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Background Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants’ experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing. Methods In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned “exchange of information” and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation. Results Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach. Conclusions Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students., BACKGROUND: Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants' experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing.METHODS: In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned "exchange of information" and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation.RESULTS: Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach.CONCLUSIONS: Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students.CLINICAL TRIALS: Clinical.trials ID NCT04783259.

Background Recruiting and securing primary care physician workforce has been the center of international attention for decades. In Denmark, the number of general practitioners has decreased by 8.5% since 2013. However, a rising population age and increasing prevalence of chronic diseases and multimorbidity place an even greater future need for general practitioners in Denmark. The choice of general practice as specialty has been associated with a range of both intrinsic and extrinsic factors, however, few studies have examined the recruitment potential that lies within medical trainees’ who are undecided about general practice specialization. The aim of this study was, therefore, to explore how medical trainees who are undecided about general practice specialization (GP-positive/undecided) differ from medical trainees who are either committed (GP-committed) or not committed to a general practice career (GP-non-committed) regarding factors related to future work life. Methods The present study concerns baseline findings from a longitudinal survey study. An online questionnaire was e-mailed to a national cohort of medical trainees during their transition from under- to postgraduate education. The associations between orientations towards general practice specialization and work-related factors and potential influencing factors, respectively, were analyzed using uni- and multivariable modified Poisson regression models. Results Of 1,188 invited participants, 461 filled out key study variables concerning specialty preferences and rejections, corresponding to a response rate of 38.8%. We found significant positive associations between GP-positive/undecided orientation and valuing a good work/life balance and the opportunity to organize own working hours when compared to GP-non-committed respondents. Compared to the GP-committed orientations, the GP-positive/undecided orientation was associated with a positive attitude towards technology, wor, BACKGROUND: Recruiting and securing primary care physician workforce has been the center of international attention for decades. In Denmark, the number of general practitioners has decreased by 8.5% since 2013. However, a rising population age and increasing prevalence of chronic diseases and multimorbidity place an even greater future need for general practitioners in Denmark. The choice of general practice as specialty has been associated with a range of both intrinsic and extrinsic factors, however, few studies have examined the recruitment potential that lies within medical trainees' who are undecided about general practice specialization. The aim of this study was, therefore, to explore how medical trainees who are undecided about general practice specialization (GP-positive/undecided) differ from medical trainees who are either committed (GP-committed) or not committed to a general practice career (GP-non-committed) regarding factors related to future work life.METHODS: The present study concerns baseline findings from a longitudinal survey study. An online questionnaire was e-mailed to a national cohort of medical trainees during their transition from under- to postgraduate education. The associations between orientations towards general practice specialization and work-related factors and potential influencing factors, respectively, were analyzed using uni- and multivariable modified Poisson regression models.RESULTS: Of 1,188 invited participants, 461 filled out key study variables concerning specialty preferences and rejections, corresponding to a response rate of 38.8%. We found significant positive associations between GP-positive/undecided orientation and valuing a good work/life balance and the opportunity to organize own working hours when compared to GP-non-committed respondents. Compared to the GP-committed orientations, the GP-positive/undecided orientation was associated with a positive attitude towards technology, working shift h

Background Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants’ experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing. Methods In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned “exchange of information” and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation. Results Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach. Conclusions Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students., BACKGROUND: Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants' experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing.METHODS: In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned "exchange of information" and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation.RESULTS: Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach.CONCLUSIONS: Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students.CLINICAL TRIALS: Clinical.trials ID NCT04783259.

Background Recruiting and securing primary care physician workforce has been the center of international attention for decades. In Denmark, the number of general practitioners has decreased by 8.5% since 2013. However, a rising population age and increasing prevalence of chronic diseases and multimorbidity place an even greater future need for general practitioners in Denmark. The choice of general practice as specialty has been associated with a range of both intrinsic and extrinsic factors, however, few studies have examined the recruitment potential that lies within medical trainees’ who are undecided about general practice specialization. The aim of this study was, therefore, to explore how medical trainees who are undecided about general practice specialization (GP-positive/undecided) differ from medical trainees who are either committed (GP-committed) or not committed to a general practice career (GP-non-committed) regarding factors related to future work life. Methods The present study concerns baseline findings from a longitudinal survey study. An online questionnaire was e-mailed to a national cohort of medical trainees during their transition from under- to postgraduate education. The associations between orientations towards general practice specialization and work-related factors and potential influencing factors, respectively, were analyzed using uni- and multivariable modified Poisson regression models. Results Of 1,188 invited participants, 461 filled out key study variables concerning specialty preferences and rejections, corresponding to a response rate of 38.8%. We found significant positive associations between GP-positive/undecided orientation and valuing a good work/life balance and the opportunity to organize own working hours when compared to GP-non-committed respondents. Compared to the GP-committed orientations, the GP-positive/undecided orientation was associated with a positive attitude towards technology, wor, BACKGROUND: Recruiting and securing primary care physician workforce has been the center of international attention for decades. In Denmark, the number of general practitioners has decreased by 8.5% since 2013. However, a rising population age and increasing prevalence of chronic diseases and multimorbidity place an even greater future need for general practitioners in Denmark. The choice of general practice as specialty has been associated with a range of both intrinsic and extrinsic factors, however, few studies have examined the recruitment potential that lies within medical trainees' who are undecided about general practice specialization. The aim of this study was, therefore, to explore how medical trainees who are undecided about general practice specialization (GP-positive/undecided) differ from medical trainees who are either committed (GP-committed) or not committed to a general practice career (GP-non-committed) regarding factors related to future work life.METHODS: The present study concerns baseline findings from a longitudinal survey study. An online questionnaire was e-mailed to a national cohort of medical trainees during their transition from under- to postgraduate education. The associations between orientations towards general practice specialization and work-related factors and potential influencing factors, respectively, were analyzed using uni- and multivariable modified Poisson regression models.RESULTS: Of 1,188 invited participants, 461 filled out key study variables concerning specialty preferences and rejections, corresponding to a response rate of 38.8%. We found significant positive associations between GP-positive/undecided orientation and valuing a good work/life balance and the opportunity to organize own working hours when compared to GP-non-committed respondents. Compared to the GP-committed orientations, the GP-positive/undecided orientation was associated with a positive attitude towards technology, working shift h

INTRODUCTION: Medical professionals meet many transitions during their careers, and must learn to adjust rapidly to unfamiliar workplaces and teams. This study investigated the use of a digital educational escape room (DEER) in facilitating medical students' learning around managing uncertainty in transitioning from classroom to clinical placement.METHODS: We used design-based research to explore the design, build, and test of a DEER, as well as gain insight into how these novel learning environments work, using Community of Inquiry (CoI) as a guiding conceptual framework. This study represented a mixed methods pilot test of a prototype DEER. Twenty-two medical students agreed to participate, and data were collected through qualitative (i.e., focus groups, game-play observations) and quantitative (i.e., questionnaires) methods.RESULTS: Eighty-two per cent of participants agreed or strongly agreed that the DEER supported their learning around uncertainty. Participants offered diverse examples of how the game had facilitated new insights on, and approaches to, uncertainty. With respect to the learning environment, multiple indicators and examples of the three domains of CoI - cognitive, teaching and social presence - were observed.DISCUSSION: Our findings suggested that DEERs offer a valuable online learning environment for students to engage with complex and emotion-provoking challenges, such as those experienced at transitions. The study also suggested that CoI can be applied to the design, implementation, and evaluation of DEER learning environments, and we have proposed a set of design principles that may offer guidance here.

BACKGROUND: Most medical educational programs emphasize clinical observation or clinical skill acquisition, fewer focus upon research. The Danish-American Research Exchange (DARE) program, sponsored by the Lundbeck Foundation, is unique in that the medical student initiates biomedical research collaboration between Danish and US medical institutions. To achieve this, Danish medical students (DARE students) conduct binational mentored research projects while based in the United States for 10 months. In addition, DARE students are introduced to interdisciplinary thinking about how to develop ultra-low-cost healthcare interventions through the '$10 Challenge'.METHODS: We conducted a cross-sectional study of DARE alumni over five consecutive years (2015-2020, n = 24). Research metrics included completion of a research project, primary authorship, and co-authorship of publications. The number of publications, prior to and after the DARE program were enumerated. For the first four cohorts, graduation from medical school and acceptance or intention to enter a joint MD-PhD program also were assessed. Two focus groups were conducted using constructivist grounded theory. Discussions were transcribed, redacted, and coded using Dedoose software.RESULTS: DARE Medical students were 31.2 years (range 24-35), the majority were women (67%;16/24). The majority (17/24;71%) completed a first author publication in a peer-reviewed journal with a median of 3.9 per DARE alumnus. DARE alumnus reported increased proficiency in biostatistics, epidemiology, coding and public speaking as well as stronger research qualities in creativity, critical thinking, comfort in approaching scientist in both the US and Denmark (p < 0.001 for all). Qualitative key themes included: increased confidence, a deepening of research inquiry and linkage to a research network.CONCLUSIONS: Preliminarily, this study suggests that medical students can initiate binational collaboration in medi

Stress during Simulation: Recognizing Resilience in Medical Students Rebekah Cole, Ph.D., James Schwartz, MPHE, Estefania Melo, BS, Kevin Matthews, Sherri L. Rudinsky, MD Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD BACKGROUND Simulation is stressful! It is well known that medical students experience stress during simulation-based learning. However, the nature of this stress, and the resilience they develop to overcome this stress, has not been studied. The objective of our study, therefore, was to examine the experiences of medical students during a high-fidelity prehospital simulation in order to understand the ways in which they experienced stress while caring for patients in a high-tempo, resource-constrained environment. We then investigated their resilience as they worked to manage these stressors. METHODS This qualitative phenomenological study explored the lived experiences of 23 fourth-year medical students as they progressed through a four-day immersive military medical simulation. We interviewed each student twice during the simulation and reviewed their post-simulation reflection papers. Following the qualitative phenomenological data analysis steps, our research team coded the interview transcripts and papers, organized these codes into categories, and came to a consensus on the themes that emerged from these categories. Once defined, these themes served as the results of the study. RESULTS Four main themes emerged that described the participants’ resilience: 1) team support; 2) mindfulness; 3) positive self-talk; and, 4) seeing the “bigger picture.” In order to manage the physical and mental stressors embedded within the simulation, they focused on regulating their thoughts and feelings as they relied on their teammates for support and motivation. This reliance resulted in increased team cohesion, morale, and an overall sense of accomplishment. CONCLUSION This insight into students' resilience during simula, RITM0035830, Simulation is stressful! It is well known that medical students experience stress during simulation-based learning. However, the nature of this stress, and the resilience they develop to overcome this stress, has not been studied. The objective of our study, therefore, was to examine the experiences of medical students during a high-fidelity prehospital simulation in order to understand the ways in which they experienced stress while caring for patients in a high-tempo, resource-constrained environment. We then investigated their resilience as they worked to manage these stressors.

INTRODUCTION: Patients living with a disability experience an illness trajectory that may be uncertain. While navigating clinical uncertainty has been well-researched, health professionals' intolerance of uncertainty for patients living with disabilities has yet to be explored. We examined the relationship between medical students' intolerance of uncertainty with their attitudes towards people living with disabilities to better inform curricular efforts. METHODS: We employed a survey-based design consisting of the Intolerance of Uncertainty Scale (IUS) and Disability Attitudes in Healthcare (DAHC) Scale to medical students upon completion of core clerkships (end of third-year of training). Data were de-identified. Mean DAHC and IUS scores were compared with published values RESULTS: Response rate was 97% (268/275 students). Mean IUS score did not differ from previously cited medical student scores, but mean DAHC score was significantly higher than previously cited scores. We observed a statistically-significant relationship between IUS and DAHC scores. Students with greater intolerance of uncertainty had lower scores for disability attitudes [ CONCLUSION: We identified a weak negative correlation between IUS and DAHC scores in medical students. Further research is needed to clarify findings and identify best practices that equip trainees with skills to care for patients with uncertain illness trajectories and patients living with disabilities.

This study was aimed at comparing the learning efficacy of a traditional instructor-led lesson with that of a completely virtual, self-directed lesson in immersive virtual reality (IVR) in teaching basic point-of-care ultrasound (PoCUS) skills. We conducted a blinded, non-inferiority, parallel-group, randomized controlled trial in which final-year medical students were randomized to an instructor-led (n = 53) or IVR (n = 51) lesson. Participants' learning efficacy was evaluated by blinded assessors, who rated each participant's performance using the Objective Structured Assessment of Ultrasound Skills (OSAUS) assessment tool.The mean total scores for participants were 11.0 points (95% confidence interval: 9.8-12.2) for the instructor-led lesson and 10.3 points (95% confidence interval: 9.0-11.5) for the IVR lesson. No significant differences were observed between the groups with respect to total score (p = 0.36) or subgroup objectives of the OSAUS score (p = 0.34 for familiarity, p = 0.45 for image optimization, p = 0.96 for systematic approach and p = 0.07 for interpretation). Maintenance costs for both courses were estimated at 400 euros each. Startup costs for the instructor-led course were estimated 16 times higher than those for the IVR course. The learning efficacy of an instructor-led lesson on basic US did not differ significantly from that of a self-directed lesson in IVR, as assessed using the OSAUS. The results suggest that IVR could be an equivalent alternative to instructor-led lessons in future basic US courses, but further research is warranted to clarify the role of IVR in PoCUS courses.

This study was aimed at comparing the learning efficacy of a traditional instructor-led lesson with that of a completely virtual, self-directed lesson in immersive virtual reality (IVR) in teaching basic point-of-care ultrasound (PoCUS) skills. We conducted a blinded, non-inferiority, parallel-group, randomized controlled trial in which final-year medical students were randomized to an instructor-led (n = 53) or IVR (n = 51) lesson. Participants' learning efficacy was evaluated by blinded assessors, who rated each participant's performance using the Objective Structured Assessment of Ultrasound Skills (OSAUS) assessment tool.The mean total scores for participants were 11.0 points (95% confidence interval: 9.8-12.2) for the instructor-led lesson and 10.3 points (95% confidence interval: 9.0-11.5) for the IVR lesson. No significant differences were observed between the groups with respect to total score (p = 0.36) or subgroup objectives of the OSAUS score (p = 0.34 for familiarity, p = 0.45 for image optimization, p = 0.96 for systematic approach and p = 0.07 for interpretation). Maintenance costs for both courses were estimated at 400 euros each. Startup costs for the instructor-led course were estimated 16 times higher than those for the IVR course. The learning efficacy of an instructor-led lesson on basic US did not differ significantly from that of a self-directed lesson in IVR, as assessed using the OSAUS. The results suggest that IVR could be an equivalent alternative to instructor-led lessons in future basic US courses, but further research is warranted to clarify the role of IVR in PoCUS courses.

BACKGROUND: Most medical educational programs emphasize clinical observation or clinical skill acquisition, fewer focus upon research. The Danish-American Research Exchange (DARE) program, sponsored by the Lundbeck Foundation, is unique in that the medical student initiates biomedical research collaboration between Danish and US medical institutions. To achieve this, Danish medical students (DARE students) conduct binational mentored research projects while based in the United States for 10 months. In addition, DARE students are introduced to interdisciplinary thinking about how to develop ultra-low-cost healthcare interventions through the '$10 Challenge'.METHODS: We conducted a cross-sectional study of DARE alumni over five consecutive years (2015-2020, n = 24). Research metrics included completion of a research project, primary authorship, and co-authorship of publications. The number of publications, prior to and after the DARE program were enumerated. For the first four cohorts, graduation from medical school and acceptance or intention to enter a joint MD-PhD program also were assessed. Two focus groups were conducted using constructivist grounded theory. Discussions were transcribed, redacted, and coded using Dedoose software.RESULTS: DARE Medical students were 31.2 years (range 24-35), the majority were women (67%;16/24). The majority (17/24;71%) completed a first author publication in a peer-reviewed journal with a median of 3.9 per DARE alumnus. DARE alumnus reported increased proficiency in biostatistics, epidemiology, coding and public speaking as well as stronger research qualities in creativity, critical thinking, comfort in approaching scientist in both the US and Denmark (p < 0.001 for all). Qualitative key themes included: increased confidence, a deepening of research inquiry and linkage to a research network.CONCLUSIONS: Preliminarily, this study suggests that medical students can initiate binational collaboration in medi

Objective To determine the socio-demographic profile of all students enrolled to study medicine in Aotearoa New Zealand (NZ). Design and setting Observational, cross-sectional study. Data were sought from the Universities of Auckland and Otago, the two NZ tertiary education institutions providing medical education, for the period 2016-2020 inclusive. These data are a subset of the larger project 'Mirror on Society' examining all regulated health professional enrolled students in NZ. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. NZ denominator population data (18-29 years) were sourced from the 2018 census. Participants 2858 students were enrolled to study medicine between 2016 and 2020 inclusive. Results There were more women (59.1%) enrolled to study medicine than men (40.9%) and the majority (96.5%) were in the 18-29 years age range. Maori students (rate ratio 0.92; 95% CI 0.84 to 1.0) and Pacific students (rate ratio 0.85; 95% CI 0.73 to 0.98) had lower overall rates of enrolment. For all ethnic groups, irrespective of rural or urban origin, enrolment rates had a nearly log-linear negative relationship with increasing socioeconomic deprivation. Enrolments were lower for students from rural areas compared with those from urban areas (rate ratio 0.53; 95% CI 0.46-0.61). Overall NZ's medical students do not reflect the diverse communities they will serve, with under-representation of Maori and Pacific students and students who come from low socioeconomic and rural backgrounds. Conclusions To meaningfully address these issues, we suggest the following policy changes: universities commit and act to Indigenise institutional ways of knowing and being; selection policies are reviewed to ensure that communities in greatest need of doctors are prioritised for enrolment into medicine (specifically, the impact of low socioeconomic status should be factored into selection de

Introduction: Medical students play an important role in achieving sexual and reproductive health outcomes, including a greater participation of men in family planning. Objective: To describe the level of knowledge, the perception, and the level of acceptance of vasectomy in a sample of Latin American medical students (i.e. if they would recommend to their patients undergoing this procedure, and in the case of male students, if they would undergo it at any time of their lifetime). Materials and methods: Multicenter, cross-sectional analytical study conducted in November 2020 in 2676 1st-7th year medical students from 8 Latin American countries. Data were collected using a questionnaire validated in each country and that was completed via Google Forms. The chi-square test of independence was used to determine the differences in the study variables (knowledge, perception, and acceptance) for each established subgroup, with a significance level of p <0.05. Results: The level of knowledge was high and medium in 55.38% and 36.32% of participants. The country with the highest ratio of students with a high level of knowledge was Mexico (77.31%) and the one with the lowest ratio was Brazil (3.33%). Regarding perception, 96.97% and 98.99% of students considered that vasectomy does not affect masculinity and that men are also responsible for contraception, respectively. With respect to acceptance, 94.02% would recommend undergoing the procedure, but only 69.82% of men (n = 759) would undergo it. Conclusions: Most of participants have a good level of knowledge, a good perception, and a good level of acceptance in relation to the procedure. However, the implementation of more training strategies that allow them to promote the use of vasectomy as a family planning alternative in their professional life is required., Introducción. Los estudiantes de medicina desempeñan un rol importante en el logro de resultados en salud sexual y reproductiva, incluyendo una mayor participación de los hombres en la planificación familiar. Objetivo. Describir el nivel de conocimientos, la percepción y el nivel de aceptación de la vasectomía (i.e. si la recomendarían a sus pacientes y, en el caso de los hombres, si se la realizarían en algún momento de su vida) en una muestra de estudiantes de medicina latinoamericanos. Materiales y métodos. Estudio multicéntrico, transversal analítico realizado en noviembre de 2020 en 2676 estudiantes de medicina (1er-7mo año) de 8 países latinoamericanos. Los datos se recolectaron mediante un cuestionario validado en cada país y diligenciado mediante Google Forms. Se utilizó la prueba de chi-cuadrado de independencia para determinar las diferencias en las variables de estudio (nivel de conocimientos, percepción y nivel de aceptación) para cada subgrupo establecido, con un nivel de significancia de p<0.05. Resultados. El nivel de conocimientos fue alto y medio en 55.38% y 36.32% de los participantes. El país con mayor proporción de estudiantes con alto nivel de conocimientos fue México (77.31%) y el de menor proporción, Brasil (3.33%). Respecto a la percepción, 96.97% de los estudiantes consideró que la vasectomía no afecta la masculinidad y el 98.99% que la anticoncepción también es responsabilidad del hombre. En cuanto a la aceptación, el 94.02% recomendaría el procedimiento, pero solo el 69.82% de los varones (n= 759) se la realizaría. Conclusiones. La mayoría de participantes tiene un buen nivel de conocimientos, buena percepción y un buen nivel de aceptación del procedimiento. No obstante, es necesario implementar más estrategias de capacitación que les permitan promover el uso de la vasectomía como alternativa de planificación familiar en su vida profesional., Introdução: Os estudantes de medicina desempenham um papel importante no alcance de conquistas em saúde sexual e reprodutiva, inclusive aumentando a participação dos homens no planejamento familiar, uma vez que futuramente serão eles os encarregados de promover o uso da vasectomia. Objetivo: Descrever o nível de conhecimento, crenças e aceitação da vasectomia em uma amostra de estudantes de medicina latino-americanos. Materiais e métodos: Estudo multicêntrico, observacional, analítico, amostra de conveniência não probabilística com 2.676 estudantes de medicina de 8 países da América Latina. Foi realizada uma pesquisa com um instrumento validado para avaliar o conhecimento, as crenças e a aceitação da vasectomia. Resultados: participaram em média 333,37 alunos por país. 55,38% apresentaram alto nível de conhecimento. O México registrou a melhor pontuação com 77%, enquanto o Brasil 3%, com o pior desempenho.94% dos alunos recomendariam o procedimento a pacientes e conhecidos; no entanto, 69% dos homens seriam submetidos ao procedimento. 70% dos alunos ateus e agnósticos apresentaram alto nível de conhecimento. Conclusões: A maioria dos estudantes de medicina latino-americanos possui um bom nível de conhecimento e atitude sobre vasectomia. Apesar da boa aceitação, espera-se que mais estratégias de capacitação sejam implementadas para que possam exercer o correto aconselhamento e promoção da saúde sexual e reprodutiva em sua vida profissional.

Introduction: Medical students play an important role in achieving sexual and reproductive health outcomes, including a greater participation of men in family planning. Objective: To describe the level of knowledge, the perception, and the level of acceptance of vasectomy in a sample of Latin American medical students (i.e. if they would recommend to their patients undergoing this procedure, and in the case of male students, if they would undergo it at any time of their lifetime). Materials and methods: Multicenter, cross-sectional analytical study conducted in November 2020 in 2676 1st-7th year medical students from 8 Latin American countries. Data were collected using a questionnaire validated in each country and that was completed via Google Forms. The chi-square test of independence was used to determine the differences in the study variables (knowledge, perception, and acceptance) for each established subgroup, with a significance level of p <0.05. Results: The level of knowledge was high and medium in 55.38% and 36.32% of participants. The country with the highest ratio of students with a high level of knowledge was Mexico (77.31%) and the one with the lowest ratio was Brazil (3.33%). Regarding perception, 96.97% and 98.99% of students considered that vasectomy does not affect masculinity and that men are also responsible for contraception, respectively. With respect to acceptance, 94.02% would recommend undergoing the procedure, but only 69.82% of men (n = 759) would undergo it. Conclusions: Most of participants have a good level of knowledge, a good perception, and a good level of acceptance in relation to the procedure. However, the implementation of more training strategies that allow them to promote the use of vasectomy as a family planning alternative in their professional life is required., Introducción. Los estudiantes de medicina desempeñan un rol importante en el logro de resultados en salud sexual y reproductiva, incluyendo una mayor participación de los hombres en la planificación familiar. Objetivo. Describir el nivel de conocimientos, la percepción y el nivel de aceptación de la vasectomía (i.e. si la recomendarían a sus pacientes y, en el caso de los hombres, si se la realizarían en algún momento de su vida) en una muestra de estudiantes de medicina latinoamericanos. Materiales y métodos. Estudio multicéntrico, transversal analítico realizado en noviembre de 2020 en 2676 estudiantes de medicina (1er-7mo año) de 8 países latinoamericanos. Los datos se recolectaron mediante un cuestionario validado en cada país y diligenciado mediante Google Forms. Se utilizó la prueba de chi-cuadrado de independencia para determinar las diferencias en las variables de estudio (nivel de conocimientos, percepción y nivel de aceptación) para cada subgrupo establecido, con un nivel de significancia de p<0.05. Resultados. El nivel de conocimientos fue alto y medio en 55.38% y 36.32% de los participantes. El país con mayor proporción de estudiantes con alto nivel de conocimientos fue México (77.31%) y el de menor proporción, Brasil (3.33%). Respecto a la percepción, 96.97% de los estudiantes consideró que la vasectomía no afecta la masculinidad y el 98.99% que la anticoncepción también es responsabilidad del hombre. En cuanto a la aceptación, el 94.02% recomendaría el procedimiento, pero solo el 69.82% de los varones (n= 759) se la realizaría. Conclusiones. La mayoría de participantes tiene un buen nivel de conocimientos, buena percepción y un buen nivel de aceptación del procedimiento. No obstante, es necesario implementar más estrategias de capacitación que les permitan promover el uso de la vasectomía como alternativa de planificación familiar en su vida profesional., Introdução: Os estudantes de medicina desempenham um papel importante no alcance de conquistas em saúde sexual e reprodutiva, inclusive aumentando a participação dos homens no planejamento familiar, uma vez que futuramente serão eles os encarregados de promover o uso da vasectomia. Objetivo: Descrever o nível de conhecimento, crenças e aceitação da vasectomia em uma amostra de estudantes de medicina latino-americanos. Materiais e métodos: Estudo multicêntrico, observacional, analítico, amostra de conveniência não probabilística com 2.676 estudantes de medicina de 8 países da América Latina. Foi realizada uma pesquisa com um instrumento validado para avaliar o conhecimento, as crenças e a aceitação da vasectomia. Resultados: participaram em média 333,37 alunos por país. 55,38% apresentaram alto nível de conhecimento. O México registrou a melhor pontuação com 77%, enquanto o Brasil 3%, com o pior desempenho.94% dos alunos recomendariam o procedimento a pacientes e conhecidos; no entanto, 69% dos homens seriam submetidos ao procedimento. 70% dos alunos ateus e agnósticos apresentaram alto nível de conhecimento. Conclusões: A maioria dos estudantes de medicina latino-americanos possui um bom nível de conhecimento e atitude sobre vasectomia. Apesar da boa aceitação, espera-se que mais estratégias de capacitação sejam implementadas para que possam exercer o correto aconselhamento e promoção da saúde sexual e reprodutiva em sua vida profissional.

type:Text, Background: In order for general practice / family medicine clerkships to be improved in undergraduate medical education, it is necessary to clarify the impacts of general practice / family medicine clerkships. Using text mining to analyze the reflective writing of medical students may be useful for further understanding the impacts of clinical clerkships on medical students. Methods: The study involved 125 fifth-year Fukushima Medical University School of Medicine students in the academic year 2018-2019. The settings were three clinics and the study period was 5 days. The clerkships included outpatient and home visits. Students' reflective writing on their clerkship experience was collected on the final day. Text mining was used to extract the most frequent words (nouns) from the reflective writing. A co-occurrence network map was created to illustrate the relationships between the most frequent words. Results: 124 students participated in the study. The total number of sentences extracted was 321 and the total number of words was 10,627. The top five frequently-occurring words were patient, home-visit, medical practice, medical care, and family. From the co-occurrence network map, a co-occurrence relationship was recognized between home-visit and family. Conclusion: Data suggest that medical students may learn the necessity of care for the family as well as the patient in a home-care setting.

Uvod/Cilj. U cilju smanjenja rizika od pojave sindroma sagorevanja (SS) kod zdravstvenih radnika, važno je identifikovati faktore koji doprinose njegovom razvoju još tokom njihovog školovanja. Cilj rada bio je da se predloži model za utvrđivanje povezanosti između različitih strategija za suočavanje sa stresom, koje koriste učenici srednje medicinske škole i studenti medicine, sa SS. Metode. Studijom je obuhvaćeno ukupno 164 učenika Srednje medicinske škole (80,5% ženskog i 19,5% muškog pola) i 344 studenta Medicinskog fakulteta Univerziteta u Beogradu, Srbija (76,9% ženskog i 23,1% muškog pola). Model za ispitivanje veze između strategija za suočavanje sa stresom (merene skalom "Brief COPE") i SS merenog skalom The Copenhagen Burnout Inventory-student version (CBI-S) testiran je upotrebom modeliranja strukturnih jednačina. Rezultati. Pri suočavanju sa stresom, učenici Srednje medicinske škole koristili su Prihvatanje, Ventiliranje, Bihevioralno neangažovanje i Planiranje, koje su im povećavali SS, a nisu koristili nijednu strategiju za pomaganje u smanjenju SS. Kod suočavanja sa stresom, studenti Medicinskog fakulteta koristili su Planiranje, Prihvatanje, Humor, Ventiliranje, Bihevioralno neangažovanje, Samookrivljavanje i Konzumiranje psihoaktivnih supstanci, što im je povećavalo SS, a Pozitivnu reinterpretaciju (redefinisanje) koristili su kako bi smanjili SS. Zaključak. Rezultati istraživanja pokazali su jasan nedostatak upotrebe adaptivnih strategija suočavanja sa stresom kod obe grupe ispitanika. Pravilno obrazovanje bi pomoglo da se nefunkcionalni način reagovanja na stres zameni konstruktivnim., Background/Aim. To reduce the risk of burnout development in medical professionals, it is important to identify the contributing factors as early as in their schooling years. The aim of this study was to propose a model for determining the relationship between the coping strategies used by medical high school and medical faculty students and burnout. Methods. The cross-sectional study included 164 students of Medical High School (80.5% female and 19.5% male) and 344 students of the Faculty of Medicine University of Belgrade, Serbia (76.9% female and 23.1% male). The model exploring the relationship between coping strategies (measured by the Brief COPE scale) and burnout [measured by the Copenhagen Burnout Inventory-student version (CBI-S) scale] was tested using structural equation modelling (SEM) analysis. Results. When copied with stress, Medical High School students used Acceptance, Venting, Behavioural Disengagement, and Planning, which increased their burnout, but they did not use any strategies to help them reduce burnout. When copied with stress, Faculty of Medicine students used Planning, Acceptance, Humour, Venting, Behavioural Disengagement, Self-Blame, and Substance Use, which increased their burnout, and Positive Reframing, which helped them reduce burnout. Conclusion. The results of this research showed an evident lack of using adaptive coping strategies with both groups of respondents. Proper education could help them replace these dysfunctional coping strategies with constructive ones.

People with substance use disorder, and pregnant women especially, are subject to a lot of stigmas, which can prevent optimal accessibility and quality of care. In this survey, we investigated attitudes of final year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes., SCOPUS: ar.j, info:eu-repo/semantics/published

Background: When it comes to scheduling interviews, medical students may wonder if they need a strategy to increase their likelihood of matching. Previous studies examined the temporal effects of the residency interview on overall match rate; however, there are additional factors that affect the match process, including board examination scores and letters of recommendation. Only few studies have examined the effect interview time of day has on match success. The current study examines the impact date and time of interview during the interview season have on candidates' respective interview scores. Methods: Interview data over a three-year period (i.e., three interview cycles) was examined at a PGY-1-3, ACGME-accredited EM residency program in Philadelphia. Date of interview and time of day of interview (i.e., morning versus afternoon) was examined. A linear regression analysis was performed to determine if there is a statistically-significant difference in overall interview scores based on date during the interview season and time of day. Results: There is no statistically-significant effect of time of day or date on residency interview scores. Conclusions: Our findings are congruent with other studies on the temporal effects of residency interviews on overall match rate. Findings should provide reassurance to students scheduling interviews, as time slots have not been found to have a significant relationship with overall interview score. Future studies should more holistically analyze the residency application process.

EFFECTS OF UNCERTAINTY ON RAPID DECISION-MAKING BY MEDICAL STUDENTS: A PILOT REALIST EVALUATION John M. Wightman, MD, MA, FACEP Professor and Chair, Department of Military & Emergency Medicine Uniformed Services University; Bethesda, Maryland, USA BACKGROUND The ability to make decisions is a competence all medical students must develop prior to becoming independently licensed practitioners. When there is no time for retrieving management information from checklists, books, or online resources nor time for conferring with colleagues outside the team, decisions must be rapid and impactful. CONTEXT The timeline for medical students to develop skills for independent emergency decision-making spans all of UME and graduate medical education (GME). Medical students with a military commitment face the potential for a shorter timeline with the possibility of deployment after only one year of GME regardless of accession source [e.g., Health Professions Scholarship Program (HPSP), Uniformed Services University (USU), etc.]. Clinical and leadership curricular threads at the USU are designed to accelerate this developmental process,1 but outcome measures that drive curriculum are needed. DISCUSSION No evaluated study directly answered any of the three research questions. One identified sources of stress from reflective journals kept by Finish medical students5 with some related to clinical situations, but none directly related to clinical decision-making. Reports of intolerance to uncertainty in practicing physicians were only slightly more plentiful. Additional articles involving out-of-hospital responders, nurses, and dentists also illuminated some effects of uncertainty stress but not real-time assessment or mitigation through education. A recent conceptual model based on interviews with medical students, residents, and attending physicians may have some categorization utility for a full realist evaluation.6 Figure 1 [above]: PRISMA4 flow diagram following PubMed search. CON, RITM0022924, The ability to make decisions is a competence all medical students must develop prior to becoming independently licensed practitioners. When there is no time for retrieving management information from checklists, books, or online resources nor time for conferring with colleagues outside the team, decisions must be rapid and impactful.

Uniformed Services University Professional & Leader Development Program Robert P. Federigan1,2, Jennifer Yutuc1, Angela M. Yarnell1,2, Erin S. Barry1,2 1 Office of the Professor of Military Science, Uniformed Services University of the Health Sciences 2 Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences The Way Ahead The USU Professional and Leader Development Program (PLDP) efforts to strengthen its offerings include the following pursuits: The USU Mentorship Program The USU Mentor Program, as the third element of the PLDP, is a developing initiative to connect USU learners with senior uniformed professionals to engage in a mentor/mentee relationship that contributes to growth as a leader and a professional. USU will partner with the Senior Service Programs in order to pair USU learners with senior uniformed officers. The OPMS will serve as the liaison between the programs. Expanded Offerings of Professional Development Workshops Post-course surveys suggests: a) workshop effectiveness, b) requests for continual offerings, and c) recommendations for other like-organizations to request workshop. USU PLDP will therefore continue to increase its outreach through Professional Development Workshops by pursuing DHA endorsement and support. Strengthening Alliances and Partnerships USU was invited by the Doerr Institute for New Leaders at Rice University to pilot a new elective classification by the Carnegie Foundation for Leader Development in higher education. USU’s application was assessed favorably in Fall 2021 and will make final submission in Spring 2022. It is through efforts such as this that USU will be able to form a consortium of diverse higher education institutions which share a common commitment to Leader Education. PROGRAM OVERVIEW USU develops self-aware, adaptive leaders and committed professionals. The USU graduate is a self-aware, adaptive leader who recognizes what it takes to support victory in the 21st C, RITM0023012, USU develops self-aware, adaptive leaders and committed professionals. The USU graduate is a self-aware, adaptive leader who recognizes what it takes to support victory in the 21st Century, and a committed professional who understands the military craft and is trained to quickly adapt to complex environments while maintaining a strong devotion to the ideals which form the basis of professionalism, teamwork, and competence as both a commissioned officer and health professional. The USU Professional and Leader Development Program (PLDP) is used to develop USU Faculty, Staff, and Learners. The USU PLDP consists of three elements: professional development workshops, leadership coaching, and professional mentoring. Professional development workshops are delivered by subject matter experts and centered on the themes of self-awareness, adaptive leadership, and committed professionalism. Individual coaching is offered by trained Leadership Coaches and is based on the International Coaching Federation (ICF) Core Competencies. The mentorship program pairs USU personnel with experienced officers and leaders in the Department of Defense.

Background: The United States opioid epidemic is a devastating public health crisis fueled in part by physician prescribing. While the next generation of prescribers is crucial to the trajectory of the epidemic, medical school curricula designated to prepare students for opioid prescribing (OP) and pain management is often underdeveloped. In response to this deficit, we aimed to investigate the impact of an online opioid and pain management (OPM) educational intervention on fourth-year medical student knowledge, attitudes, and perceived competence. Methods: Graduating students completing their final year of medical education at Sidney Kimmel Medical College of Thomas Jefferson University were sent an e-mail invitation to complete a virtual OPM module. The module consisted of eight interactive patient cases that introduced topics through a case-based learning system, challenging students to make decisions and answer knowledge questions about the patient care process. An identical pre- and posttest were built into the module to measure general and case-specific learning objectives, with responses subsequently analyzed using the Wilcoxon matched-pairs signed-rank test. Results: Forty-three students (19% response rate) completed the module. All median posttest responses ranked significantly higher than paired median pretest responses (p < 0.05). Comparing the paired overall student baseline score to module completion, median posttest ranks (Mdn = 206, IQR = 25) were significantly higher than median pretest ranks (Mdn = 150, IQR = 24) (p < 0.001). Regarding paired median Perceived Competence Scale metrics specifically, perceived student confidence, capability, and ability in opioid management increased from "disagree" (2) to "agree" (4) (p < 0.001), and student ability to meet the challenge of opioid management increased from "neither agree nor disagree" (3) to "agree" (4) (p < 0.001). Additionally, while 77% of students reported receiving OP training in medical school

CONTEXT: The psychological realm of medical students' moral experiences is explored tangentially in medical education literature, often in the context of ethics or professionalism education. This study deepens our understanding by (a) investigating the nature of moral dilemmas experienced at the onset of clinical practice, (b) exploring students' emotional response to these dilemmas, and (c) examining how students perceive the influence of these dilemmas on their professional development.METHODS: This is a cross-sectional qualitative study carried out in 2017 that applied thematic template analysis to individual interviews performed with last-year medical students. The interviews followed the drawing of a Rich Picture representing moral dilemmas experienced by medical students at the onset of clinical practice.RESULTS: Moral dilemmas have four intertwined dimensions. The first relates to students' struggle to prioritise, balance and apply conflicting moral values; the second comprises the clash between students' inner motivation and the external constraints that limit the moral action; the third refers to the conflict between students' current attitudes with the desired/idealised attitudes of the doctor they intend to become; and the fourth corresponds to weighting conflicting ethical principles during the moral decision. Students' emotional responses are intense and long-lasting, and with a remarkable residue effect, particularly when the moral decision does not align with their moral beliefs. Moral dilemmas are impactful experiences that affect the professional development of medical students and can culminate in both detachment and growth in moral courage.CONCLUSION: Moral dilemmas are memorable, complex and emotionally intense experiences that impact the professional development of medical students. Understanding students' moral dilemmas can help educators to devise pedagogical activities to anticipate and reflect on these experiences. Th

En Perú cada año se realiza el Congreso Científico Nacional (CCN) de Estudiantes de Medicina, un evento organizado por la Sociedad Científica Médico Estudiantil Peruana (SOCIMEP) que desde 1987 reúne a estudiantes de 40 facultades de medicina del país con el objetivo de promover la investigación científica durante el pregrado. Para cumplir con este propósito, en cada CCN se realiza un concurso científico que evalúa y premia los mejores trabajos en tres modalidades: trabajos de investigación, proyectos de investigación y casos clínicos.

Introduction: Many of the research works developed by students and presented in scientific events are not published in scientific journals. Objective: To characterize the research works presented in the 2016 and 2018 editions of the Evento Científico Estudiantil Nacional de Medicina Interna (National Student Scientific Event on Internal Medicine) (MEDINTÁVILA) and those published in scientific journals, and to identify factors associated with their publication. Material and methods: Cross-sectional analytical study. A search strategy was carried out on April 2020 in Google Scholar in order to check if the works presented in the 2016 y 2018 editions of the event had been published, whether in English or Spanish, in scientific journals. Bivariate analyses were performed to determine if there were characteristics of the works associated with their publication, where prevalence ratios, along with their respective confidence intervals and p values were calculated by means of generalized linear models (family=Poisson; link=log) in which each university submitting the research work was used as a cluster. A significance level of p≤0.05 was considered. Results: Out of the 335 research works that were analyzed, 180 (53.73%) were presented at the 2016 edition. Regarding their typology and the topics they addressed, 190 (56.72%) were classified under the free topics category, and 170 addressed chronic illnesses (50.75%). A total of 24 works were published (7.16%), of those only nine were cited, and in 19 (79.17%) there were authoring changes. In the bivariate analysis there were no factors associated with the publication of the works. Conclusion: The publication in scientific journals of the research works presented in both editions of the event is very low, thus it is necessary for Cuban universities to provide medical sciences students with more research-related support, since this could increase the probability of publishing their works., Introducción. Muchas de las investigaciones desarrolladas por estudiantes y presentadas en eventos científicos no se publican en revistas científicas. Objetivo. Caracterizar los trabajos presentados en las ediciones 2016 y 2018 del Evento Científico Estudiantil Nacional de Medicina Interna (MEDINTÁVILA) y los publicados en revistas científicas, así como identificar los factores asociados a su publicación. Materiales y métodos. Estudio transversal analítico. Mediante una estrategia de búsqueda realizada en abril de 2020 en Google Académico, se constató si los trabajos presentados en 2016 y 2018 en el evento habían sido publicados, en inglés o español, en revistas científicas. Se realizaron análisis bivariados para determinar si hubo características de los trabajos asociadas con su publicación, calculándose razones de prevalencia, junto con sus respectivos intervalos de confianza al 95% y valores p mediante modelos lineales generalizados (familia Poisson, función de enlace log) en los que se usó como clúster a cada universidad que presentó la investigación. Se consideró un nivel de significancia de p≤0.05. Resultados. De los 335 trabajos analizados, 180 (53.73%) correspondieron a la edición de 2016. Respecto a la tipología y temática, 190 (56.72%) fueron clasificados bajo la categoría temas libres y 170 (50.75%) abordaron enfermedades crónicas. Se publicaron 24 (7.16%) trabajos, de los cuales solo nueve fueron citados, y en 19 (79.17%) hubo cambios de autores. No se identificaron factores asociados a la publicación de los trabajos en el análisis bivariado. Conclusión. La publicación en revistas científicas de los trabajos presentados en ambas ediciones del MEDINTÁVILA es muy baja, por lo que es necesario que las universidades cubanas brinden más apoyo en investigación a los estudiantes de ciencias médicas, ya que esto podría aumentar las probabilidades de publicación de sus trabajos.

Introduction: Much of the research works developed by students and presented in scientific events are not published in scientific journals. Objective: To characterize the research works presented in the 2016 and 2018 editions of the Evento Científico Estudiantil Nacional de Medicina Interna (National Student Scientific Event on Internal Medicine - (MEDINTÁVILA) and those published in scientific journals, as well as to identify factors associated with their publication. Materials and methods: Cross-sectional analytical study. A search strategy was carried out in April 2020 in Google Scholar in order to verify if the works presented in the 2016 y 2018 editions of the event had been published, in English or Spanish, in scientific journals. Bivariate analyses were performed to determine whether there were characteristics of the works associated with their publication, calculating prevalence ratios, along with their corresponding 95% confidence intervals and p-values and using generalized linear models (family=Poisson; link=log) in which each university submitting the research work was used as a cluster. A significance level of p<0.05 was considered. Results: Out of the 335 research works analyzed, 180 (53.73%) were presented at the 2016 edition. Regarding typology and the topics they addressed, 190 (56.72%) were classified under the free topics category, and 170 addressed chronic illnesses (50.75%). A total of 24 works were published (7.16%), of which only 9 were cited, and there were authoring changes in 19 (79.17%). No factors associated with the publication of the works were identified in the bivariate analysis. Conclusion: The publication in scientific journals of the research works presented in both editions of the event is very low, thus it is necessary for Cuban universities to provide medical science students with more research-related support, since this could increase the probability of publishing their works., Introducción. Muchas de las investigaciones desarrolladas por estudiantes y presentadas en eventos científicos no se publican en revistas científicas. Objetivos. Caracterizar los trabajos presentados en las ediciones 2016 y 2018 del Evento Científico Estudiantil Nacional de Medicina Interna (Medintávila) y los publicados en revistas científicas, así como identificar los factores asociados a su publicación. Materiales y métodos. Estudio transversal analítico. Mediante una estrategia de búsqueda realizada en abril de 2020 en Google Académico, se constató si los trabajos presentados en 2016 y 2018 en el evento habían sido publicados, en inglés o español, en revistas científicas. Se realizaron análisis bivariados para determinar si hubo características de los trabajos asociadas con su publicación, calculándose razones de prevalencia, junto con sus respectivos intervalos de confianza al 95% y valores p mediante modelos lineales generalizados (familia Poisson, función de enlace log) en los que se usó como clúster a cada universidad que presentó la investigación. Se consideró un nivel de significancia de p<0.05. Resultados. De los 335 trabajos analizados, 180 (53.73%) correspondieron a la edición de 2016. Respecto a la tipología y temática, 190 (56.72%) fueron clasificados bajo la categoría Temas libres y 170 (50.75%) abordaron Enfermedades crónicas. Se publicaron 24 (7.16%) trabajos, de los cuales solo 9 fueron citados, y en 19 (79.17%) hubo cambios de autores. No se identificaron factores asociados a la publicación de los trabajos en el análisis bivariado. Conclusión. La publicación en revistas científicas de los trabajos presentados en ambas ediciones del Medintávila es muy baja, por lo que es necesario que las universidades cubanas brinden más apoyo en investigación a los estudiantes de ciencias médicas, ya que esto podría aumentar las probabilidades de publicación de sus trabajos.

Objective: To develop a valid and reliable instrument for measuring attitudes toward osteopathic medicine. Methods: Participants included 5,669 first-year students from 33 U.S. colleges of osteopathic medicine, who completed an online survey at the beginning of the 2019-2020 academic year. Using data from the nationwide Project in Osteopathic Medical Education and Empathy, we developed a 13-item instrument: Attitudes Toward Osteopathic Medicine Scale (ATOMS) and demonstrated the validity and reliability of its scores. The social desirability response bias was controlled in statistical analyses. Results: The corrected item-total score correlations were all positive and statistically significant, and the effect sizes of item discrimination indices were large. Cronbach's coefficient alpha reliability was 0.83. Construct validity, corroborating face and content validity of the ATOMS, was supported by three components, emerged from factor analysis: "Perspectives on Osteopathic Medicine," "Osteopathic Diagnosis and Treatment," and "Holistic-Integrative Care." Correlations between ATOMS scores and scores of cognitive empathy, emotional empathy; orientation toward interprofessional collaboration; lifelong learning; and burnout were statistically significant in the expected direction, providing validity evidence for the ATOMS. Using the method of contrasted groups, significant differences in the ATOMS scores were found by gender, ethnicity, academic background, and career interest in the expected direction, supporting the validity of the ATOMS scores. National norms were developed to assess individual scores alongside national percentile ranks. Conclusions: The ATOMS, developed in a nationwide study, supported by strong psychometric evidence for measuring orientation toward osteopathic medicine, has implications for the assessment of osteopathic medical education, patient outcomes, and admission decisions.

The European Higher Education Area (EHEA) recommends the use of new educational methodologies and the evaluation of student satisfaction. Different instruments have been developed in Spain to evaluate different aspects such as clinical decisions and teamwork, however no instruments have been found that specifically evaluate student self-confidence and satisfaction during clinical simulation. The aim was to translate the Student Satisfaction and Self-Confidence in Learning Scale (SCLS) questionnaire into Spanish and analyse its reliability and validity and understand the level of satisfaction and self-confidence of nursing students with respect to learning in clinical simulations. The study was carried out in two phases: (1) adaptation of the questionnaire into Spanish. (2) Cross-sectional study in a sample of 489 nursing students. The reliability and exploratory and confirmatory factorial analyses were performed. To analyse the relationship of the scale scores with the socio-demographic variables, the Fisher Student T-test or the ANOVA was used. The scale demonstrated high internal consistency reliability for the total scale and each of its dimensions. Cronbach's alpha was 0.88 (0.83 to 0.81) for each of the dimensions. The exploratory and confirmatory factor analysis showed that both the one-dimensional and two-dimensional models were acceptable. The results showed average scores above 4 for both dimensions. The SCLS-Spanish translation demonstrated evidence of its validity and reliability for use to understand the level of satisfaction and self-confidence of nursing students in clinical simulation. Clinical simulations help students to increase their levels of confidence and satisfaction, enabling them to face real scenarios in clinical practice.

Introduction Excessive use and misuse of antibiotics worldwide, both in human medicine and in agriculture has led to increased occurrence of bacterial resistance. Medical students should be aware of the judicious use of antibiotics, so that they can help the general population in future. Present study assesses knowledge of antibiotic use among first year undergraduate medical students and their practice in own life. Materials and Methods An observational, cross sectional study was conducted during a three-month period among first year undergraduate medical students of a teaching hospital in Kolkata. A validated self- administered questionnaire was used to collect the data. The data were analyzed by using simple descriptive statistics. Wherever it was relevant, the Chi-square test was carried out to determine any significant difference. Results About 85% of the participants were aware of the indication of antibiotic for treating bacterial infections only. Around 44% of the students had an average knowledge score compared to 28% having good knowledge score. Majority (76%) of the medical students obtained last antibiotics by a doctor’s prescription, but 54% completed the course as advised by doctor and purpose of taking antibiotic was fever mainly (41%). Statistically significant (P< 0.05) difference on pattern of their antibiotic use was found according to their socioeconomic status and knowledge score. Conclusion Changing the prescribing behaviour and knowledge of the healthcare professionals can help a lot to achieve rational use of antibiotic. It is also suggested that giving a comprehensive training of antibiotic use to the medical students and creating their awareness about frequent antimicrobial resistance could be a successful and encouraging approach.

Introduction Excessive use and misuse of antibiotics worldwide, both in human medicine and in agriculture has led to increased occurrence of bacterial resistance. Medical students should be aware of the judicious use of antibiotics, so that they can help the general population in future. Present study assesses knowledge of antibiotic use among first year undergraduate medical students and their practice in own life. Materials and Methods An observational, cross sectional study was conducted during a three-month period among first year undergraduate medical students of a teaching hospital in Kolkata. A validated self- administered questionnaire was used to collect the data. The data were analyzed by using simple descriptive statistics. Wherever it was relevant, the Chi-square test was carried out to determine any significant difference. Results About 85% of the participants were aware of the indication of antibiotic for treating bacterial infections only. Around 44% of the students had an average knowledge score compared to 28% having good knowledge score. Majority (76%) of the medical students obtained last antibiotics by a doctor’s prescription, but 54% completed the course as advised by doctor and purpose of taking antibiotic was fever mainly (41%). Statistically significant (P< 0.05) difference on pattern of their antibiotic use was found according to their socioeconomic status and knowledge score. Conclusion Changing the prescribing behaviour and knowledge of the healthcare professionals can help a lot to achieve rational use of antibiotic. It is also suggested that giving a comprehensive training of antibiotic use to the medical students and creating their awareness about frequent antimicrobial resistance could be a successful and encouraging approach.

Introduction Excessive use and misuse of antibiotics worldwide, both in human medicine and in agriculture has led to increased occurrence of bacterial resistance. Medical students should be aware of the judicious use of antibiotics, so that they can help the general population in future. Present study assesses knowledge of antibiotic use among first year undergraduate medical students and their practice in own life. Materials and Methods An observational, cross sectional study was conducted during a three-month period among first year undergraduate medical students of a teaching hospital in Kolkata. A validated self- administered questionnaire was used to collect the data. The data were analyzed by using simple descriptive statistics. Wherever it was relevant, the Chi-square test was carried out to determine any significant difference. Results About 85% of the participants were aware of the indication of antibiotic for treating bacterial infections only. Around 44% of the students had an average knowledge score compared to 28% having good knowledge score. Majority (76%) of the medical students obtained last antibiotics by a doctor’s prescription, but 54% completed the course as advised by doctor and purpose of taking antibiotic was fever mainly (41%). Statistically significant (P< 0.05) difference on pattern of their antibiotic use was found according to their socioeconomic status and knowledge score. Conclusion Changing the prescribing behaviour and knowledge of the healthcare professionals can help a lot to achieve rational use of antibiotic. It is also suggested that giving a comprehensive training of antibiotic use to the medical students and creating their awareness about frequent antimicrobial resistance could be a successful and encouraging approach.

PURPOSE: Virtual reality (VR) simulation surgical skills training is well established, but self-directed practice is often associated with a learning curve plateau. In this study, we investigate the effects of structured self-assessment as a means to improve performance in mastoidectomy training.METHODS: The study was a prospective, educational study. Two cohorts of novices (medical students) were recruited for practice of anatomical mastoidectomy in a training program with five distributed training blocks. Fifteen participants performed structured self-assessment after each procedure (intervention cohort). A reference cohort of another 14 participants served as controls. Performances were assessed by two blinded raters using a modified Welling Scale and simulator-recorded metrics.RESULTS: The self-assessment cohort performed superiorly to the reference cohort (mean difference of final product score 0.87 points, p = 0.001) and substantially reduced the number of repetitions needed. The self-assessment cohort also had more passing performances for the combined metrics-based score reflecting increased efficiency. Finally, the self-assessment cohort made fewer collisions compared with the reference cohort especially with the chorda tympani, the facial nerve, the incus, and the malleus.CONCLUSIONS: VR simulation training of surgical skills benefits from having learners perform structured self-assessment following each procedure as this increases performance, accelerates the learning curve thereby reducing time needed for training, and induces a safer performance with fewer collisions with critical structures. Structured self-assessment was in itself not sufficient to counter the learning curve plateau and for continued skills development additional supports for deliberate practice are needed.

The introduction of ultrasound into medical student education is well underway in many locations around the world, but is still in its infancy or has yet to begin in others. Proper incorporation of ultrasound education into medical training requires planning and resources, both capital and human. In this article, we discuss the state of the art of ultrasound in medical education throughout the world, as well as various methodologies utilized to improve student education and to incorporate ultrasound into every facet of training. Experiences from various educational systems and available evidence regarding the impact of ultrasound education are summarized. Representing multiple societies and specialties throughout the world, we discuss established modern as well as novel education structures and different successful approaches.

The relationship between students' withdrawal and educational variables has generated a considerable number of publications. As the explosion of information in sciences and integration theories led to creating different curriculum designs, it has been assumed that differences among designs explain academic success and, therefore, students' retention. However, little attention has been given to examine explicitly how diverse designs influence dropout rates in practice, which questions if decisions to reform curricula are sufficiently informed. This article describes our curriculum reform, which exposes our former and current curriculum designs as having had dissimilar dropout percentages. Furthermore, we aimed to explore the influence of different curriculum designs on students' dropout rates. The conclusion is that dropout variations may be explained not only because of the curriculum design itself, but also because of the power relationship changes between teachers and students that brought out the design change. Consequently, more research is needed to fully understand the political implications of different curriculum designs and their influence on dropout rates.

Good supervision during clinical placements is essential for the medical student's learning process. Supervision of medical students can, however, be challenging for doctors and resident physicians, and it can also be challenging for students to request this supervision. Here we give 5 tips for provision of good supervision and 5 tips for requesting good supervision, on the basis of three relevant educational theories - 'self-regulated learning', 'cognitive apprenticeship', and 'communities of practice'.

Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

BACKGROUND: Medical education in Sub-Saharan Africa is in need of reform to promote the number and quality of physicians trained. Curriculum change and innovation in this region, however, face a challenging context that may affect curriculum outcomes. Research on outcomes of curriculum innovation in Sub-Saharan Africa is scarce. We investigated curriculum outcomes in a Sub-Saharan African context by comparing students' perceived preparedness for practice within three curricula in Mozambique: a conventional curriculum and two innovative curricula. Both innovative curricula used problem-based learning and community-based education.METHODS: We conducted a comparative mixed methods study. We adapted a validated questionnaire on perceived professional competencies and administered it to 5th year students of the three curricula (n = 140). We conducted semi-structured interviews with 5th year students from these curricula (n = 12). Additional contextual information was collected. Statistical and thematic analyses were conducted.RESULTS: Perceived preparedness for practice of students from the conventional curriculum was significantly lower than for students from one innovative curriculum, but significantly higher than for students from the other innovative curriculum. Major human and material resource issues and disorganization impeded the latter's sense of preparedness. Both innovative curricula, however, stimulated a more holistic approach among students toward patients, as well an inquiring and independent attitude, which is valuable preparation for Sub-Saharan African healthcare.DISCUSSION: In Sub-Saharan Africa, risks and benefits of curriculum innovation are high. Positive outcomes add value to local healthcare in terms of doctors' meaningful preparedness for practice, but instead outcomes can be negative due to the implementation challenges sometimes found in Sub-Saharan African contexts. Before embarking on innovative curriculum reform, medi

BACKGROUND: Medical education in Sub-Saharan Africa is in need of reform to promote the number and quality of physicians trained. Curriculum change and innovation in this region, however, face a challenging context that may affect curriculum outcomes. Research on outcomes of curriculum innovation in Sub-Saharan Africa is scarce. We investigated curriculum outcomes in a Sub-Saharan African context by comparing students' perceived preparedness for practice within three curricula in Mozambique: a conventional curriculum and two innovative curricula. Both innovative curricula used problem-based learning and community-based education.METHODS: We conducted a comparative mixed methods study. We adapted a validated questionnaire on perceived professional competencies and administered it to 5th year students of the three curricula (n = 140). We conducted semi-structured interviews with 5th year students from these curricula (n = 12). Additional contextual information was collected. Statistical and thematic analyses were conducted.RESULTS: Perceived preparedness for practice of students from the conventional curriculum was significantly lower than for students from one innovative curriculum, but significantly higher than for students from the other innovative curriculum. Major human and material resource issues and disorganization impeded the latter's sense of preparedness. Both innovative curricula, however, stimulated a more holistic approach among students toward patients, as well an inquiring and independent attitude, which is valuable preparation for Sub-Saharan African healthcare.DISCUSSION: In Sub-Saharan Africa, risks and benefits of curriculum innovation are high. Positive outcomes add value to local healthcare in terms of doctors' meaningful preparedness for practice, but instead outcomes can be negative due to the implementation challenges sometimes found in Sub-Saharan African contexts. Before embarking on innovative curriculum reform, medi

Introduction Statistical data on prevalence of tinnitus in India and on the relationship between exposure to recreational sound/music and the presence of tinnitus are scarce. This study was conducted to assess relationship between tinnitus and the use of personal sound system(PSS) in medical students. Materials and Methods A questionnaire based study was conducted on 100 randomly selected medical students to assess their sound habits with the use of PSS. Information on commonly used intensity, frequency, duration of use, type of earphones and severity of tinnitus was sought. Conventional frequency audiometry (0.25-8kHz) was also performed. Result The prevalence of tinnitus was found to be 33%, which was on the higher side of the global prevalence data. All the medical students surveyed in this study used personal sound system. Majority of the students (45%) used PSS less than 1 hour daily. More than 60% of the students complaining of tinnitus preferred louder settings in their PSS. Discussion The most common personal sound system used was mobile phones. No statistically significant association was seen with relation to the type of personal sound system, the type of ear phone used, average duration of use and hearing loss. Tinnitus was found to have statistically significant association with volume in our study with majority having tinnitus listening to higher levels of sound. Conclusion Use of personal sound system is common in medical students. Though duration of use of the personal sound system was not associated with the complaint of tinnitus, exposure to louder sounds had statistically significant association with tinnitus.&nbsp

Introduction Statistical data on prevalence of tinnitus in India and on the relationship between exposure to recreational sound/music and the presence of tinnitus are scarce. This study was conducted to assess relationship between tinnitus and the use of personal sound system(PSS) in medical students. Materials and Methods A questionnaire based study was conducted on 100 randomly selected medical students to assess their sound habits with the use of PSS. Information on commonly used intensity, frequency, duration of use, type of earphones and severity of tinnitus was sought. Conventional frequency audiometry (0.25-8kHz) was also performed. Result The prevalence of tinnitus was found to be 33%, which was on the higher side of the global prevalence data. All the medical students surveyed in this study used personal sound system. Majority of the students (45%) used PSS less than 1 hour daily. More than 60% of the students complaining of tinnitus preferred louder settings in their PSS. Discussion The most common personal sound system used was mobile phones. No statistically significant association was seen with relation to the type of personal sound system, the type of ear phone used, average duration of use and hearing loss. Tinnitus was found to have statistically significant association with volume in our study with majority having tinnitus listening to higher levels of sound. Conclusion Use of personal sound system is common in medical students. Though duration of use of the personal sound system was not associated with the complaint of tinnitus, exposure to louder sounds had statistically significant association with tinnitus.&nbsp

Introduction Statistical data on prevalence of tinnitus in India and on the relationship between exposure to recreational sound/music and the presence of tinnitus are scarce. This study was conducted to assess relationship between tinnitus and the use of personal sound system(PSS) in medical students. Materials and Methods A questionnaire based study was conducted on 100 randomly selected medical students to assess their sound habits with the use of PSS. Information on commonly used intensity, frequency, duration of use, type of earphones and severity of tinnitus was sought. Conventional frequency audiometry (0.25-8kHz) was also performed. Result The prevalence of tinnitus was found to be 33%, which was on the higher side of the global prevalence data. All the medical students surveyed in this study used personal sound system. Majority of the students (45%) used PSS less than 1 hour daily. More than 60% of the students complaining of tinnitus preferred louder settings in their PSS. Discussion The most common personal sound system used was mobile phones. No statistically significant association was seen with relation to the type of personal sound system, the type of ear phone used, average duration of use and hearing loss. Tinnitus was found to have statistically significant association with volume in our study with majority having tinnitus listening to higher levels of sound. Conclusion Use of personal sound system is common in medical students. Though duration of use of the personal sound system was not associated with the complaint of tinnitus, exposure to louder sounds had statistically significant association with tinnitus.&nbsp

BACKGROUND: Peer-assisted learning (PAL) is increasingly used in medical education, and the benefits of this approach have been reported. Previous reviews have focused on the benefits of peer tutoring of junior students by senior students. Forms of PAL such as discussion groups and role-playing have been neglected, as have alternative teacher-learner configurations (e.g. same-level PAL) and the effects on other stakeholders, including clinician educators and patients. This review examines the benefits of same-level PAL for students, clinician educators and patients in pre-registration clinical medical education. METHODS: Medline, PsycINFO, CINAHL and ERIC were searched in March 2014. A total of 1228 abstracts were retrieved for review; 64 full-text papers were assessed. Data were extracted from empirical studies describing a same-level PAL initiative in a clinical setting, focusing on effects beyond academic performance and student satisfaction. Qualitative thematic analysis was employed to identify types of PAL and to cluster the reported PAL effects. RESULTS: Forty-three studies were included in the review. PAL activities were categorised into role-play, discussion, teaching and assessment. Only 50% of studies reported information beyond self-report and satisfaction with the PAL intervention. Benefits for students (including development of communication and professional skills) and clinician educators (developing less-used facilitation skills) were reported. Direct patient outcomes were not identified. Caveats to the use of PAL emerged, and guidelines for the use of PAL were perceived as useful. CONCLUSION: Many student-related benefits of PAL were identified. PAL contributes to the development of crucial skills required for a doctor in the workplace. Vertical integration of learning and teaching skills across the curriculum and tools such as feedback checklists may be required for successful PAL in the clinical environment. Ben

BACKGROUND: It is unknown whether fasting has any impact on surgical performance. This simulator-based study investigates whether fasting affects surgical performance.METHODS: Twelve healthy medical students [seven women, mean age 26.5 years (range 23-34)] with no prior experience with surgical simulators underwent a short course introduction to the LapSim(®) simulator. After having reached a predefined level, the participants performed five simulated salpingectomies on the LapSim(®) simulator 5-30 days after the initial introduction. The procedures took place at 9 a.m. and 2 p.m. after fasting from 9 p.m. the previous day. Time used to complete the procedure, instrument movements and "blood loss" were registered.RESULTS: The participants performed significantly better at 2 p.m. compared with 9 a.m. with regard to time, "blood loss" and instrument movements except from instrument movements in the longitudinal axis with the left hand.CONCLUSION: The simulator-based study suggests that 17 h of fasting does not deteriorate surgical performance. Further studies on the effect of fasting on surgical performance are needed.