The effect of a compulsory curriculum on ethical attitudes of medical students

The purpose of the present study was to assess the influence of a compulsory curriculum on first-year medical students. The ethical attitude study was performed at the School of Medicine, University of Rijeka, Croatia. The samples consisted of 171 medical students (68 males and 103 females) interviewed at the beginning of the first year of studies. Some of them, namely 143 (56 males and 87 females) were interviewed again at the end of the same academic year. Data were analysed by applying factor analysis under principal component model and varimax criterion as the rotation model. The results clearly show that the current compulsory curriculum without formal ethical education has a limited influence on first-year medical students. That points to the obvious necessity to implement the medical ethics in the course of medical education.     

Attitudes of medical staff towards the psychiatric label "schizophrenic patient" tested by an anti-stigma questionnaire

The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in questions 10, 13, 22, 23. The results point to the existence of prejudices and stigmatizing attitudes in all three investigated groups. The most frequent reasons for stigmatizing attitude of students are based on fear and insufficient knowledge about mental patients and schizophrenia as a disease, while there are a high percentage of positive answers to the questions on rehabilitation and resocialization. The nurses/technicians also show a high degree of mistrust towards schizophrenic patients and mostly answer with "I don't know", thus presenting insufficiently formed attitudes about the mentioned problems. The physicians in their answers confirm fear, mistrust and stigmatizing attitudes towards schizophrenic patients found in general population in Croatia. The consequences of such attitudes are the low quality of life of schizophrenic patients, and slow, often incomplete, resocialization.     

Undergraduate teaching in gerodontology in Leipzig and Zürich – a comparison of different approaches

Objective: To evaluate undergraduate students’ attitude towards the clinical components of the Leipzig (LPEG) and Zürich (ZPEG) Programmes of Education in Gerodontology. Background: Undergraduate student education is the seedbed for conscientious professionals. Extramural clinical education contributes to the formation of positive attitudes. Students in Zürich participate in three clinical activities (in‐house gerodontology clinic, extramural acute geriatrics ward, mobile dental service), in Leipzig they visit a long‐term care facility on six occasions within 4 years. Methods: A structured questionnaire with 10 items was administered to students in Leipzig [n = 34, 70.6% female, mean age 25.8 (SD 3.04) years] at the beginning and after completion of gerodontology training and to students in Zürich [n = 33, 48.5% female, mean age 27.0 (SD 3.28) years] on three occasions after clinical training. Students indicated the degree of their agreement with seven statements presented using a 5‐point scale. A choice of responses which characterised the course was offered for assessment. Results: Close collaboration with dental tutors, while self‐treating patients in the mobile dental service (mobiDent^?) attracted the most positive responses. Ratings from students completing their training in Leipzig were less favourable than their initial responses. Conclusion: The lack of a dental service and Leipzig students’ inability to offer treatment in the presence of disease was associated with frustrations. Practical training should go beyond dental examinations at a long‐term care facility and include the opportunity for dental treatment. Personnel and equipment required for mobile treatment exceed resources available at most German dental schools.     

Science attitudes and knowledge among preclinical medical students in Pokhara, Nepal

Knowledge of science and the scientific method are important in learning about and using evidence-based medicine in practice. Courses in research methodology have been introduced for both medical students and practicing doctors. In Pokhara, the basic science subjects are taught in an integrated manner during the first four semesters of the undergraduate medical course. Studies on students' attitudes towards and knowledge of science are lacking in medical colleges in Nepal. Hence the study was carried out to obtain information on students' attitude towards and knowledge of science and scientific methodology among preclinical medical students and note the association, if any, of students' attitudes and their demographic characteristics. The study was carried out in March 2005 among the students of the first four semesters at the Manipal College of Medical Sciences, Pokhara, Nepal using a questionnaire developed by Hren and coworkers. Two hundred and twenty students (overall response rate 73.3%) successfully completed the questionnaire. Seventy-five respondents were Nepalese, 115 were Indians, 27 were Sri Lankans and 3 belonged to other nationalities. The X +/- SD total attitude score was 147.4 +/- 10.8 (neutral score 135). The X +/- SD scores on the subscales, value of science to humanity, value of scientific methodology and value of science to medicine were 51.3 +/- 5.4, 39.6 +/- 3.7 and 58.5 +/- 5.9 (neutral scores were 36, 51 and 48 respectively). The knowledge score measured using a set of 8 multiple choice questions was 3.3 +/- 1.4. The attitude scores were lower and the knowledge score was comparable to that reported previously in a study in Croatia but higher than that reported from Southeast Europe.     

Local advisers for the teaching of microbiology in schools

The purpose of this study was to examine the effect of formal teaching of ethical issues related to science on middle school students' attitudes towards science and science achievement. A total of 132 Grade 8 (age 13 – 14years) students in Seoul participated, who were divided into the control and the experimental group. Student attitude toward science was assessed using a questionnaire before and after the intervention which composed of five sub-categories: students' interest level in science, students' perception of the practicality of science knowledge, student's opinion on how science is defined, students' perception of the relationships within science, scientists and society, and students' perception of the value of science. The study further examined whether teaching ethical issues in science had any effect on students' achievement level by means of a pre- and post-test evaluation.

The results of this study showed that teaching ethical issues in science had a positive influence on the students' attitudes toward science, specifically, the interest level in science (p = 0.028) and perception of practicality of science knowledge (p = 0.044). However, there was no statistically significant difference in science achievement level between the control and experimental groups. The results imply that there is a need to explore ethical issues in science education, and that incorporating various materials on the ethical perspectives of science and technology in educational material will promote students' positive attitude towards science.     

Denture repairs in different regions of Croatia in relation to prosthodontic teams

The purpose of this paper is to evaluate the incidence of denture repairs in different districts of Croatia through the year of 2002. and to analyse the percentage of different repairs (relinings, simple repairs up to 2 elements and complicated repairs-more than 2 elements) in relation to prosthodontic teams. Data on the number of dentures, and the number and types of denture repairs delivered in the Croatian regions of Zagreb, Rijeka, Split and Karlovac were obtained from the Croatian Institute for Health Insurance for the whole of the year 2002. Information of the number of prosthodontic teams operating in those regions was also obtained. Proportionally more denture repairs were carried out in Karlovac (18%) than Split (5%). The smallest percantage of dentures that required relining was registered in Split and the highest in Rijeka (chi2 = 36.7, p < 0.01). The smallest percentage of simple repairs was registered in Rijeka and the highest in Split (chi2 = 24.3, p < 0.01). The smallest percentage of complicated repairs was registered in Split and the highest in Karlovac. In each region the proportion of denture repairs and types of repairs were correlated with a number of prosthodontic teams in that region. Karlovac had the smallest percentage of specialistic prosthodontic teams and the highest rate of denture repairs.     

A model in environmental training--The University / Elementary School / Municipality Cooperation

This study targets development of an effective training scheme model that can be implemented at elementary school level with focus on recovery and recycling of wasted papers in Turkey. For this purpose, three schools were chosen from a district within Istanbul. They were separated from one another as full intervention (FI), semi-intervention (SI) and control (C) schools. Different levels of educational activities carried out in the schools, mostly in the FI school, were directed toward being informative as regards recycling and the development of a positive attitude. Afterwards, in order to evaluate the effects of the training, paper wastes were collected in recycle bins placed at appropriate points in schools and weighed on a weekly basis. Quite a significant result was found (p = 0.0001), when the difference was calculated through the Kruskal Wallis Variance Analysis method, regarding the weekly average amount of paper in each of the three schools against per person. Furthermore, when the results were evaluated and compared as to the ones before the 2.5 months summer vacation and the ones after it, the seven measurements taken before (p = 0.001) and the eight taken afterwards (p = 0.0001), were found to have valid differences, once again, as against schools. The results show that the approach we provided to education is an effective method not only for the collection of paper wastes but also for applications in various areas of health education.     

Prevalence and risk factors of alcohol abuse among university students from eastern Croatia: questionnaire study

The aim of the study was to examine the prevalence of alcohol abuse among university students in Osijek, Croatia and its possible interconnections with gender, year of study, repetition of year of study, faculty subject area, sources of financing and type of residence during study. A validated questionnaire was self-administered to cross-faculty representative student sample of "J. J. Strossmayer" University of Osiek in June 2006. General demographic data, as well as data on academic features and student socio-economical status were obtained. The Alcohol Use Disorders Identification Test (AUDIT) was used for assessing the extent of alcohol consumption, with cut off value of 8 indicating possible alcohol problems. The majority of study participants 90.9% (755/831) had tried alcohol at least once in their life. Among this group, 43.8% (331/755) had an AUDIT total score of 8 or more: 69.2% (229/331) were males and 30.8% (102/331) were females. Among the study participants who screened positive, 70.4% (233/331) responded positively to simple advice focused on the reduction of hazardous drinking (AUDIT 8-15), 14.5% (48/331) needed brief counseling and continued monitoring (AUDIT 16-19), and 15.1% (50/331) clearly warranted further diagnostic evaluation for alcohol dependence (AUDIT 20 and above). Significantly different statistical data was found within the following factors: gender, repetition of year of study, faculty subject area and type of residence (chi2 = 76.232, p = 0.0000; Fisher exact test = 31.828, p = 0.0000; chi2 = 11.667, p = 0.0086 and chi2 = 6.639, p = 0.0362 respectively). Alcohol consumption resulting in risk behaviors is common among university students from eastern Croatia. These findings emphasize the need for comprehensive and effective preventative strategies directed towards student population.     

Correlation of levels of depressiveness and choice of elective subjects in medical students

The aim of this research was to establish if a correlation exists between the choice of an elective subject, namely subjects "Depression" and "Diabetes", and levels of depressiveness in medical students. Three groups of third year medical students attending School of medicine, Rijeka University, were tested for the level of depression using Beck's self-evaluation scale. The groups consisted of 30 non-randomly selected students that had enrolled elective subject "Depression" and 29 non-randomly selected students that had enrolled elective subject "Diabetes", and the third group of 30 randomly selected third year medical students that had enrolled none of the previously mentioned elective subjects. Median age of participants in this research was 25.24. The results showed no statistically significant difference in overall level of depressiveness among the groups. By testing for the difference between group pairs, there was a statistically significant difference between depressiveness in students attending "Depression" and "Diabetes", the latter being significantly more depressed (M = 8.30 in "Depression" group; M = 11.41 in "Diabetes" group; p = 0.04). In total there were 33 males and 56 females that participated in this research. Gender difference was also tested, and there was no statistically significant difference between sexes among groups. The difference was found only within the group of students attending "Depression" elective subject, where females scored significantly higher on Beck's questionnaire (z = 2.26; p = 0.03). The analysis of difference between items of the Beck's questionnaire showed statistically significant difference in the item "Feeling of rejection", where students attending elective subjects other then "Depression" scored significantly higher; differences in the items "Urge for punishment" and "Suicidal tendencies" were also found between "Diabetes" and "other elective subjects" group, in favor of "Diabetes" group; in the item "Weight loss" students attending "Diabetes" elective subject scored significantly higher then their peers in both other groups. The results indicate the possibility of a protective role of psycho-educative component provided to the students attending elective subject on depression within medical school environment, that has repeatedly been shown to be stressful and demanding and is beneficial for the onset of depressive disorders.     

Organization of the "Marine Colony" for children with tuberculosis in Rijeka (Croatia): entanglement between medicine and politics

Tuberculosis was a major public health concern in the beginning of the 20th century. Since medications were not available at the time, therapy in general was based on health education, healing effects of climate, nutrition and rest. The Marine Colony was founded in 1924 in Rijeka, a city with turbulent political history, by the Antitubercular Consortium which was part of a planned program for the fight against tuberculosis on a national level in the whole of Italy. The Colony in Rijeka, Croatia specialised in care of children with clinical tuberculosis or under greater risk of developing disease. This article gives an overview of the medical treatment provided for children in Colony, as well as pointing out the political-agenda at that period.     

Undergraduate education in gerodontology in Germany: the Leipzig Programme

Objective: To evaluate students’ attitude towards the clinical component of the Leipzig Programme of undergraduate Education in Gerodontology (LPEG). Background: Undergraduate student education has long been recognised as a mainstay of fostering the aims of gerodontology. Extramural clinical education with direct exposure to various groups of vulnerable elderly is known to contribute to the formation of positive attitudes. LPEG has been designed to include didactic components and six visits to a long‐term care facility (LTC) spread over 4 of the 5 years of the dental course. Methods: A structured questionnaire with 10 items was administered to 230 students (60.9% female) on three occasions in 2004–05. Total return was 411 questionnaires. The mean age of respondents was 24.3 (SD 2.67) years. Students were asked to indicate the degree of their agreement with seven statements presented using a 5‐point scale. A choice of responses which characterised the course was offered to mark all those deemed agreeable. Results: The vast majority of students responded positively. In the students perception there was no significant difference (Kruskal–Wallis p = 0.24) in the amount of knowledge acquired between subjects participating once, twice or three times. ‘Interesting’ and ‘feel pity for patients’ were the two items that received the most support. Respondents expressed the wish to accompany up to 10 patients during their course with a mean of 3.5 (SD 2.9) but 31 (7.5%) subjects did not wish to see any frail elderly patients at all. Conclusion: The LPEG is well received by dental students. A complex subject including overarching social skills has been integrated seamlessly into the dental curriculum.     

Effectiveness of School-based Education on HIV/AIDS Knowledge, Attitude, and Behavior among Secondary School Students in Wuhan, China

Background

Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are among the most complex health problems in the world. Young people are at high risk of HIV and AIDS infections and are, therefore, in need of targeted prevention. School-based HIV/AIDS health education may be an effective way to prevent the spread of AIDS among adolescents.

Methods

The study was a school-based intervention conducted in three middle schools and two high schools in Wuhan, China, which included 702 boys and 766 girls, with ages from 11 to 18 years old. The intervention was a one-class education program about HIV/AIDS for participants. HIV/AIDS knowledge, attitude, and high-risk behaviors were investigated using an anonymous self-administered questionnaire before and after the education intervention. Chi-square test was used to compare differences before and after the intervention. Non-conditional logistic regression analysis was used to identify the factors that affect HIV/AIDS knowledge.

Results

Misconceptions about basic medical knowledge and non-transmission modes of HIV/AIDS among all the students prevail. Approximately 10% to 40% of students had negative attitudes about HIV/AIDS before the intervention. After the intervention, all of the students had significant improvements in knowledge and attitude about HIV/AIDS (P<.05), indicating that educational intervention increased the students’ knowledge significantly and changed their attitudes positively. Logistic regression analyses indicated that before the intervention the students’ level of knowledge about HIV/AIDS was significantly associated with grade, economic status of the family, and attitudes toward participation in HIV/AIDS health information campaigns.

Conclusions

HIV/AIDS education programs were welcomed by secondary students and positively influenced HIV/AIDS-related knowledge and attitudes. A systematic and long-term intervention among secondary school students must be conducted for the prevention of HIV.     

Examining psychic consequences in firefighters exposed to stress

The total of 178 firefighters from the Littoral Mountainous County, the Republic of Croatia, have undergone psychotestings in three groups--99 professionals from city Rijeka, 44 professionals from suburb and 35 volunteers from suburb. The scores of PSS 10 Cohen Stress Perception Scale, COPE questionnaire, STAI X1 anxiety test as condition and STAI X2 anxiety test as trait personality and Beck Depression Inventory were analyzed. The results have shown that firefighters do not suffer from negative effects of stress. There is slight anxiety as condition in city firefighters and medium anxiety as trait personality in all firemen. All firefighters are often problem-oriented, need only occasionally compassion of environment and sometimes react by avoiding to face stress. They differ significantly by depression (p < 0.001), which is negligible in relation to ordinary population. "Working anxiety", i.e. medium anxiety which is a distinctive trait of their personality becomes the necessary initiator of functioning in the most difficult working conditions.     

“Sharks in Your Hands”—A Case Study on Effects of Teaching Strategies to Change Knowledge and Attitudes Towards Sharks

This study was designed to exemplify how hands-on based teaching strategies enhanced students’ knowledge and positive attitudes towards sharks. Hands-on activities for sharks’ biological and morphological features were carried out. Eleven elementary school students from a remote area in Taiwan were recruited and assigned to the hands-on condition. They were encouraged to draw pictures of sharks before and after the instruction as the main data for pre- and post-test comparison. Two years later, the retention test and attitude inventory towards sharks were implemented. The results revealed that large effect size emerged for both the post-test and retention test. In regards to attitude inventory, students involved in hands-on activities also significantly outperformed the baseline group. Many of them have taken notice of television programs and books about sharks or marine ecology since the hands-on activities, indicating the instruction had a beneficial impact on their extracurricular lives. Empirical findings of this study suggest hands-on instruction is a powerful strategy for learning, both for immediate and prolonged effects on improving students’ knowledge and attitudes toward sharks.     

Instructors' practices in and attitudes toward teaching ethics in the genetics classroom

There is strong consensus among educators that training in the ethical and social consequences of science is necessary for the development of students into the science professionals and well-rounded citizens needed in the future. However, this part of the curriculum is not a major focus of most science departments and it is not clear if, or how, students receive this training. To determine the current status of bioethics education of undergraduate biology students in the United States, we surveyed instructors of introductory genetics. We found that there was support for more ethics education both in the general curriculum and in the genetics classroom than is currently being given. Most instructors devote <5% of class time to ethical and social issues in their genetics courses. The majority feels that this is inadequate treatment of these topics and most cited lack of time as a major reason they were unable to give more attention to bioethics. We believe biology departments should take the responsibility to ensure that their students are receiving a balanced education. Undergraduate students should be adequately trained in ethics either within their science courses or in a specialized course elsewhere in the curriculum.     

Presenteeism towards absenteeism: manual work versus sedentary work, private versus governmental--a Croatian review

The research objectives were to find out the extent of presenteeism and absenteeism in manual workers and whether it differs in clerks that perform sedentary jobs. For that purpose 121 manual workers of "3.maj" were polled, of whom 61 are employed by the shipyard in state ownership and 60 are sub-contracted workers. Also 120 clerks were interviewed, 60 postal employees of "Telecom" Zadar and 60 of the police administration. The Stanford Presenteeism Scale (SPS-6), the internationally recognized questionnaire for assessing presenteeism was used as well as the Rijeka Presenteeism Scale (RPS-6), the new questionnaire compiled for this research, and also the Rijeka Absenteeism Scale (RAS-6). The results have shown that in our country the RPS-6 test is adequate for assessment of presenteeism with high reliability for this type of testing, Crombach's alpha = 0.757. The RAS-6 test has shown a low level of reliability and so have our questions on absenteeism which therefore cannot be considered an official scale. All four groups of employees have shown high positive presenteeism with no considerable differences, p = 0.3610, p > 0.05. Only when the question referred to one's performing efficient work with maximum care there were considerable differences p = 0.023, p < 0.05. The research has shown that the use of SPS-6 is not suitable in our parts probably because of cross-cultural differences, reasoning and speech differences. The research has also shown that the notion presenteeism as a positive presenteeism has to be distinguished from the "sickness-presenteeism" for which the SPS-6 scale could conditionally be suitable, which showed medium presenteeism in our workers, but that cannot be considered reliable due to low correlations. To conclude, although the workers show good, positive presenteeism the working conditions are to be further enhanced as well as the contact with the company management, to maintain such presenteeism and not to exhaust the worker's positive energy.     

Control of urinary schistosomiasis on Zanzibar (Unguja Island): a pilot evaluation of the educational impact of the Juma na Kichocho health booklet within primary schools

To improve health education within primary schools, the health education booklet "Juma na kichocho" was evaluated during a study within 5 schools using key-informant questionnaires that recorded children's knowledge and attitude (KA) towards schistosomiasis before and after daily structured-use of booklets. A total of 229 schoolchildren (114 boys : 115 girls) of between 11 and 15 years of age were interviewed and re-assessed after a working school week. Existing and putative booklet-induced changes in KA scores for schistosomiasis were compared directly against equivalent KA scores for malaria. In total 47.4% of children were already aware that schistosomiasis was a water-borne disease while only 10.5% knew of its exact aetiology; after booklet intervention these levels increased to 54.6 and 15.7%, respectively. The majority of children still failed, however, to realise that re-infection could take place soon after treatment. While a positive increase was observed for children's total KA questionnaire scores for both malaria and schistosomiasis after booklet intervention, these were not statistically significant. In the context of control, further educational efforts are needed to promote and guide behavioural change, especially in relation to reduction of environmental water contact.     

A Three-Lesson Teaching Unit Significantly Increases High School Students’ Knowledge about Epilepsy and Positively Influences Their Attitude towards This Disease

Epilepsy is not a regular topic in many countries’ schools. Thus many people harbor misconceptions about people suffering from this disease. It was our aim to a) examine what grade ten students know and believe about epilepsy, and b) to develop and test a teaching unit to improve their knowledge and attitude. The test group comprised eight grade ten classes from six different Austrian high schools (54 girls and 51 boys aged 14–17), the control group (no intervention) five grade ten classes from the same schools (26 girls and 37 boys aged 14–17). The teaching unit consisted of three 45-min lessons using different methods and material. Changes in knowledge about and attitude towards epilepsy as a result of the intervention were psychometrically assessed in a pre-test intervention post-test design (along with a follow-up assessment two months after the intervention) by means of a questionnaire capturing different facets of epilepsy-related knowledge and attitude. Across all knowledge/attitude domains, students of the test group had a significantly improved knowledge about and a more positive attitude towards epilepsy and people suffering from it after the teaching unit. However, starting levels were different between the five knowledge/attitude domains tested. Medical background knowledge was lowest and consequently associated with the highest increase after the intervention. This study shows that epilepsy-related knowledge of many grade ten high school students is fragmentary and that some harbor beliefs and attitudes which require improvement. Our comprehensive but concise teaching unit significantly increased knowledge about epilepsy and positively influenced attitude towards individuals with epilepsy. Thus we recommend implementing this unit into regular school curricula.     

Paint and Paper Creations

This article investigates generalist kindergarten teachers’ academic music training based on data collected from students undertaking an undergraduate degree in preschool (kindergarten) education (students aged 4–6 years) in Greece. The study was carried out through a questionnaire survey that addressed students’ aspirations when entering the university and the real learning outcomes by the end of their studies. This article seeks to find relationships between students’ academic experiences and their level of confidence and enthusiasm to teach music in kindergarten. The findings suggest that higher education provides students with most of the learning outcomes that they anticipate. However, students lack adequate practical experiences in terms of observing lessons in real educational settings, which can significantly affect their confidence levels. Finally, the author explores some implications for higher education policy and teaching practice.     

Quality of screening for diabetic retinopathy in the Rijeka region of Croatia

The aim of this study was to compare the quality of screening for diabetic retinopathy in cities of Rijeka and Zagreb, Croatia. Review of a random sample of 500 diabetic patient records and prospective ophthalmologic survey of 466 randomly selected diabetic patients in a secondary level diabetologic service in Rijeka (coastal region of Croatia). The main outcome measures were proportion of diabetic patient records with notes on ophthalmologic examination; rate of diabetic patients involved with screening for diabetic retinopathy; comparison with rates in Zagreb (Croatian capital). A total of 67% patients visited the ophthalmologist at least once after diagnosed with diabetes, and notes on ophthalmologic examination were found in only 28% patient records. Fifty percent of patients underwent an ophthalmologic examination within two years. Only one third of patients diagnosed with DM in last two years visited the ophthalmologist within this time, and 14% of patients older than 50 years never visited the ophthalmologist. Model of screening for diabetic retinopathy in Croatia works better in Zagreb than in Rijeka region, and needs certain improvements. The authors suggested modern methods of screening, the incorporation of the mechanisms of quality control, the obligatory reporting of newly diagnosed diabetic patients to the national registry, and the direct referral from diabetologist to ophthalmologist.