referring to the transcripts and reaching consensus. Results. The participants’ satisfaction with the course as described in the interviews correlated with the early satisfaction surveys. Reasons offered for this impact fell into four broad categories: course content, course format, social networking during the course, and the course facilitation coaching strategies to achieve goals. Conclusions. Course focusing on the process, experiential learning, and situating the course facilitator in the role of a functional mentor or coach to complete projects can be effective in facilitating behaviour change after faculty development programs. Anupma Wadhwa, Lopamudra Das, and Savithiri Ratnapalan Copyright © 2014 Anupma Wadhwa et al. All rights reserved. A Continuing Medical Education Campaign to Improve Use of Antibiotics in Primary Care Sun, 25 May 2014 12:36:32 +0000 Because inappropriate use of antibiotics is common, it is an important area for continuing medical education. At an annual review, we conducted a two-year campaign to achieve appropriate use. Our methods included two surveys, directed course content, programmatic evaluation, and a sample practice audit. Ninety percent of learners perceived inappropriate antibiotic use as a “very big” or “big” problem in the United States, but only 44% perceived this about their practice (). Top perceived barriers to appropriate antibiotic use were patient expectations, breaking old habits, and fear that patients would go elsewhere. Top strategies to overcome these barriers were patient educational materials, having guidelines accessible, and developing practice policies. In a hypothetical patient with acute bronchitis, 98% would likely prescribe an antibiotic in certain clinical scenarios even though The Centers for Disease Control and Prevention does not recommend empiric antibiotic treatment. The most common scenarios leading to likely antibiotic prescription were symptoms over 15 days (84%), age over 80 years (70%), and fever (48%). Practitioners are under multiple pressures to prescribe antibiotics even in situations where antibiotics are not recommended (such as acute bronchitis). To achieve complex practice changes such as avoiding inappropriate antibiotic use, no one strategy predominated. Ronald S. Gibbs, Carolyn Wieber, Leslie Myers, and Timothy Jenkins Copyright © 2014 Ronald S. Gibbs et al. All rights reserved. Understanding Student Experiences in a Near-Peer Resident Shadowing Program Sun, 18 May 2014 00:00:00 +0000 Introduction. The preparation of medical students for clerkship has been criticized, both in terms of students’ ability to understand their new role as clinical trainees and in their ability to carry out that role. To begin to address this gap, this paper reports the experiences of students in a shadowing program aimed at enhancing the preparedness of medical students for clinical training. The study examined a novel program, the Resident-Medical Student Shadowing Program, in which first-year medical students at the University of Alberta shadowed a first-year resident during clinical duties over the course of eight months. Methods. A study was conducted to assess the experiences of 83 first-year medical student participants who shadowed a first-year resident intermittently for one year. Student and resident participants’ experiences were explored using semistructured interviews. Results. Students and residents experiences indicate that participation increased students’ understanding of the clinical environment and their role within it and introduced them to skills and knowledge needed to perform that role. Students reported that a close relationship with their resident enhanced their learning experience. Conclusion. This study demonstrates that a low-cost program in which first-year students shadow residents may be a useful tool for helping prepare students for clerkship. Simon R. Turner, Jonathan White, Cheryl Poth, and W. Todd Rogers Copyright © 2014 Simon R. Turner et al. All rights reserved.