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Year Medical Students (year + medical_student)
Selected AbstractsWhat I learnt from studying epilepsy: Epileptology and myselfPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2004HARUO AKIMOTO Abstract, My life work with epilepsy has allowed me to learn a great deal. As an old soldier, I would like to give an account of some important milestones in my lifetime learning. The first factor that linked me to epilepsy was listening to a lecture delivered by Dr Yushi Uchimura on ,The pathogenesis of Ammon's horn sclerosis' at a conference of the Japanese Society of Neurology (now Japanese Society of Psychiatry and Neurology) in 1928 when I was a 4th year medical student at Tokyo University. The following year, I started to study under Dr Uchimura at the Department of Psychiatry, Hokkaido University School of Medicine. Another factor that linked me to clinical care and research of epilepsy as a psychiatrist was my encounter with the two volumes of ,Selected Writing of John Hughlings Jackson' edited by J. Taylor. Jackson's greatest asset and contribution to modern epileptology include (i) the discovery of ,Jacksonian epilepsy', (ii) ,conceptual revolution of epilepsy' by recognizing transient mental disorders as seizures, (iii) modern definition of epilepsy by defining epileptic seizures as discharges in the gray matter, and (iv) discovery of ,new epilepsy' (now temporal lobe epilepsy). In 1940, I reported clinical courses indistinguishable from schizophrenia in epilepsy cases. Through my studies, I disputed the then prevailing interpretation of this condition as epilepsy complicating schizophrenia, and proved that these cases were in fact epileptic mental disorders caused by epilepsy. Many patients with epilepsy require medical care as well as rehabilitation and welfare support. We need to further promote the facilities for rehabilitation and employment in the community for persons with epilepsy, such as co-operatives and welfare worksites. The issues that epileptology and epilepsy face in the 21st century is to realize the goals of liberating epilepsy from social stigma and protecting all the citizen's rights for persons with epilepsy. [source] Setting and maintaining professional role boundaries: an educational strategyMEDICAL EDUCATION, Issue 8 2004Gillian E White Aim, To develop and evaluate a programme focused on assisting medical students in setting and maintaining social and sexual boundaries, within their training and in future medical practice. Context, In response to allegations of sexual misconduct by medical practitioners, a teaching programme was implemented with, and evaluated by, final year medical students who were undertaking 9 weeks of community health and general practice experience. Outcome, The consensus of the students was that professional role boundary issues were complex, their professional ethos had been challenged, and there was a need to incorporate teaching about setting and maintaining role boundaries throughout all facets of the medical curriculum. Results, The pilot programme was successful in engaging students in the process of developing teaching to assist in setting and maintaining social and sexual boundaries. Recommendations to formalise the programme were approved. [source] Teaching and learning in the clinical setting: a qualitative study of the perceptions of students and teachersMEDICAL EDUCATION, Issue 11 2003Patsy Stark Objective, To describe the perceptions of medical students and clinical teachers of teaching and learning in the clinical setting. Design, Qualitative study of focus groups with undergraduate medical students and semistructured interviews with hospital consultant clinical teachers. Setting, The School of Medicine, University of Leeds and the Leeds Teaching Hospitals Trust, UK. Participants, Fourth year medical students and consultant clinical teachers. Main outcome measures, Analysis of narratives to identify students' perceptions of clinical teaching and consultants' views of their delivery of undergraduate clinical teaching. Results, Students believed in the importance of consultant teaching and saw consultants as role models. However, they perceived variability in the quality and reliability of teaching between physicians and surgeons. Some traditional teaching venues, especially theatre, are believed to be of little clinical importance. Generally, consultants enjoyed teaching but felt under severe pressure from other commitments. They taught in a range of settings and used various teaching strategies, not all of which were perceived to be ,teaching' by students. Conclusions, While students and teachers are educational partners, they are not always in agreement about the quality, quantity, style or appropriate setting of clinical teaching. To enable teachers to provide more high quality teaching, there needs to be support, opportunities and incentives to understand curricular developments and acquire teaching skills. [source] Reliability and validity of the direct observation clinical encounter examination (DOCEE)MEDICAL EDUCATION, Issue 3 2003Hossam Hamdy Context, The College of Medicine and Medical Sciences at the Arabian Gulf University, Bahrain, replaced the traditional long case/short case clinical examination on the final MD examination with a direct observation clinical encounter examination (DOCEE). Each student encountered four real patients. Two pairs of examiners from different disciplines observed the students taking history and conducting physical examinations and jointly assessed their clinical competence. Objectives, To determine the reliability and validity of the DOCEE by investigating whether examiners agree when scoring, ranking and classifying students; to determine the number of cases and examiners necessary to produce a reliable examination, and to establish whether the examination has content and concurrent validity. Subjects, Fifty-six final year medical students and 22 examiners (in pairs) participated in the DOCEE in 2001. Methods, Generalisability theory, intraclass correlation, Pearson correlation and kappa were used to study reliability and agreement between the examiners. Case content and Pearson correlation between DOCEE and other examination components were used to study validity. Results, Cronbach's alpha for DOCEE was 0·85. The intraclass and Pearson correlation of scores given by specialists and non-specialists ranged from 0·82 to 0·93. Kappa scores ranged from 0·56 to 1·00. The overall intraclass correlation of students' scores was 0·86. The generalisability coefficient with four cases and two raters was 0·84. Decision studies showed that increasing the cases from one to four improved reliability to above 0·8. However, increasing the number of raters had little impact on reliability. The use of a pre-examination blueprint for selecting the cases improved the content validity. The disattenuated Pearson correlations between DOCEE and other performance measures as a measure of concurrent validity ranged from 0·67 to 0·79. Conclusions, The DOCEE was shown to have good reliability and interrater agreement between two independent specialist and non-specialist examiners on the scoring, ranking and pass/fail classification of student performance. It has adequate content and concurrent validity and provides unique information about students' clinical competence. [source] An acute care skills evaluation for graduating medical students: a pilot study using clinical simulationMEDICAL EDUCATION, Issue 9 2002David Murray Purpose, This investigation aimed to explore the measurement properties of scores from a patient simulator exercise. Methods, Analytic and holistic scores were obtained for groups of medical students and residents. Item analysis techniques were used to explore the nature of specific examinee actions. Interrater reliability was calculated. Scores were contrasted for third year medical students, fourth year medical students and emergency department residents. Results, Interrater reliabilities for analytic and holistic scores were 0·92 and 0·81, respectively. Based on item analysis, proper timing and sequencing of actions discriminated between low- and high-ability examinees. In general, examinees with more advanced training obtained higher scores on the simulation exercise. Conclusion, Reliable and valid measures of clinical performance can be obtained from a trauma simulation provided that care is taken in the development and scoring of the scenario. [source] The influence of admissions variables on first year medical school performance: a study from Newcastle University, AustraliaMEDICAL EDUCATION, Issue 2 2002Frances Kay-Lambkin Aims This study examined the relationship between the performance of first year medical students at the University of Newcastle, Australia, and admission variables: previous educational experience, and entry classification (standard , academic or composite, Aboriginal and Torres Strait Islander, or overseas), age and gender. Methods Admission and demographic information was obtained for students who entered first year medicine at Newcastle between the years 1994 and 1997 inclusive. Academic performance was measured according to results of first assessment (`satisfactory' vs. `not satisfactory') and the final assessment of the first year (`satisfactory' vs. `not satisfactory'). Logistic regression was used to examine the relationship between predictor variables and outcomes. Results Assessment and admissions information was obtained for 278 students, 98% of all students who entered the medical course between 1994 and 1997. Regression analysis of first assessment indicated that Aboriginal and Torres Strait Islander and overseas students were significantly more likely to be `not satisfactory' than all other students (RR=3·1,95% CI: 1·4. , 6 7 and RR=1·5, 95% CI: 1·2,1·8, respectively). Analysis of final assessment indicated these two student groups were also significantly more likely to be `not satisfactory' than all other students (RR=4·5, 95% CI: 1·4,13·5 and RR=3·5, 95% CI: 1·2,10·8, respectively). At first assessment, students entering via the standard academic pathway and older students were less likely to be `not satisfactory' (RR=0·6, 95% CI: 0·5,0·7 and RR=0·8, 95% CI: 0·7,0·9, respectively). However both these differences were not evident at final assessment. There were no significant relationships between performance in first year and the remaining variables. Conclusions Aboriginal and Torres Strait Islander, and overseas medical students had academic difficulties in the first year of the course, suggesting the need for extra course support. The result may reflect the educational and other obstacles these students must overcome in order to enter and progress through their medical degree. More research is warranted to explore the extent to which these differences persist throughout the medical degree. [source] ALTERNATIVE CURRICULAR OPTIONS IN RURAL NETWORKS (ACORNS): IMPACT OF EARLY RURAL CLINICAL EXPOSURE IN THE UNIVERSITY OF WEST AUSTRALIA MEDICAL COURSEAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2000June Talbot The aim of this study was to assess the impact of a 4-day rural placement in Western Australia on the interest of fourth year medical students in a career in rural general practice. Students undertaking their Alternative Curricular Options in Rural Networks attachment (ACORNS) completed pre- and post-questionnaires examining their expectations, experiences of, and attitudes to rural general practice. Of the 103 students who participated, 81% expressed an interest in a rural career after the placement, whereas prior to this experience only 48% had been interested. The students also recorded a wide range of learning experiences, both clinical and procedural, and expressed positive attitudes to the variety of experiences and the role of the rural GP. The study concluded that early exposure to rural general practice enhances students' interest in a potential rural practice career and provides them with a broad range of experiences. The role of rural practitioners as role models for students needs to be acknowledged and reinforced. [source] Evaluation of a pharmacotherapy context-learning programme for preclinical medical studentsBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 6 2006J. A. Vollebregt What is already known about this subject ,,Context-learning in medicine is mainly based on theories explaining how medical expertise is achieved, particularly with regard to diagnostic problem solving. ,,By frequently solving diagnostic clinical problems doctors generate so-called networks of organized knowledge in their memory. ,,Preclinical medical students are well able to learn to choose and prescribe drugs. What this study adds ,,Preclinical pharmacotherapy context learning for medical students has a modest but positive effect on learning cognitive pharmacotherapeutic skills, i.e. choosing a drug treatment and determining patient information. ,,The effect can be obtained with role-play sessions, a suboptimal form of context learning, with a minimal study load and a high appreciation by students. Aim To evaluate a context-learning pharmacotherapy programme for approximately 750 2nd, 3rd and 4th year preclinical medical students with respect to mastering cognitive pharmacotherapeutic skills, i.e. choosing a (drug) treatment and determining patient information. Methods The context-learning pharmacotherapy programme consists of weekly organized role play sessions in the form of consulting hours. Fourth year students sit for a therapeutic Objective Structured Clinical Examination (OSCE) in the form of consulting hours at the outpatient clinic. Sixty-one 2nd, 74 3rd and 49 4th year medical students who attended the role play sessions and the OSCE were randomly selected. Their performances were assessed by clinical examiners and clinical experts and compared with a reference group of 6th year graduated students. Additionally, the scores of a questionnaire on study load and appreciation were collected. Results The level of the pharmacotherapeutic skills of the 4th year students who followed the pharmacotherapy context-learning programme was not far below that of 6th year graduates who had finished their clinical clerkships, but had not followed the pharmacotherapy programme. The time spent on the programme was about 1% of the total study load per year. The students appreciated the role play sessions and OSCE by around 80% and 99% of the maximum possible scores. Conclusions Preclinical pharmacotherapy context learning has a modest but positive effect on learning cognitive pharmacotherapeutic skills, i.e. choosing a drug treatment and determining patient information. This effect has been obtained with role play sessions, a suboptimal form of context learning, with a minimal study load and a high appreciation by students. [source] A needs-based study and examination skills course improves students' performanceMEDICAL EDUCATION, Issue 5 2003Lutz Beckert Background, Adult learning theory suggests that learning is most effective when related to need, when driven by the learner and when it is flexible. We describe the effect of an educational intervention that was driven by student need, and largely designed by students. Methods, We undertook a needs assessment of fifth year medical students' study needs. Based on this, we helped them design a course to meet these needs. This was predominantly related to study skills and a practice objective structured clinical examination (OSCE). We evaluated the course by asking for student opinion and by measuring the effect on student performance in a high stakes medical school examination (written examination and OSCE). Findings, Despite the course being run voluntarily and in after-hours sessions, 80,90% of the medical student class attended each session. Student performance on the end of year examinations was significantly enhanced in the year of the intervention, compared with previous years and with students from other schools sitting identical examinations in the same year. Interpretation, Learning activities that are directly based on student needs, that focus on study and examination techniques, and that are largely student-driven, result in effective and valuable outcomes. [source] | ||||||||||