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Background: The role of animal-assisted therapy (AAT) in complementary and alternative medicine is well acknowledged. AAT is widely patronized, in developed countries such as USA, Canada, and many European countries, but less so in developing countries in Africa including Ghana. For persons in developing African countries and elsewhere to benefit from AAT, healthcare professionals must be acquainted with it recommend it to their patients when necessary. This study therefore assessed the perspectives of clinical-level medical students on AAT. Method: A semi-structured questionnaire was used to collect data in a cross-sectional study from 206 randomly selected clinical-level medical students of the University for Development Studies, Tamale, Ghana. The data was analyzed using Microsoft Excel and SPSS (Version 26) and the results were presented in Tables and charts. The association between demographic variables and the knowledge and attitude of the students were determined using ANOVA, while bivariate Pearson's correlation was used to measure the relationships between continuous variables. Associations were considered significant when p-value < 0.05. Results: The knowledge about AAT among the medical students was very poor (0.971 ± 2.407 over 10; 9.7%); almost all of them (≈ 99.0%) had very little or no exposure to AAT in school or at home. The attitude of the students was however averagely positive (3.845 ± 0.748 over 7; 54.9%), with a perceived health benefit of ATT score of 4.768 ± 1.002 (68.1%). The motivation of the students to acquire more knowledge and skills about AAT mostly through lectures and practical sessions (70.9%) was good (4.809 ± 1.221; 68.7%). Female students were significantly more knowledgeable about AAT than their male counterparts (1.5 versus 0.6; p-value = 0.006). No other sociodemographic characteristics had any significant association with knowledge, attitude, and perception of benefit variables. However, a significant positive relationship was found to exist between the students' knowledge, attitude and perception of animal-assisted therapy (r ≥ 0.236; p-value ≤ 0.001). Conclusion: We conclude that the knowledge about AAT among medical students is inadequate and this is worrying given the beneficial complementary role of AAT in achieving SDG 3. Medical schools and their regulators in Ghana should incorporate complementary and alternative medicine (CAM) lessons in their training curricula. For practising medical doctors, topics on CAM should be discussed during their Continuous Professional Development sessions. With better knowledge, physicians would possibly be more willing and confident in recommending this useful complementary and alternative medicine to patients who may seek other forms of therapy besides conventional medicine or which will augment the orthodox medication the patients may have been using to treat their conditions. [ABSTRACT FROM AUTHOR]

Aim: Objective structured clinical examinations have long been used in dietetics education. This observational study aims to describe the development, deployment, feasibility and validity of assessment using an oral interview in place of traditional objective structured clinical examinations, and to determine the ability of this assessment to identify students who are either not ready for placement or may require early support and/or remediation. Methods: Student assessment data were collected over a two‐and‐a‐half‐year period and used to test the predictive ability of an oral interview to determine dietetic placement outcomes and highlight a need for early remediation. Descriptive statistics as well as a between‐group one‐way ANOVA was used to describe results. Results: A total of 169 students participated in the oral interview and subsequent medical nutrition therapy placement over the study period. Significant differences in oral interview score were seen between students who passed placement and students who passed with remediation or those who failed. Oral interview performance was able to predict placement outcome, yet required less resources than traditional objective structured clinical examinations. Conclusion: An oral interview may provide the same utility as the objective structured clinical examination in dietetics education. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior is associated with various adverse health outcomes. Medical students often experience high academic demands, leading to increased sedentary time. This study aimed to evaluate the effectiveness of a mobile app providing real-time feedback in reducing total sedentary time and prolonged sedentary bouts and in promoting physical activity among medical students. Methods: Seventy-seven medical students from Jazan University (mean age: 21.4 years; range: 20–25 years) participated in this study. Participants were assigned to either the control group (n = 40) or the intervention group (n = 37). The intervention group received real-time vibration feedback via a mobile app, prompting movement every 30 min of sedentary time, while the control group received no intervention. Sedentary behavior and physical activity levels were assessed using the Activities Completed Over Time in 24 h. Paired t-tests were conducted to examine within-group changes, and a two-way ANOVA was used to assess the interaction effect of time and group on sedentary time and physical activity. Results: After six weeks, the intervention group showed significant within-group reductions in their total sedentary time of 1.82 h (p = 0.01) and prolonged sedentary bouts of 1.91 h (p = 0.001), while the control group had no significant changes. Physical activity levels did not significantly change within either group. The two-way ANOVA revealed that there was no significant change over time between the two groups in their total sedentary time F (1, 75) = 1.590, p = 0.21, prolonged sedentary bouts F (1, 75) = 3.499, p = 0.06, or physical activity F (1, 75) = 0.565, p = 0.45. Conclusions: Real-time feedback from mobile apps resulted in significant within-group reductions in total and prolonged sedentary time among medical students in the intervention group. Low-cost mobile apps providing real-time feedback may be an effective intervention for reducing sedentary behavior among medical students, potentially improving their health and well-being. [ABSTRACT FROM AUTHOR]

Introduction: Student engagement is influenced by several variables, among which are the teaching styles employed by faculty. In problem‐based learning (PBL), the role of faculty is to facilitate the learning of the tutorial group as they work through clinical problems. However, the influence of tutor intervention styles and group process on engagement of students in PBL tutorials is unclear. Methods: The study was conducted with year 2 and 3 medical students (n = 176) in PBL tutorial groups at the end of an integrated PBL course. Students evaluated their behavioural, cognitive and emotional engagement in PBL tutorials using a pre‐validated 11‐item questionnaire. Students also filled in a modified version of a previously published tutor intervention profile (TIP) questionnaire. The modified TIP questionnaire represents three constructs (1) steering the learning process (6 items), (2) stimulating student autonomy (4 items) and (3) establishing relatedness with students (3 items). In addition, PBL group process was evaluated using a 5‐item nominal scale: (1) tutorial atmosphere, (2) listening and information sharing, (3) group performance, (4) decision making and (5) reaction to leadership. Results: Establishing sense of relatedness in the group by PBL tutors was the most important predictor of emotional engagement (F = 41.213, ΔR2 = 0.191, β = 0.438, P = 0.000). On the other hand, steering the learning process was a significant predictor of behavioural engagement (F = 19.0, ΔR2=0.098, β = 0.314, P = 0.000). However, stimulating student autonomy was not a significant predictor of student engagement in PBL tutorials. On the other hand, enhancing the group process in PBL tutorials significantly predicts student engagement with strong impact on emotional and cognitive engagement of students. Conclusions: Establishing the sense of relatedness in the group and steering the learning process by PBL tutors as well as improving PBL group process are significant predictors of student engagement in PBL tutorials with emotional and cognitive engagement being the most sensitive variables affected. Enabling engagement in medical education! This study reveals the power of fostering relatedness, guiding learning processes, and refining group dynamics in problem‐based learning. [ABSTRACT FROM AUTHOR]

Despite the importance of sexual well-being in overall health, health providers do not communicate with their patients about sexual health sufficiently and highlight their discomfort with the topic as one key barrier. This study tested the effectiveness of a brief reflective sexual health workshop as an online intervention to increase comfort in sexual health communication. Participants were students enrolled on an undergraduate medical programme at a private university in Malaysia who were randomly allocated to a workshop that focused either on sexual health communication (intervention, n = 48) or on cultural competence in communication training (active control, n = 50). While the workshops varied in their focus, both followed identical structures and tasks. Multilevel modelling analyses revealed that both workshops increased subjective (self-reported) comfort and observed comfort through more direct verbal mentions of sex during history-taking. However, the sexual health workshop was more effective than the cultural competence workshop in reducing verbal avoidance behaviours and in promoting awareness of the value of effective communication about sex. Our Findings highlight the value of conducting brief reflective workshops that focus on comfort in communication to supplement other aspects of the medical school curriculum. [ABSTRACT FROM AUTHOR]

Background: Scottish Graduate Entry Medicine (ScotGEM) is a new four-year graduate entry medical programme. During the third year, students undertake a Longitudinal Integrated Clerkship (LIC) where they are integrated into one General Practice for two and a half days a week. The remaining time is 'white space', allowing students to undertake placements and portfolio work; while directing their learning. Aims: To explore the students' perceptions of the utility of the 'white space' of the ScotGEM LIC. Secondary aims were to explore the positive aspects of this space, the challenges of utilising this space and to explore any difference in the 'white space' between LIC regions. Methods: An explorative case study methodology was utilised and semi-structured interviews were conducted with third and fourth-year students. 13 interviews were transcribed for inductive thematic analysis. Findings: Four themes were established: the students' usage of the 'white space'; the tools they used to guide learning in this space; regional variations in LIC experiences and they offered suggestions to improve the utility of this space. Discussion and conclusion: The findings are detailed and integrated with relevant literature to inform recommendations for future LIC practice and suggestions for future research are offered. [ABSTRACT FROM AUTHOR]

Reflective writing (RW) is a popular tool in medical education, but it is being used in ways that fail to maximize its potential. Literature in the field focuses on why RW is used – that is to develop, assess, and remediate learner competencies – but less so on how to use it effectively. The emerging literature on how to integrate RW in medical education is haphazard, scattered and, at times, reductionist. We need a synthesis to translate this literature into cohesive strategies for medical educators using RW in a variety of contexts. These 12 tips offer guidelines for the principles and practices of using RW in medical education. This synthesis aims to support more strategic and meaningful integration of RW in medical education. [ABSTRACT FROM AUTHOR]

Oncology clinicians often miss opportunities to communicate empathy to patients. The current study examined the relationship between implicit bias (based on cancer type and ethnicity) and medical students' empathic communication in encounters with standardized patients who presented as Hispanic (lung or colorectal) individuals diagnosed with cancer. Participants (101 medical students) completed the Implicit Association Test (IAT) to measure implicit bias based on cancer type (lung v. colorectal) and ethnicity (Hispanic v. non-Hispanic White). Empathic opportunities and responses (assessed by the Empathic Communication Coding System; ECCS) were evaluated in a mock consultation (Objective Structured Clinical Examination; OSCE) focused on smoking cessation in the context of cancer. Among the 241 empathic opportunities identified across the 101 encounters (M = 2.4), 158 (65.6%) received high empathy responses from the medical students. High empathy responses were most frequently used during challenge (73.2%) and emotion (77.3%) opportunities compared to progress (45.9%) opportunities. Higher levels of implicit bias against Hispanics predicted lower odds of an empathic response from the medical student (OR = 3.24, p =.04, 95% CI = 0.09–0.95). Further work is needed to understand the relationship between implicit bias and empathic communication and inform the development of interventions. [ABSTRACT FROM AUTHOR]

Background: The transformational potential of electronic medical records (EMRs) in global healthcare is evident, but their adoption in low- and middle-income countries, including Nigeria, remains low. Objective: This study aimed to understand the perceptions of southwestern Nigerian medical students toward EMRs given the limited literature on this topic. Methods: A descriptive, cross-sectional online survey was conducted among 412 medical students from four institutions in southwestern Nigeria. Data on the students' demographics, exposure to, and perspectives on EMR was collected. Data was analyzed using R Version 3.6.1. Results: Majority (79%) of respondents were in their clinical years. We found that 68.4% of the respondents had good perception (scores ≥ 16) about EMRs while 31.6% were deemed as having fair level of perception (scores < 16). Interestingly, 54.9% had never used an electronic medical record (EMR). Although 46.4% felt very comfortable with EMRs' postgraduation use, 16% felt very uncomfortable. Notably, 94.5% believed that health technology solutions could enhance Nigerian health outcomes. Furthermore, 81.8% felt that their medical education would benefit from greater EMR exposure, while 80.9% believed that EMRs are essential for adequate patient care. Males exhibited significantly more EMR experience and more positive attitudes toward EMRs. However, there was no significant association between the level of study, location of medical school, and respondents' experience or perceptions of EMRs. Conclusion: More than half of students surveyed reported that they have never used EMRs. Despite this, many students felt comfortable with the idea of using EMRs in their future practice. Observed gender differences in EMR use and attitudes highlight the need for targeted strategies to prepare all students, regardless of gender, for the digital transition in healthcare. [ABSTRACT FROM AUTHOR]

Food safety is a public health concern worldwide due to an increased morbidity and mortality risk associated with the outbreak of food-borne diseases. This study aimed to assess knowledge, attitude, and food safety practices (KAP) among university students in northern Tanzania. This is interesting because it allows data to be collected for creating awareness on safety, sanitation, and quality of food available within and outside the university environments.We conducted a cross-sectional study among 407 university students in Kilimanjaro region and all authors participated equally. Participants completed an online, self-administered questionnaire. Data was analyzed using SPSS version 25 and summarized using descriptive statistics. The Chi-squared test compared the proportion of KAP by participant characteristics and the multiple logistic regression model used to determine the associated factors. Participants had a mean age (standard deviation) of 23.2 (2.6) years, 51.4% were males, and 83% were < 25 years. The overall proportion of good knowledge, attitude, and food safety practices were 82.6, 78.4, and 31.9%, respectively. Higher odds of knowledge and attitude on food safety were students from KCMUCo (OR = 2.36; 95% CI 1.33–4.17) and (OR = 4.80; 95% CI 2.67–8.63). Also higher odds of food safety practice were students with good knowledge (OR = 1.80; 95% CI 1.03–3.13).Good food safety knowledge but not attitudes was associated with good food safety practices. This shows the need to introduce practical food safety within college environments to help students improve food hygiene and safety practices. [ABSTRACT FROM AUTHOR]

Background: Experiential learning holds high potential for medical students' education in palliative care. At RWTH Aachen University in Germany, medical students can participate in the course "The Patient as Teacher" offering a one-to-one exchange with a terminally ill patient over a period of several weeks complemented with four supervision sessions and writing of a reflective essay. The course had run from 2005 to 2020 before it was paused due to the Covid-19 pandemic. This study aimed to assess the course's value as a palliative care teaching tool by investigating students' motivation and experiences over the years 2005–2020. Methods: A stratified sample of 24 essays was taken from all submitted essays (n = 78), eight essays from the years 2005–2009, 2010–2014, and 2015–2020. Subsequently, a thematic analysis of the selected essays was conducted. Results: The students felt motivated by the opportunity to gain more experience in palliative care, to improve their communication skills and to decrease insecurities in interaction with terminally ill patients. They learned about the patient's biography and medical history, and encountered physical, psychological, social, and spiritual dimensions of living with a life-limiting disease. Moreover, they experienced relationship building and communication with a terminally ill patient outside their role as future doctors. Ultimately, they considered their participation as a beneficial experience on both a personal and professional level. Conclusions: The course "The Patient as Teacher" presents a valuable tool for experiential learning in palliative care, which has elicited an unceasingly positive response among the students who participated over the years. It has facilitated medical students in overcoming insecurities in dealing with terminally ill patients and supported them in further developing their professional identity. [ABSTRACT FROM AUTHOR]

Copyright of ESTUDAM Public Health Journal is the property of ESTUDAM Public Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ESTUDAM Public Health Journal is the property of ESTUDAM Public Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: International students account for a significant proportion of medical graduates Australia‐wide, and most opting to remain in Australia for their first year of practice (Internship). Hence, understanding this particular demographic's perspectives is crucial for curriculum and workforce planning. Despite this, very few studies have addressed this demographic, and none have explored the impact of the COVID‐19 pandemic on international medical students specifically. Aim: A qualitative design was used to explore the perspectives of final‐year international medical students at an Australian medical school as they prepared for transition to internship during the COVID‐19 pandemic. Methods: Participants engaged in a semi‐structured interview about the pandemic's personal and professional implications. The data were analysed using inductive thematic analysis. Results: Seven out of 34 final‐year international medical students at the University of Adelaide participated. The main themes identified were that isolation was magnified, institutional support was lacking and that uncertainty was challenging. The pandemic did not deter participants from pursuing an Australian internship, as Australia was considered a desirable place for internship compared to their home countries. Conclusions: While the COVID‐19 pandemic exacerbated the situation, many of the challenges identified by international students already existed. Issues such as social isolation, racial discrimination, financial hardship and lack of institutional support have been prevalent for decades. Insights from this study reveal a need to improve the medical school experience. Australian Universities have a responsibility to ensure fair treatment of international students by training faculty, implementing support programmes and ensuring an inclusive and culturally safe learning environment. [ABSTRACT FROM AUTHOR]

Test anxiety (TA) is a common emotion among students during examinations. Test‐induced stress can remarkably impact students' emotions and limit their performance. Mental stress is a crucial factor that could significantly alter gut microbial composition, but rare reports focus on the correlation between TA and oral microbial composition. This study aims to investigate the impact of TA on students' oral microbiota composition. This study targeted medical students who usually face heavier workloads than average undergraduates. 28 females and 19 males aged 18–30 were enrolled in this study. Questionnaires and saliva samples were collected from the participants before, during, and after the end‐term examination. The level of anxiety was classified as normal, mild, moderate, and severe based on the questionnaire scores. In addition, 16S amplicon sequencing was used to analyse the composition of oral microbes. More than half of the students faced different levels of TA before and after the examination. Over three‐quarters of students showed anxiety during the examination, and a quarter suffered severe TA. The 16S sequencing data showed that TA significantly altered the oral microbial composition between students with and without TA in all three survey periods. Moreover, during the examination, the genera Rothia and Streptococcus, the oral‐beneficial bacteria, markedly decreased in students with TA. On the other hand, the potential pathogenic genera, such as Prevotella, Fusobacterium, and Haemophilus, significantly increased in the students with TA. And the TA effect on oral microbes displayed a gender difference among students. A high ratio of TA existed in the students during their examination period, and TA could significantly alter the oral microbial composition, decrease beneficial microbes, and promote potential pathogenic oral microbes. [ABSTRACT FROM AUTHOR]

Childhood hypertension (HTN) is becoming one of the most important health concerns in children, and it is the most important predictor of adult HTN. The objective was to assess the level of knowledge and to develop and validate questionnaires about childhood HTN among final-year medical students. This facility-based cross-sectional study was conducted from January 2018 to September 2018 in 5 teaching hospitals of Central India. A total of 383 interviews were conducted by non-probability purposive sampling using a validated tool. Exploratory factor analysis was used to assess the validity of the questionnaire, and internal consistency of items was assessed with Cronbach α. A total of 26 items were finalized through consensus. The Kaiser–Meyer–Olkin (KMO) measure of sample adequacy was measures of sampling adequacy (MSA) = 0.83, and Bartlett's test of sphericity was (x2 = 15.89, P =.014). This study shows that the tool developed had acceptable validity and reliability to assess the knowledge about childhood HTN among undergraduate medical students. [ABSTRACT FROM AUTHOR]

In the Brazilian Amazon, snakebite envenomations (SBEs) disproportionately affect Indigenous populations, and have a significantly higher incidence and lethality than in non‐Indigenous populations. This qualitative study describes the Indigenous and biomedical healthcare domains for SBE care from the perspective of the Indigenous medical and nursing students in Manaus, Western Brazilian Amazon. In‐depth interviews were conducted with five Indigenous students from the Amazonas State University, between January and December 2021. The interviews were analyzed using inductive content analysis. We organized an explanatory model with five themes: (1) participants' identities; (2) causality levels in Indigenous and biomedical systems; (3) therapeutic itineraries in Indigenous and biomedical systems; (4) ideological implications of adding biomedical devices to Indigenous healing systems; and (5) therapeutic failure in and efficacy of Indigenous and biomedical systems. From a noncolonial perspective and seeking to increase the quality and acceptability of health care for the Indigenous populations of the Brazilian Amazon, the training of Indigenous health professionals presents itself as a promising strategy. For this goal, universities should serve as empowering settings for Indigenous health students that support them in their growth and development, raise their awareness of injustice, and catalyze change toward a culturally adapted and effective service for the users. [ABSTRACT FROM AUTHOR]

Background: The increase in high-risk behaviors (HRBs) is recognized as a serious threat to the health of societies. Selfexpression is one of the social skills that can have a positive effect on controlling some risky behaviors. Objectives: This study aimed to investigate the correlation between self-expression and HRBs among newly arrived students at Isfahan University of Medical Sciences. Methods: In this cross-sectional study, 402 students (166 males and 236 females) were recruited from Isfahan University of Medical Sciences in 2020. They were selected using a multi-stage random sample and answered questions from the selfexpression questionnaire and the high-risk behavior questionnaire. Various statistical indicators were utilized, such as mean, standard deviation (SD), t-test for comparison between the two gender groups, ANOVA for the mean difference between three age groups, and a Pearson correlation matrix to examine the correlations between all components of HRBs. Additionally, the Pearson test and regression analysis were employed. Results: A significant negative correlation was found between the self-expression score and HRBs (r = -0.56, P < 0.001). The mean score of HRBs was 15.33 ± 18.047. The mean score of self-expressions in male students was significantly lower than that of female students (74.51 ± 16.33 vs. 80.36 ± 14.30). The most common HRBs were related to smoking, hookah use (mean = 7.53 ± 8.75), and suicidal ideation (mean = 3.11 ± 3.93). Conclusions: It accentuates the significance of incorporating self-expression interventions in educational and health programs to foster healthier behaviors and promote mental health among this vulnerable population. Further research is warranted to explore additional factors influencing the link between self-expression and HRBs among university students. [ABSTRACT FROM AUTHOR]

Objectives: The aim is to assess the level of stigmatization and knowledge of dementia among university students of medical, rehabilitation and social faculties in Poland. Possible correlates of these concepts and group differences are also investigated. Methods: We applied quantitative methods using an online questionnaire comprising sociodemographics, the Alzheimer's Disease Knowledge Scale, a vignette of a person with dementia and the modified Family Stigma in Alzheimer's Disease Scale. Results: Students had low levels of dementia knowledge and moderate levels of stigma. Medical science students had significantly better knowledge than the other groups but did not differ in their level of stigma. Relationships between the main variables were complex. Emotional and cognitive stigmatizing attributions were negatively correlated with knowledge about communication and behaviors of people with dementia. Better knowledge on causes and characteristics, as well as on risks and health promotion of the disease also triggered fewer negative attributions toward people with dementia. Conclusions: If health-related programs are to be effective, they should provide opportunities for the acquisition of relevant knowledge and skills that also address the stigmatization of people living with dementia. Well-established biomedical knowledge on dementia must be supplemented with a person-centered approach and proper communication skills. [ABSTRACT FROM AUTHOR]

Background: Medical students are potential role models for the community in tobacco control. Therefore, we aimed to determine the prevalence and dynamics of tobacco smoking among their grades. Methods: A questionnaire prepared in cooperation with the "World Health Organization" was completed online by 697 medical students in 2020 as a randomized cross-sectional study covering all medical school grades. Results: The prevalence of smoking among pre-grade 1 students was 3.3%, while it was 23% in grade-6. The highest prevalence was 31% in grade-2. Of the 135 current smokers, 43% smoked their first cigarette in medical school. "Having smoker best friends" was the most critical factor in starting smoking. Of current smokers, 59.3% want to quit. Only 20.7% of students who tried to quit smoking received professional help. Students took only a 1-hour lecture on tobacco control in the first two years. Conclusion: While there was almost no smoking in pre-grade 1, the high prevalence seen in grade-2 indicates that psychosocial support mechanisms and tobacco control lectures should be developed to prevent students. University administrations should implement adequate programs and increase awareness that will lead to a reduction in diseases in the student population and thus in the general population. [ABSTRACT FROM AUTHOR]

Background: A shortage of images of pathology on diverse skin tones has been recognized for decades in health professions education. Identifying skin manifestations of disease depends on pattern recognition, which is difficult without visual examples. Lack of familiarity with visual diagnosis on skin of color can lead to delayed or missed diagnoses with increased morbidity and mortality. As the United States continues to increase in ethnic and racial diversity, addressing the disparity in health outcomes with education is vital. Case Presentation: At the Hackensack Meridian School of Medicine, students, librarians, and faculty came together to address this problem and develop a database of dermatological conditions in people with darker skin tones. A student group initiated a series of meetings with faculty to determine the best approach to address and enhance the representation of diversity in disease images within the curriculum. With the guidance of faculty and librarians, students performed a literature search and created a database of images of skin pathologies in people with darker skin tones. The database was disseminated to course directors and lecturers, and the noted disparities were corrected for the next cohort of students. The database provides an easily accessible resource for creating lecture slides. Conclusion: This project brought awareness of the need for inclusivity and generated a broad review of the curriculum to be more representative of all patient populations. Most importantly, our experience provides a roadmap for institutional change through student, librarian and faculty collaboration and cultivation of a culture of optimism and acceptance. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic pain is the type of pain that healthcare professionals frequently encounter. Health care students' attitudes towards pain management are not sufficient and this negatively affects their chronic pain management. When students cannot manage the chronic pain they will experience professional burnout, depersonalization, and a decrease in compassion and empathy in patient care. Therefore, the first step in improving health care students' attitudes towards patients with chronic pain is to determine their attitudes. OBJECTIVE: This study aims to test the validity and reliability of the Scale for Healthcare Professionals' Attitudes towards Patients with Chronic Pain (HCPAPCP Scale) in healthcare students. METHOD: This quantitative study was conducted with 205 health care students in January-February 2022. Data were collected online with Personal Information Form and the HCPAPCP Scale. To determine the reliability of the scale, internal consistency and test-retest, and for construct validity, exploratory factor analysis and confirmatory factor analysis were performed. RESULTS: The results of the exploratory factor analysis showed that the two-factor scale consisting of 18 items, the factor structure, and the distribution of factors in items were the same as the findings of the original scale. The Cronbach's Alpha coefficient was 0.88 for the first factor and 0.74 for the second factor. Test-retest reliability was 0.60. In confirmatory factor analysis, the model had a good and acceptable fit. CONCLUSION: We found that the HCPAPCP Scale was valid and reliable in healthcare students. [ABSTRACT FROM AUTHOR]

We aimed to explore attitudes and training experiences of medical students toward gender medicine (GM). A cross-sectional study with convenience sampling was conducted (sample size = 430). To assess predictors of high GM consideration in patient management, a multivariable logistic regression was performed. A total of 82% considered sex and gender important; 61% stated that they would use GM skills in their careers. A total of 76% had never discussed GM with their tutors, with differences between male and female students (p =.002). Predictors of high GM consideration were: age (adjOR = 1.4, 95%CI = 1.1–1.8) and the impression that tutors considered patients' sex and gender during practice (adjOR = 3.9, 95%CI = 2.0–7.6). Thus, participants considered GM important, but some students were unsure whether it could be useful in practice. The strongest predictor of high GM consideration was the tutors' good example during training. It would be advisable to implement the teaching of this topic during both courses and traineeships. [ABSTRACT FROM AUTHOR]

Aim: To explore the core competencies needed on part of the medical and dental teachers to carry out effective digital teaching for their students. Methods: It was a qualitative study which employed phenomenological approach. The data were collected from 12 teachers who were purposively selected for semi-structured interviews. They were all expert digital teachers. The data were transcribed verbatim, coded and analyzed thematically. Textural and structural description of the themes helped to develop a new competency framework. Results: The data yielded 47 selective codes with 15 sub-themes and five themes. The emergent themes included general digital competencies, specific digital teaching competencies, mastery of the subject matter, mastery of pedagogical strategies and proficiency in using innovative digital technologies for teaching. The themes 1, 2 and 5 relate to digital competencies only whereas the themes 3 and 4 are generic competencies which apply to both digital and non-digital teaching. These generic competencies form the basis of all kinds of teaching, hence equally important for digital teaching. Conclusion: Medical teachers should possess diverse digital competencies. The competency framework that emerged in the current research encompasses the essential attributes that should be included in any future training program aiming at the digital capacity building of the teachers. This will keep them primed for effective digital teaching. Given its crucial importance, the digital teaching competency should be considered as a cross-cutting competency that applies to almost all of the famous eight roles of medical teacher. [ABSTRACT FROM AUTHOR]

Purpose: Undergraduate medical education (UGME) has to prepare students to do safety-critical work (notably, to prescribe) immediately after qualifying. Despite hospitals depending on them, medical graduates consistently report feeling unprepared to prescribe and they sometimes harm patients. Research clarifying how to prepare students better could improve healthcare safety. Our aim was to explore how students experienced preparing for one of their commonest prescribing tasks: intravenous fluid therapy (IVFT). Methods: Complexity assumptions guided the research, which used a qualitative methodology oriented towards hermeneutic phenomenology. The study design was an uncontrolled and unplanned complex intervention: judicial review of the iatrogenic death of five children due to hyponatraemia in our region had resulted in the recommendation that students' education in 'the implementation of important clinical guidelines' relevant to fluid and electrolyte balance should be intensified. An opportunity sample of 40 final-year medical students drew and gave audio-recorded commentaries on rich pictures. We completed two template analyses: one of participants' transcribed commentaries on the pictures and one using a novel heuristic to analyse the pictures themselves. We then reconciled the two analyses into a single template. Results: There were four themes: affects, teaching and learning, contradictions, and the curriculum as a journey. To explore interconnections between themes, we chose the picture best exemplifying each of the four themes and interpreted the curriculum journey depicted in each of them. These interpretations were grounded in each participant's picture, verbal account of the picture, and the aggregate findings of the template analysis. Participants' experiences were influenced by the situated complexity of IVFT. Layered on top of that, contradictions, overlaps, and gaps within the curriculum introduced extraneous complexity. Confusion and apprehension resulted. Conclusions: After spending five years preparing to prescribe IVFT, participants felt unprepared to do so. We conclude that intensive teaching had not achieved its avowed goal of improving students' preparedness for safe practice. Merton's seminal work on the 'unanticipated consequences of purposive social action' suggests that intensive teaching may even have contributed to their unpreparedness. [ABSTRACT FROM AUTHOR]

Rationale and Aim: Testing of new drugs through clinical trials is essential in efforts to increase generalizable knowledge. Little is known about the medical students' perception of their participation as research subjects in clinical trials. The aim of this study was to examine the willingness and attitudes of medical students towards participation as volunteer subjects in clinical trials. Methods: A cross‐sectional study was conducted among 297 medical students in years 4, 5 and 6 at the University of Belgrade, from October to December 2023. Participants completed a pen‐and‐paper questionnaire including demographic characteristics, opinions on their participation in clinical trials, and attitudes towards clinical trials in general. The validity of the attitude scale was verified. Results: One in five medical students expressed a positive opinion about their participation in clinical trials, with the majority (about one‐half) remaining undecided. General attitudes of students about research and their participation were positive. Students with prior blood donation experience were more willing to participate. Lower socioeconomic status and volunteering experience were also associated with stronger positive attitudes towards clinical trials in general. Conclusion: Most students were undecided about their participation, but their attitudes towards clinical trials in general were positive. Positive attitudes towards clinical trials did not uniformly translate to the willingness for personal participation. Promotion of blood donation and volunteering at universities could help to increase the interest in clinical trials as volunteer subjects. [ABSTRACT FROM AUTHOR]

Background: Students' attitudes towards digital technologies affect their use of innovations in digital education. In the study, it was aimed to determine undergraduate health sciences students' views about the Metaverse and digital technology. Methods: This study was a cross-sectional descriptive study. In the study sample, 289 health sciences students who voluntarily agreed to participate in the research and filled out the online data collection form were included. The Independent Samples T-Test, Multivariate ANOVA analysis of variance (MANOVA) and Pearson correlation analysis were used. P-values less than 0.05 were considered statistically significant. Results: The mean score the participants obtained from the Metaverse Scale was 53.54 ± 9.00, indicating that their levels of knowledge and awareness about the Metaverse were high. The mean score they obtained from the Attitude Scale for Digital Technology was 135.98 ± 21.28, which indicated that displayed positive attitudes towards digital technology. There was no significant difference between the mean scores the participants obtained from the Attitude Scale for Digital Technology and the Metaverse Scale according to their departments and years in school. There was a positive and weak relationship between the Metaverse Scale scores and Attitude Scale for Digital Technology scores. Conclusions: The participants' knowledge and awareness levels about the Metaverse were high and they displayed positive attitudes towards digital technology. It is recommended that digital technologies should be used in planning undergraduate education and Metaverse platforms or applications in virtual classroom settings. [ABSTRACT FROM AUTHOR]

Objective: To identify generalism-related competencies that medical students in Japan should acquire in order to provide comprehensive care for patients. Methods: The team responsible for developing the new 'Generalism' section of the 2022 revision of the Model Core Curriculum for Medical Education in Japan (MCC) consisted of nine members from diverse medical backgrounds across Japan. We adopted pragmatism paradigm and analyzed to identify decision-making processes using a qualitative document analysis. Results: The competency list was presented as a four-tier structure. The first tier of generalism was defined as 'take a multi-systemic view of the patient's problems and consider the patient's psychosocial background in order to provide comprehensive, flexible medical care that responds to the needs of the patient and is not limited to one's own specialty, supporting the achievement of individual and societal well-being.' The second tier was framed in terms of 'perspectives' and constructed of four different domains: 'holistic,' 'community,' 'life,' and 'social.' Conclusion: We identified and defined the competencies required by medical students in Japan to provide comprehensive care for patients. By including these competencies in the MCC, undergraduate medical education will be better placed to respond to anticipated changes in the demand for medical care in Japan. Success factors in our guideline development process include facilitating a collaborative and iterative development process, ensuring that diverse perspectives are integrated, and using practical examples and feedback to refine competencies based on a pragmatic approach. [ABSTRACT FROM AUTHOR]

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Background: Social connections between medical students provide a key basis for learning and support. These connections, and associated social identity, may be patterned by ethnicity, and students often perform similarly academically to those they connect with. The mechanisms that underpin the formation of these connections and the role that they play are not fully understood. This study explored how medical students connect with each other, and the potential impact of this on their academic attainment and well‐being, with a focus on students with minoritised ethnic identities. Methods: A mixed methods study combining (1) a survey to establish the number and strength of connections formed by Years 1 and 2 medical students with both minoritised and non‐minoritised ethnicities and (2) semi‐structured interviews to understand how connections were formed, whether this was shaped by ethnicity and the role of connections in supporting students with their learning and well‐being. Results: One hundred fifty‐one students (15.5% response rate) completed the survey. Students connected regularly with three to four peers with the goal of supporting learning and 71.9% of students reported a sense of social identification with this group. There was no statistical difference between ethnically minoritised and White students on either of these measures (t = 0.1, p = 0.92, χ2 = 2.9, p = 0.56). Interviews with 19 students found that social connections were shaped by perceptions of their self‐identity and the need to find 'equilibrium' by forming relationships with compatible others. The education environment, including its ethnic diversity, impacted on the opportunities to make connections. Students who were ethnically minoritised reported encountering challenges, especially in the clinical environment, and described the burden of these for them. Discussion: Curriculum designers should consider the time and space that is afforded to student interaction during course development, as finding compatible others with whom students can socially connect is important to balancing well‐being with academic performance. Bull et al. analyze students' experiences to show that they seek individuals with whom they feel compatible to maintain 'equilibrium' and support both academic performance and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Medical students of colour face numerous challenges during their undergraduate training period, reflecting the harmful norms and cultures in the learning context of medical school. Despite negative experiences for students of colour in medicine, there are episodes of support and encouragement that come from faculty or staff. This asset‐based qualitative study uses Rendón's Validation Theory to illuminate specific ways faculty at a community‐based medical college support medical students of colour, thereby challenging structural injustices in medical school. Methods: This study is grounded in a humanising and asset‐based perspective, where participants are viewed as legitimate knowers from whom researchers can learn. Twenty‐four medical students of colour and 14 faculty identified by students as supportive participated in five focus groups where participants shared how they felt validated and supported during their undergraduate medical school experiences. Inductive open‐coding followed by deductive thematic coding using Validation Theory—a theory that describes how external validation is a necessary component of fostering students' personal and academic drive—and literature about the context of medical school informed the three findings. Findings: Three major themes provide examples of ways faculty validated students. First, participants indicated the importance of acknowledging identities and experiences to understand the socio, historical and cultural context of learning. Second, participants implored the value of giving praise and offering encouragement to work against professional expectations. Finally, participants shared the intimacy of fostering personal relationships to reduce hierarchies. Conclusion: This study offers concrete guidance on teaching practices faculty can use to support students of colour. As medical schools may seek to move toward a more student‐centred approach, promoting feelings of validation for students of colour can be a key practice in teaching and learning to ensure support for medical students throughout their medical school journey. Validation Theory helps Blalock et al. shine light on how to better support medical students of color in undergraduate medical education. [ABSTRACT FROM AUTHOR]

Background: Organ donation is a critical component in the field of transplantation medicine, offering lifesaving opportunities for patients with end-stage organ failure. This study investigated the knowledge, attitude, and practice (KAP) survey regarding organ donation among medical students in Jordan. Methods: A cross-sectional survey was conducted among medical students across six Jordanian universities. Using a convenience sampling method, participants were invited via email, social media, and professional networks to complete a structured online questionnaire. The survey captured data on demographics, knowledge about organ donation processes, attitudes toward organ donation, and self-reported practices. Statistical analyses explored associations between students' KAP and their demographic characteristics. Results: A total of 539 medical students participated in the study. Findings revealed moderate knowledge and generally positive attitudes toward organ donation, with significant variability influenced by demographic factors. Students from various universities demonstrated different levels of knowledge and attitudes. Notably, religious and cultural beliefs significantly affected students' attitudes toward organ donation. Conclusions: The study highlighted a gap between the positive attitudes and the actual commitment to organ donation among the participants, revealing a need for targeted educational interventions to address misconceptions and enhance the willingness to donate organs. Promoting organ donation education within medical schools could foster a more supportive environment for organ donation, ultimately contributing to increased donor rates and improved transplantation outcomes in Jordan. [ABSTRACT FROM AUTHOR]

The current research evaluates the Perfectionism Social Disconnection Model (PSDM) by considering the links between measures of trait perfectionism and perfectionistic self-presentation and measures of social support, loneliness, and distress in cross-sectional research. A particular focus is on perfectionism and levels of social support as assessed by the Social Provisions Scale. The current study also uniquely evaluates levels of perfectionism and perfectionistic self-presentation in undergraduate students, medical students, and law students. The results across samples provided evidence that loneliness mediates the link between interpersonal perfectionism and distress in keeping with the predictions of the PSDM. Correlational results found robust links between loneliness and low levels of social support. Moreover, socially prescribed perfectionism and perfectionistic self-presentation were associated negatively with social support, and this was especially evident in terms of the facet tapping the nondisclosure of imperfections. Group comparisons of perfectionism yielded few significant differences in accordance with expectations. Levels of perfectionism tended to be lower among medical students. However, the links between perfectionism and distress were clearly evident among undergraduates, medical students, and law students, thus attesting to the vulnerability of perfectionistic students in general. Overall, the results further confirm the relevance of perfectionism in distress among students and applicability of the PSDM in various types of students. [ABSTRACT FROM AUTHOR]

Background: There is limited literature to date regarding medical students' expectations of the psychiatric inpatient environment. This study aims to explore what medical students expect from psychiatric wards and psychiatric intensive care units prior to their placement. Psychiatric intensive care, arguably the most intense experience students will have in psychiatry, was used to highlight the full extent of student preconceptions. Methodology: Students were invited to complete a semi-structured questionnaire over a six-month period, from July to December 2021. Questions explored emotions prior to placement, expectations of the ward atmosphere, layout, patient behaviour and care strategies. 37 responses were received. Analysis followed the well-recognised six stages of thematic analysis. Results: Five themes emerged from the data: (1) Mixed feelings about placement; (2) Varied views about patient behaviour and illness; (3) Restrictive and controlled practice; (4) Similarities to acute general hospital care; (5) Care with empathy and compassion. Some of the expectations of students were markedly different to the reality of psychiatric inpatient and intensive care settings, with ideas of patients being physically restrained, unconscious and attached to ventilators. Conclusion: This study offers a unique insight into what medical students expect from psychiatry inpatient and intensive care settings, an issue that all clinicians who have student contact should be aware of. Results can better inform student preparation and placement supervision, leading to more meaningful learning and improved wellbeing. [ABSTRACT FROM AUTHOR]

Background and Objectives: Quality of life reflects the health of individuals, physically and mentally. Health literacy is one of the factors that can be related to quality of life. Therefore, this study aimed to determine the relationship between quality of life and health literacy among students of Birjand University of Medical Sciences, Iran. Materials and Methods: This descriptive-analytical study was conducted on 357 university students in 2020-2021. Data were collected using the standardized Health Literacy for Iranian Adults (HELIA) and the SF-36 scale. Data analysis was conducted using SPSS version 22. Descriptive statistics and the Pearson correlation coefficient were used for data analysis. Results: The mean score of total QOL in university students was 70.88 ±15.73; among the eight dimensions of SF-36, the highest and the lowest scores were seen in physical functioning with 87.24 ±16.42, and role limitations due to emotional problems with 57.23 ±40.55. There was a positive significant relationship between the total mean score of HELIA and the general health dimension of SF-36. There was a positive significant relationship between reading, understanding, and appraisal dimension of HELIA with a mean score of general health dimension of SF-36. There was a positive significant relationship between understanding, and appraisal dimension of HELIA with mean score of mental health dimension of SF-36. There was a positive significant relationship between the understanding dimension of HELIA with mean score of physical health component score, and total mean score of SF-36. Also, there was a positive significant relationship between appraisal dimension of HELIA and mean score of physical health component score, mental health component score, vitality and total mean score of SF-36. Conclusion: The study shows an association between health literacy and quality of life in medical university students. However, this association is not strong. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the perceptions and attitudes of Canadian undergraduate students in health-related fields of study regarding the sexuality of disabled people. More specifically, we examine what is being taught to undergraduate students regarding the sexuality of disabled people, the sources of information that students rely upon to learn about this topic, and the current attitudes that these students hold. A modified version of the Attitudes to Sexuality Questionnaire was completed by 156 healthcare students from 30 different Canadian post-secondary institutions. Data analysis revealed that participants generally held non-restrictive views about parenting, sexual rights, non-reproductive sexual behavior, and sexual self-control of people with disabilities; however, over half of the participants noted that their post-secondary curriculum did not provide them with enough information regarding disability and sexuality. The results of this study speak to the need for more information about the sexuality of disabled people in healthcare education curricula. [ABSTRACT FROM AUTHOR]

We examined the degree that optimism and hope predicted coping and perceived competence in counselling psychology practicum students. Masters students from a Northern California university (N = 74) completed surveys at four points during practicum year: (T1) baseline, (T2) one month, (T3) mid-year, and (T4) final month. Measures assessed dispositional optimism and hope, adaptive and maladaptive coping, and perceived clinical competence. Over time, self-reported competence increased. There was a T1 optimism X time Interaction predicting perceived competence, but no T1 hope X time interaction. This interaction continued to be significant when covarying adaptive and maladaptive coping and appeared driven by the fact that low-optimism trainees initially had worse perceived competence than high-optimism trainees. In the absence of previous counselling experience, there was a relationship between trainees' levels of optimism and their perceived clinical competence. Specifically, low-optimism students saw themselves as less competent at baseline than high-optimism students, but this perceived competence subsequently increased over time, with both groups seeing themselves as similarly competent by end of year. Past authors theorized that individuals with high levels of positive expectancies initially overestimate their abilities in novel situations. This may explain why high-optimism students rated their competence as relatively great at baseline. [ABSTRACT FROM AUTHOR]

The personal health behaviours, including physical activity, of healthcare professionals influence their counselling practices as they relate to non-communicable diseases (NCDs). However, despite the importance of producing healthy, physically active graduates, there are limited data on the physical fitness of future healthcare professionals. This cross-sectional observational study determined the prevalence of below-average fitness in the four components of fitness in first-year university medical students. 152 participants (46 male, 106 female, 20.16 ± 2.69 years) completed cardiorespiratory fitness tests (submaximal step test), flexibility (sit-and-reach test), muscle strength (handgrip), and muscle endurance tests (sit-ups, push-ups). Sex differences were reported using one-way ANOVA or Chi square test and significance was set at p < 0.05. The prevalence (%) of below-average fitness was 69.54% for cardiorespiratory, 25.66% for handgrip strength, 65.79% for sit-ups, 23.03% for push-ups and 7.24% for flexibility. Physical fitness parameters (mean±standard deviation (SD)) were compared between sexes, where it was found that females were more flexible than males (40.61 ± 8.40 cm vs 36.70 ± 9.31 cm, p = 0.012). Males had better handgrip strength (88.96 ± 12.04 kg vs 59.34 ± 10.36 kg, p < 0.001), muscle endurance sit-ups (33.46 ± 9.04 vs 24.48 ± 12.18, p < 0.001) and push-ups (30.28 ± 13.95 vs 24.27 ± 12.35, p = 0.009). First-year medical students have poor physical fitness, notably cardiorespiratory fitness and muscle strength, which are important markers for NCD risk assessment. Tertiary institutions training healthcare professionals should consider developing interventions to improve students' physical fitness thereby influencing their health, wellbeing, academic performance and future counselling practices. [ABSTRACT FROM AUTHOR]

Introduction: Effective medical education must balance clinical service demands for institutions and learning needs of trainees. The question of whether these are competing demands or can serve complementary roles has profound impacts on graduate medical education, ranging from funding decisions to the willingness of community-based hospitals and physicians to include learners at their clinical sites. Our objective in this article was to systematically review the evidence on the impact of medical trainees on productivity and efficiency in the emergency department (ED). Methods: We queried PubMed, Embase, Scopus, and Web of Science from earliest available dates to March 2023. We identified all studies evaluating the impact of medical students and/or residents in the ED on commonly used productivity and efficiency metrics. Only studies in EDs in the United States were included. No additional filters were used. We assessed the risk of bias of included studies using the Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool. Certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Study findings were combined in a narrative synthesis and reported according to PRISMA guidelines. Results: The literature search yielded 3,390 unique articles for abstract screening. Eighty-one abstracts were identified as relevant to our PICO question (population, intervention, control, and outcomes), 76 of which had retrievable full-text articles and the themes of which were discussed in a narrative synthesis. We selected 13 of the full-text articles for final inclusion in a systematic review. Studies were roughly split between observational (6) and quasi-experimental (7) designs. The majority of studies (11) were singlesite studies. Only two studies could be graded as low risk of bias per the ROBINS-I tool. Conclusion: Low-GRADE evidence suggests that students and residents decrease ED efficiency by a statistically small effect size of debatable clinical importance. Residents provide a moderate boost to ED productivity. Students do not produce a statistically or clinically significant impact on ED productivity. Residents increase emergency department relative value units revenue by $26.30 an hour, while students have no impact. Both types of learners decrease efficiency. [ABSTRACT FROM AUTHOR]

Purpose: During the third-year emergency medicine (EM) clerkship, medical students are immersed in traumatic incidents with their patients and clinical teams. Trauma-informed medical education (TIME) applies trauma-informed care (TIC) principles to help students manage trauma. We aimed to qualitatively describe the extent to which students perceived the six TIME domains as they navigated critical incidents during their EM clerkship. Methods: We employed a constructivist, modified grounded theory approach to explore medical students’ experiences. We used the critical incident technique to elicit narratives to better understand the six TIME domains as they naturally appear in the clerkship. Participants were asked to describe a traumatic incident they experienced during the clerkship, followed by the clerkship’s role in helping them manage the incident. Using the framework method, transcripts were analyzed 1) deductively by matching transcript excerpts to relevant TIME domains and 2) inductively by generating de novo themes to capture factors that affected students’ handling of trauma during critical incidents. Results: Twelve participants were enrolled and interviewed in July 2022. “Safety” was the most frequently described TIME domain, whereas “Gender, Cultural, and Historical issues” and “Peer Support” were discussed least. Inductive analysis revealed themes that hindered or supported their ability to manage traumatic experiences, which were grouped into three categories: 1) student interactions with the learning environment: complex social determinants of health, inequalities in care, and overt discrimination; 2) student interactions with patients: ethically ambiguous care, witnessing acute patient presentations, and reactivation of past trauma; and 3) student interactions with supervisors: power dynamics, invalidation of contributions, role-modeling, and student empowerment. Conclusion: The six TIME domains are represented in students’ perceptions of immediate, stressful critical incidents during their EM clerkship, with “Safety” being the most commonly described; however, the degree to which these domains are supported in students’ experiences of the EM clerkship differ, and instances of inadequately experienced domains may contribute to student distress. Understanding the EM clerkship through the specific lens of students’ experiences of trauma may be an effective strategy to guide curricular changes that promote a supportive learning environment for students in the emergency department. [ABSTRACT FROM AUTHOR]

Introduction: During a pandemic, in addition to a serious threat to the physical health of vulnerable people, the fear of disease and fear of death, along with everyday disturbances, causes healthy people to be involved with the anxiety and stress of the disease and suffer psychological disorders. In the meantime, healthcare workers and medical students are groups of people whose mental health status can be endangered by this virus. Therefore, the present study aimed to assess the relationship between perceived psychological stress and anxiety caused by COVID-19 in students and healthcare workers working at the Asadabad School of Medical Sciences. Materials & Methods: During a descriptive-analytical study, 113 students and 85 health workers working at Asadabad School of Medical Sciences in 2019 were examined using a stratified sampling method with proportional allocation. The data collection tool included demographic information, Alipur Corona Disease Anxiety Scale (2018), and the 14-item version of Cohen's Perceived Stress Scale (1983). After collecting the data, they were analyzed using SPSS software (version 26). Spearman's correlation test and MannWhitney's non-parametric test with an alpha significance level of less than 0.05 were used to check the relationships and compare the data. Results: The overall mean scores of perceived psychological pressure of workers (22.25±9.29) and students (23.90±9.35) were close to the mean level, and the overall mean of COVID-19-induced anxiety in both groups was at a moderate level (workers: 16.36±10.85 and students: 15.24±10.15). Moreover, there was a positive and significant statistical relationship between perceived psychological pressure and COVID-19-induced anxiety in both groups of workers (r=0.55; P0.00) and students (r=0.37: P=0.00). Nonetheless, the comparison of the level of perceived psychological pressure of medical workers and students did not demonstrate a statistically significant difference between the two groups (u=4108.5; P=0.08). This comparison was not significant for the level of COVID-19-induced anxiety caused in the two groups (u=4582.5; P=0.58). Conclusion: The results of the present study pointed out that both groups of medical workers and students experienced almost the same amount of psychological pressure and anxiety. Furthermore, with the increase in participants' level of COVID-19 anxiety, the perceived psychological pressure also increased and vice versa. Therefore, it is recommended that psychiatrists and psychologists be employed in COVID-19 centers, that free psychological counseling be provided to health-treatment workers and students with problems, and that workshops and retraining courses on resilience and problem-solving skills be held. [ABSTRACT FROM AUTHOR]

Background: A novel COVID-19 has spread worldwide and created a big threat for the public and their daily life. Due to its rapid transmission and the mortality rate, governments across the world had created many restrictions such as social isolation which leads to economic crisis that also leads to the source of fear, stress, anxiety, and mood conditions and negatively affects people's mental health (Praveen et al., 2021). Although the initiatives were prepared, the coronavirus may also cause mental defects. These defects also affected the medical students, since they were the backbone and the future of public health, hence the study would describe the quality of well-being by different domains. Materials and Methods: The study was designed by the questionnaire based on the World Health Organization Quality of life-BREL, Subjective Well-Being Inventory (SWBI), and Beck Anxiety Inventory (BAI) research tool. A total of 288 students were participated in the study. Results: A total of 288 medical students were participated in the study, according Cronbach Alpha method, all three domains had obtained a value of above 0.7, and the descriptive analysis showed the highest score of about 67.12 with physical activity. According to the BAI, 84% of medical students with low anxiety, the study also investigates the quality of well-being and compared with gender, with religion, with family type, place of living, religions, and among family's monthly income. The results of the study were statistically defined, and it has a significant relationship with environment and SWBI. Conclusion: The quality of well-being was assessed on medical students and the study revealed that there is no impact with gender, religion, year of study, and family's monthly income. Although the study also revealed that the mean score of social well-being is high with physical activity and considerably low with psychological and environmental activity. [ABSTRACT FROM AUTHOR]

Healthcare workers face significant mental health challenges, including stress, burnout, and psychological distress, leading to high rates of mental health symptoms and even suicide attempts, as well as an increase in medication errors and unprofessional behavior. Targeted interventions are needed to address these issues. However, promoting healthier traits in medical students or refining selection could also prove beneficial, as research shows that mental health is significantly influenced by personality traits and personal values. This study examines the relationship between personality traits, values, and attitudes toward professionalism among medical students in Slovenia. A total of 996 participants were examined in three data collections from the academic years 2015–2016 to 2019–2020 using the Big Five Questionnaire, the Personal Values Scale, and the Attitude Toward Professionalism Scale. Hierarchical linear regression analysis was conducted to examine the factors associated with professionalism. The results showed that attitudes toward professionalism were stable over the years, with higher scores consistently associated with the female gender, agreeableness, and conscientiousness. Conversely, material value orientation had a negative impact on professionalism. In addition, we examine the associations between mental health and personality traits, personal values, and attitudes toward professionalism to illustrate the importance of selecting and nurturing medical students, based on traits that promote mental health and professional behavior. These findings may lead to improvements in medical education and selection processes to improve the well-being and functioning of future medical professionals. [ABSTRACT FROM AUTHOR]

Introduction: Clinical reasoning skills are essential for decision-making. Current assessment methods are limited when testing clinical reasoning and management of uncertainty. This study evaluates the reliability, validity and acceptability of Practicum Script, an online simulation-based programme, for developing medical students' clinical reasoning skills using real-life cases. Methods: In 2020, we conducted an international, multicentre pilot study using 20 clinical cases with 2457 final-year medical students from 21 schools worldwide. Psychometric analysis was performed (n = 1502 students completing at least 80% of cases). Classical estimates of reliability for three test domains (hypothesis generation, hypothesis argumentation and knowledge application) were calculated using Cronbach's alpha and McDonald's omega coefficients. Validity evidence was obtained by confirmatory factor analysis (CFA) and measurement alignment (MA). Items from the knowledge application domain were analysed using cognitive diagnostic modelling (CDM). Acceptability was evaluated by an anonymous student survey. Results: Reliability estimates were high with narrow confidence intervals. CFA revealed acceptable goodness-of-fit indices for the proposed three-factor model. CDM analysis demonstrated good absolute test fit and high classification accuracy estimates. Student survey responses showed high levels of acceptability. Conclusion: Our findings suggest that Practicum Script is a useful resource for strengthening students' clinical reasoning skills and ability to manage uncertainty. [ABSTRACT FROM AUTHOR]

Purpose: To assess the Consultation And Relational Empathy (CARE) measure as a tool for examiners to assess medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), as the best tool for assessing empathy during OSCEs remains unknown. Methods: We first assessed the psychometric properties of the CARE measure, completed simultaneously by examiners and standardized patients (SP, either teachers - SPteacher - or civil society members - SPcivil society), for each student, at the end of an OSCE station. We then assessed the qualitative/quantitative agreement between examiners and SP. Results: We included 129 students, distributed in eight groups, four groups for each SP type. The CARE measure showed satisfactory psychometric properties in the context of the study but moderate, and even poor inter-rater reliability for some items. Considering paired observations, examiners scored lower than SPs (p < 0.001) regardless of the SP type. However, the difference in score was greater when the SP was a SPteacher rather than a SPcivil society (p < 0.01). Conclusion: Despite acceptable psychometric properties, inter-rater reliability of the CARE measure between examiners and SP was unsatisfactory. The choice of examiner as well as the type of SP seems critical to ensure a fair measure of empathy during OSCEs. [ABSTRACT FROM AUTHOR]

Background: Patient involvement in the interdisciplinary bedside round (IBR) increases care quality and safety but is influenced and perceived differently by different round participants. Nursing and medical students are still not structurally embedded in the healthcare system, and they participate in interdisciplinary bedside rounds for educational purposes. Thus, the students may give a valuable perspective on patient involvement from the 'outside view'. Aim: This study aimed to describe nursing and medical students' perceptions of patient involvement in IBRs. Methods: This study has a qualitative design with individual interviews. Eighteen informants were recruited with the help of gatekeepers from two sites in Sweden: a university training health clinic and a county hospital. They participated in one‐to‐one semi‐structured interviews, which were analysed with an inductive qualitative content analysis approach. Ethical Issues and Approval: The study has been approved by the Swedish Ethical Review Authority. Informed consent was received from all participants. Results: The results yielded five categories. Two sub‐themes and one theme of meaning emerged as a 'red thread' across the categories. The theme of meaning was: 'In hospital rounds, the patient is a respected guest, but with a disadvantaged "alien status" due to the hosts' difficult medical language and unclear routines'. Students perceive patients are not fully involved in IBRs, and the healthcare team controls this involvement due to patients' lack of knowledge and vulnerability, the hectic hospital environment, and complicated medical language. Doctors lead IBRs and encourage or discourage patient involvement and nurses act as patient advocates, supporting their involvement. Conclusions: According to nursing and medical students, patients are seldom involved in IBRs due to multiple interaction barriers and despite communicational facilitators. Their involvement depends on healthcare professionals. Further research should investigate other IBRs stakeholders' perspectives on patient involvement in IBRs to facilitate it. [ABSTRACT FROM AUTHOR]

Purpose: There is a shortage of generalist physicians globally impacting health equity and access to care. An important way in which medical schools can demonstrate social accountability is by graduating learners interested in careers in generalism. While generalism is endorsed as a matter of principle in medical education, how this translates into curricula is less clear. The aim of this study was to identify how generalism is understood and supported by family physician educational leaders in undergraduate medical education (UME) in Canada. Methods: We conducted a qualitative study, interviewing 38 family medicine leaders in UME across all 17 Canadian medical schools. We examined the data with template analysis, informed by the iceberg model of systems thinking. Results: Four themes were identified: (1) Teaching and learning strategies in support of generalism—a consistent range existed across UME curricula; (2) Curriculum patterns—changes in leadership and curriculum reform created positive or negative feedback loops that promoted or hindered initiatives to support generalism; (3) Curriculum structures—organ‐system‐based curricula and availability of generalist faculty presented particular challenges to teaching generalist approaches; (4) Mental models and ways of knowing—the preponderance of biomedical frameworks of thinking in curricula unconsciously undermined generalist approaches to patient care. Conclusions: UME programmes promoted generalism through a range of teaching activities and strategies, but these efforts were countered by curriculum structures and mental models that perpetuate epistemic inequity between biomedical approaches to medical education and generalist models of care. Novel curricular frameworks are needed to align undergraduate programmes' commitment to social accountability with community‐based need. To graduate sufficient generalists to meet community healthcare needs, Kelly et al. explore how the curriculum structures and mental models underlying undergraduate medical education need to change [ABSTRACT FROM AUTHOR]

Context: Much remains unanswered regarding how clinical reasoning is learned in the clinical environment. This study attempts to unravel how novice medical students learn to reason, by examining how they make sense of the clinical patient encounter. Method: The current study was part of a greater research project employing constructivist grounded theory (CGT) to develop a learning model of clinical reasoning. Introducing the sensemaking perspective, as a sensitising concept, we conducted a second level analytic phase with CGT, to further advance our previously developed model. This involved re‐examining collected data from semi‐structured interviews, participant observations and field interviews of novice students during their early clinical clerkships. Results: A learning model of how medical students make sense of the patient encounter emerged from the analysis. At its core lie three interdependent processes that co‐constitute the students' clinical sensemaking activity. Framing the situation is the process whereby students discern salient situational elements, place them into a meaningful relationship and integrate them into a clinical problem. Inquiring into the situation is the process whereby students gain further insight into the situation by determining which questions need to be asked. Lastly, taking meaningful action is the process whereby students carve out a pathway of action, appropriate for the circumstances. Tensions experienced during these processes impair clinical sensemaking. Conclusions: The study provides an empirically informed learning model of clinical reasoning, during the early curricular stages. The model attempts to capture the complexity of medical practice, as students learn to recognise and respond to what constitutes the essence of a clinical situation. In this way, it contributes to a conceptual shift in how we think and talk about clinical reasoning. It introduces the concept of clinical sensemaking, as the act of carving a tangible clinical problem out of an often undetermined clinical situation and pursuing justified action. The authors offer an empirically informed model of learning of clinical reasoning in the clinical environment by drawing on the concept of "sensemaking". [ABSTRACT FROM AUTHOR]

Background: Feedback is a crucial element in learning. While studies in the field of healthcare professions education have highlighted the process of educators feeding back to learners, relatively little investigation exists on learners feeding back to educators in Asian cultures. Studies show that recipients of effective feedback develop educational skills and reflective practice, but the process of giving feedback seems to have been mainly studied through surveys and questionnaires. Such research offers little to no insights on feedback providers' and recipients' experiences of feedback. To fill the gap, in the context of multi‐source feedback, we investigate medical students, residents, and nurses feedback giving to clinical educators (and their receiving of this) following a case presentation training course. We aim to understand the facilitators and inhibitors that encourage and/or prevent feedback provision alongside educators' uptake and reactions. Methods: We used semi‐structured group interviews. Participants comprised five different categories of participants: year‐4 medical students (n = 6); residents (n = 5); nurses (n = 4); junior clinical educators (n = 9); senior clinical educators (n = 3). We asked them about their experiences of providing feedback to educators and educators receiving of feedback on their teaching. Group interviews were conducted in the largest healthcare institution in Taiwan. Data were analysed using thematic Framework Analysis and managed in ATLAS.ti 8.0. Results: We identified two major themes with respective sub‐themes: (1) Factors affecting feedback giving (including desire for improvement, feedback content, process of feedback, feedback fears, feedback prevention and medical hierarchy); and (2) Educators' reactions to receiving feedback (including validity of feedback, face‐saving and emotional reactions to receiving feedback). Conclusions: Feedback provision to educators on their teaching, and educators' receiving of this feedback in an Asian culture brings forth issues around medical hierarchy, in‐person feedback and face‐saving, which have important implications for effective and optimal delivery of feedback. Curricular developers should consider the context of feedback (e.g. anonymously online), facilitating students as active participants for the development of educational quality, and educators' mindful practice when engaging with student feedback. This study from Taiwan reports on how medical hierarchy, in‐person feedback and face‐saving all have important implications for effective feedback delivery to clinical educators. [ABSTRACT FROM AUTHOR]