Medical Students’ Attitudes toward Abortion Education: Malaysian Perspective

Background

Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools.

Methods and Results

A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity.

Conclusions

Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights.     

Medical Students’ Attitudes towards Overweight and Obesity

Objective

Studies from the USA have identified medical students as a major source of stigmatizing attitudes towards overweight and obese individuals. As data from Europe is scarce, medical students’ attitudes were investigated at the University of Leipzig in Leipzig, Germany.

Design

Cross-sectional survey containing an experimental manipulation consisting of a pair of vignettes depicting an obese and a normal weight 42-year-old woman, respectively. Vignettes were followed by the Fat Phobia Scale (FPS), a semantic differential assessing weight related attitudes. In case of the overweight vignette a panel of questions on causal attribution for the overweight preceded administration of the FPS.

Subjects

671 medical students were enrolled at the University of Leipzig from May to June 2011.

Results

The overweight vignette was rated significantly more negative than the normal weight vignette (mean FPS score 3.65±0.45 versus 2.54±0.38, p<0.001). A higher proportion of students had negative attitudes towards the overweight as compared to the normal weight individual (98.9% versus 53.7%, p<0.001). A “positive energy balance” was perceived as the most relevant cause for the overweight, followed by “negligent personality trait”, “societal and social environment” and “biomedical causes”. Attributing a “positive energy balance” or “negligent personality trait” as relevant cause for the overweight was positively associated with negative attitudes.

Conclusion

The results of this study confirm and complement findings from other countries, mainly the USA, and indicate that weight bias in the health care setting may be a global issue. Stigmatizing attitudes towards overweight and obesity are prevalent among a sample of medical students at the University of Leipzig. Negative attitudes arise on the basis of holding the individual accountable for the excess weight. They call for bringing the topic of overweight and obesity more into the focus of the medical curriculum and for enhancing medical students’ awareness of the complex aetiology of this health condition.     

Rural and Urban Students’ Perceptions of and Attitudes toward Brown Bears in Turkey

Many studies have examined adults’ perceptions of and attitudes toward large carnivores to assess human–wildlife conflict and inform conservation strategies, but there have been few studies concerning children. I studied secondary school students’ perceptions of and attitudes toward brown bears (Ursus arctos) and other large mammals in Turkey via a questionnaire survey. The questionnaire, consisting of 18 questions, was completed by 215 rural and 98 urban secondary school students. Both sets of students liked bears; they were also afraid of them and unsure about living with them in the future. While there were no gender differences in attitudes and perceptions, there were marked differences between urban and rural students. Urban students had less contact with nature, gained more of their knowledge about bears from documentaries, and had less positive attitudes toward bears. They were also more likely to be afraid of species not present in Turkey, for example, anaconda, while rural students were most afraid of wild boars. Factor analysis identified three important themes: familiarity with bears, conservation of bears, and experiencing conflict with bears, which explained 49.8% of the variance in attitudes toward bears. The most important factor for the development of negative attitudes toward bears was personal experience of human–bear conflict, suggesting that measures to reduce human–bear conflict in rural areas may help to sustain students’ positive attitudes toward the conservation of bears.     

Medical Students’ Perceptions of Clinical Teachers as Role Model

Introduction

Role models facilitate student learning and assists in the development of professional identity. However, social organization and cultural values influence the choice of role models. Considering that the social organization and cultural values in South East Asia are different from other countries, it is important to know whether this affects the characteristics medical students look for in their role models in these societies.

Methods

A 32 item questionnaire was developed and self-administered to undergraduate medical students. Participants rated the characteristics on a three point scale (0 = not important, 1 = mildly important, 2 = very important). One way ANOVA and student''s t-test were used to compare the groups.

Results

A total of 349 (65.23%) distributed questionnaires were returned. The highest ranked themes were teaching and facilitating learning, patient care and continuing professional development followed by communication and professionalism. Safe environment and guiding personal and professional development was indicated least important. Differences were also observed between scores obtained by males and females.

Conclusion

Globally there are attributes which are perceived as essential for role models, while others are considered desirable. An understanding of the attributes which are essential and desirable for role models can help medical educators devise strategies which can reinforce those attributes within their institutions.     

Women’s Knowledge,Attitudes and Behavior about Maternal Risk Factors in Pregnancy

Background

The aims of this study were to assess the levels of knowledge, attitudes and behaviors of women about the main maternal risk factors in pregnancy and to identify the factors linked to the main outcomes of interest.

Materials and Methods

A cross-sectional survey was conducted in 513 pregnant women randomly selected from the gynecological ambulatory services of five hospitals located in Naples, Italy.

Results

Only 42% of women correctly knew all the main maternal risk factors in pregnancy (alcohol, smoking, passive smoking and obesity). Only 21.7% of women were very worried about causing harm to the fetus or child with their risk behaviors, and 22.3% of women reported smoking during pregnancy. Approximately one-third of women (28.9%) reported regularly drinking alcohol before pregnancy and 74.8% of these women reported stopping drinking alcohol during pregnancy. However, only 27.3% of women who were drinking alcohol during pregnancy had the intention of stopping. Only 43.7% of women indicated that during ambulatory gynecological examinations they received information from physicians about the possible damage resulting from all the main risk factors in pregnancy (alcohol, smoking, passive smoking and obesity).

Conclusion

The results indicate that pregnant women lack knowledge regarding the main maternal risk factors. Pregnant women claim to receive little information during gynecological examinations and, therefore, some continue to smoke and drink alcohol during pregnancy. Our results suggest an urgent need for the design of interventions to improve women’s levels of knowledge and to promote appropriate behavior in relation to the major risk factors in pregnancy.     

Continuing Medical Education: Planning and Goals Conference in Continuing Medical Education—Workshop Recommendations

Following are recommendations drawn up by workshops held as a part of the Planning and Goals Conference in Continuing Medical Education, sponsored by the California Medical Association and directed by its Committee on Continuing Medical Education, San Diego, 11 to 12 March 1967. The general subject was divided among four workshops and the reports of two of them—No. 1, (a) and (b), and No. 2—were printed in the August issue of California Medicine. The Reports herewith are those of the other two workshops.The conference was supported in part by Contract No. PH 108-67-158, Bureau of Health Manpower, Public Health Service, Department of Health, Education and Welfare.     

Adolescents’ Experience and Knowledge of,and Attitudes toward,Bees: Implications and Recommendations for Conservation

Invertebrates are generally regarded with apathy, distaste, and fear in Western society. These negative sentiments likely contribute to the disparity in wildlife conservation efforts, which largely favor vertebrate organisms. Bees represent one of the most ecologically and economically important invertebrate groups, yet bee diversity and abundance is declining worldwide, mirroring the general decline of invertebrate biodiversity. Developing and implementing successful conservation efforts requires interdisciplinary research that considers the ecological and social realities of today’s world. To better inform conservation efforts related to bees, we examined adolescents’ experiences and knowledge of, and attitudes toward, bees and investigated how these dimensions related to one another. A total of 794 eighth-grade science students from the suburbs of Chicago, USA completed a 48-item, paper questionnaire. The results indicated that adolescents were only somewhat knowledgeable about bee biology and services, and they confused bees with other flying insects, especially those with black-and-yellow coloration. Adolescents regarded bees with a generally neutral attitude; their knowledge and attitudes were correlated in a positive manner. Various bee-related experiences were linked to adolescents’ knowledge and attitudes and may have influenced bee-related behavior. In particular, students who engaged in gardening and lawn-care activities demonstrated higher levels of knowledge and more positive attitudes. This study provides insight into the relationships between experiences and knowledge of, and attitudes toward, invertebrates and suggests that engaging in certain outdoor activities may promote positive attitudes toward bees among adolescents.     

Medical Students’ Attitudes About Cosmetic Pesticides before and after an Ecosystem Health Seminar: A Pilot Study

The University of Western Ontario has incorporated ecosystem health as an integral component of its Community Health course for medical students. There is increasing concern regarding the negative health effects of pesticides. The issue of pesticides is, therefore, an obvious topic for the Community Health course. The goal of this pilot study was to compare the attitudes of medical students about cosmetic pesticide use before and after attending a special seminar on that topic. Sixty-three students were surveyed on their opinions before and after the pesticides seminar. After the seminar, the students’ attitudes shifted towards a more negative view of unrestrained cosmetic pesticide use. The students also felt that there were greater risks involved with the use of pesticides (P < 0.001) after attending the seminar. The results of this pilot study demonstrate the need and the effectiveness of including ecosystem health topics in medical curricula.     

Students’ Perceptions of Peer-Organized Extra-Curricular Research Course during Medical School: A Qualitative Study

Early integration of research education into medical curricula is crucial for evidence-based practice. Yet, many medical students are graduating with no research experience due to the lack of such integration in their medical school programs. The purpose of this study was to explore the impact of a peer-organized, extra-curricular research methodology course on the attitudes of medical students towards research and future academic careers. Twenty one medical students who participated in a peer-organized research course were enrolled in three focus group discussions to explore their experiences, perceptions and attitudes towards research after the course. Discussions were conducted using a semi-structured interview guide, and were transcribed and thematically analyzed for major and minor themes identification. Our findings indicate that students’ perceptions of research changed after the course from being difficult initially to becoming possible. Participants felt that their research skills and critical thinking were enhanced and that they would develop research proposals and abstracts successfully. Students praised the peer-assisted teaching approach as being successful in enhancing the learning environment and filling the curricular gap. In conclusion, peer-organized extra-curricular research courses may be a useful option to promote research interest and skills of medical students when gaps in research education in medical curricula exist.     

Cultural Adaptation of a Survey to Assess Medical Providers’ Knowledge of and Attitudes towards HIV/AIDS in Albania

Though the HIV/AIDS epidemic in Southeastern Europe is one of low reported prevalence, numerous studies have described the pervasiveness of medical providers’ lack of knowledge of HIV/AIDS in the Balkans. This study sought to culturally adapt an instrument to assess medical providers’ knowledge of and attitudes towards HIV/AIDS in Albania. Cultural adaptation was completed through development of a survey from previously validated instruments, translation of the survey into Albanian, blinded back translation, expert committee review of the draft instrument, focus group pre-testing with community- and University Hospital Center of Tirana-based physicians and nurses, and test-retest reliability testing. Blinded back translation of the instrument supported the initial translation with slight changes to the idiomatic and conceptual equivalences. Focus group pre-testing generally supported the instrument, yet some experiential and idiomatic changes were implemented. Based on unweighted kappa and/or prevalence adjusted bias adjusted kappa (PABAK), 20 of the 43 questions were deemed statistically significant at kappa and/or PABAK ≥0.5, while 12 others did not cross zero on the 95% confidence interval for kappa, indicating their probable significance. Subsequently, an instrument to assess medical providers’ knowledge of and attitudes toward HIV/AIDS for an Albanian population was developed which can be expanded within Albania and potentially to other countries within the Balkans, which have an Albanian-speaking population.     

Q Fever Knowledge,Attitudes and Vaccination Status of Australia’s Veterinary Workforce in 2014

Q fever, caused by Coxiella burnetii, is a serious zoonotic disease in humans with a worldwide distribution. Many species of animals are capable of transmitting C. burnetii, and consequently all veterinary workers are at risk for this disease. An effective Q fever vaccine has been readily available and used in Australia for many years in at-risk groups, and the European Centre for Disease Prevention and Control has recently also called for the use of this vaccine among at-risk groups in Europe. Little is known about attitudes towards this vaccine and vaccine uptake in veterinary workers. This study aimed to determine the Q fever vaccination status of veterinarians and veterinary nurses in Australia and to assess and compare the knowledge and attitudes towards Q fever disease and vaccination of each cohort. An online cross-sectional survey performed in 2014 targeted all veterinarians and veterinary nurses in Australia. Responses from 890 veterinarians and 852 veterinary nurses were obtained. Binary, ordinal and multinomial logistic regression were used to make comparisons between the two cohorts. The results showed that 74% of veterinarians had sought vaccination compared to only 29% of veterinary nurses. Barriers to vaccination among those not vaccinated did not differ between cohorts, and included a lack of perceived risk, financial expense, time constraints, and difficulty in finding a vaccine provider. Poor knowledge and awareness of Q fever disease and vaccination were additional and notable barriers for the veterinary nursing cohort, suggesting veterinary clinics and veterinarians may not be meeting their legal responsibility to educate staff about risks and risk prevention. Further evaluation is needed to identify the drivers behind seeking and recommending vaccination so that recommendations can be made to improve vaccine uptake.     

Improving Upper Elementary Students’ Humane Attitudes and Prosocial Behaviors through an In-class Humane Education Program

Humane education is a long-standing field of education that endeavors to nurture kindness, compassion, and concern for nonhuman animals, people, and the environment. Despite its long history, however, few randomized control studies have evaluated its effectiveness to promote the development of relevant outcomes. The current study sought to address this dearth by investigating the effects of a humane education program on not only participating students’ attitudes, but also their behaviors. Classes of under-served, fourth-grade students in two major US cities were randomly assigned to participate in either a school-based humane education program or a chess club (the control group); all students participated in their respective activity during the same period once a week for 11 weeks. Data were collected on the attitudes (n = 236) and behaviors (n = 167) of participating students exactly one week before and exactly one week after these programs were conducted. Students self-reported their attitudes about the treatment of animals and the environment via the Intermediate Attitude Scale. Teachers rated each students’ prosocial and disruptive behaviors through sub-scales of the Teacher Observation of Classroom Adaptation– Checklist. Nested multilevel models of change found that the development of prosocial behaviors and self-reported attitudes significantly interacted with group assignment: Students who participated in the humane education program showed stronger growth in both of these outcomes compared with students in the control group. Changes in disruptive behaviors, how-ever, were not found to differ between groups. The results support the effectiveness of a humane education program to teach a relatively large and diverse group of upper elementary students to learn about animal welfare issues and to improve their prosocial behaviors. Effects appeared strongest on attitudes; behavioral effects were found to be largely limited to behaviors directly addressed by the humane education program.     

“Do Octopuses Have a Brain?” Knowledge,Perceptions and Attitudes towards Neuroscience at School

The present study contributes to the question of school literacy about the brain, with an original survey conducted on Italian students from the 3^rd to 10^th grades (n = 508). The main goal was to test student''s knowledge, attitudes, and interests about neuroscience, to assess needs, prospects, and difficulties in teaching about the brain from elementary to high school. A written questionnaire, maintaining anonymity, asked 12 close-ended multiple choice questions on topics related to human and animal brains, plus one facultative open-ended question about interests and curiosities on brain topics. The results show that respondents have a fragmentary level of basic knowledge about the brain, with aspects related to brain functions and consciousness the most challenging. As expected, degrees of performance improve with school level; elementary school students answered correctly an average number of 5.3 questions, middle school 6.5, and high school 7.4. Overall, students show great interest in the brain, as shown by the large number of questions gathered through the open-ended question (n = 384). Other topics are addressed, mostly related to brain structure/functions and the role of the brain in the everyday life. The survey indicates the need of more thorough school programs on this subject, reinforced by interdisciplinary teaching where comparative anatomy and evolutionary aspects of brain development are covered.     

Knowledge,Attitudes, and Decision Making in Hospital Glycemic Management: are Faculty up to Speed?

Objective: Knowledge and confidence deficits in the management of hospital glucose abnormalities are prevalent among resident physicians. However, it is unclear whether such gaps prevail among faculty within different professional fields. In this study, we examined faculty knowledge and explored perceptions of challenges related to the management of inpatient hyperglycemia and diabetes.Methods: We conducted a survey that examined management decisions about inpatient hyperglycemia and diabetes among Medicine, Medicine/Pediatrics, Family and Community Medicine, Surgery, and Neurology faculty clinicians. All participating faculty had teaching and patient care responsibilities.Results: Responses from 69 faculty participants revealed gaps in several areas, including biomedical and contextual knowledge, familiarity with resources, clinical decision making, and self-efficacy. We identified important factors perceived as barriers to optimal glycemic management in the inpatient settings.Conclusion: The results of this study enhance our insight about the limitations existing among faculty related to the management of hyperglycemia and diabetes in hospitalized patients. We suggest that these barriers may impede optimization of patient care. Faculty play a crucial role in the clinical decision-making process and quality of care delivered by trainees. Therefore, attending physicians are likely to impact trainees' clinical performance and competency in the management of inpatient diabetes during training and beyond. Education in this subject should be a priority among trainees and faculty alike.Abbreviation: ICU = intensive care unit     

Effect of High-Fidelity Simulation on Medical Students’ Knowledge about Advanced Life Support: A Randomized Study

High-fidelity simulation (HFS) is a learning method which has proven effective in medical education for technical and non-technical skills. However, its effectiveness for knowledge acquisition is less validated. We performed a randomized study with the primary aim of investigating whether HFS, in association with frontal lessons, would improve knowledge about advanced life support (ALS), in comparison to frontal lessons only among medical students. The secondary aims were to evaluate the effect of HFS on knowledge acquisition of different sections of ALS and personal knowledge perception. Participants answered a pre-test questionnaire consisting of a subjective (evaluating personal perception of knowledge) and an objective section (measuring level of knowledge) containing 100 questions about algorithms, technical skills, team working/early warning scores/communication strategies according to ALS guidelines. All students participated in 3 frontal lessons before being randomized in group S, undergoing a HFS session, and group C, receiving no further interventions. After 10 days from the end of each intervention, both groups answered a questionnaire (post-test) with the same subjective section but a different objective one. The overall number of correct answers of the post-test was significantly higher in group S (mean 74.1, SD 11.2) than in group C (mean 65.5, SD 14.3), p = 0.0017, 95% C.I. 3.34 – 13.9. A significantly higher number of correct answers was reported in group S than in group C for questions investigating knowledge of algorithms (p = 0.0001; 95% C.I 2.22–5.99) and team working/early warning scores/communication strategies (p = 0.0060; 95% C.I 1.13–6.53). Students in group S showed a significantly higher score in the post-test subjective section (p = 0.0074). A lower proportion of students in group S confirmed their perception of knowledge compared to group C (p = 0.0079). HFS showed a beneficial effect on knowledge of ALS among medical students, especially for notions of algorithms and team working/early warning scores/communication.     

Patients’ Knowledge,Attitudes, Behaviour and Health Care Experiences on the Prevention,Detection, Management and Control of Hypertension in Colombia: A Qualitative Study

Hypertension is a leading cause of premature death worldwide and the most important modifiable risk factor for cardiovascular disease. Effective screening programs, communication with patients, regular monitoring, and adherence to treatment are essential to successful management but may be challenging in health systems facing resource constraints. This qualitative study explored patients’ knowledge, attitudes, behaviour and health care seeking experiences in relation to detection, treatment and control of hypertension in Colombia. We conducted in-depth interviews and focus group discussions with 26 individuals with hypertension and 4 family members in two regions. Few participants were aware of ways to prevent high blood pressure. Once diagnosed, most reported taking medication but had little information about their condition and had a poor understanding of their treatment regime. The desire for good communication and a trusting relationship with the doctor emerged as key themes in promoting adherence to medication and regular attendance at medical appointments. Barriers to accessing treatment included co-payments for medication; costs of transport to health care facilities; unavailability of drugs; and poor access to specialist care. Some patients overcame these barriers with support from social networks, family members and neighbours. However, those who lacked such support, experienced loneliness and struggled to access health care services. The health insurance scheme was frequently described as administratively confusing and those accessing the state subsidized system believed that the treatment was inferior to that provided under the compulsory contributory system. Measures that should be addressed to improve hypertension management in Colombia include better communication between health care professionals and patients, measures to improve understanding of the importance of adherence to treatment, reduction of co-payments and transport costs, and easier access to care, especially in rural areas.