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.     

The Effects of Group-Administered Canine Therapy on University Students’ Wellbeing: A Randomized Controlled Trial

University students with elevated stress levels are at risk for experiencing compromised mental health and for underperforming academically. In an effort to support student wellbeing, post-secondary campuses are increasingly offering canine therapy programs. These programs provide students opportunities to interact with dogs known for their calm public behavior, docile temperaments, and eagerness to interact with strangers. Despite the interest in canine therapy, there remains a paucity of research attesting to the benefits of this approach to support university student wellbeing. The aim of this study was to examine the effect of a group-administered, single-session canine therapy intervention on university students’ perceptions of stress, homesickness, and affinity to campus. Participants (n = 163) were randomly assigned to a treatment (n = 84, 20-minute exposure to therapy dog, handler, and fellow students) condition or a business-as-usual control (n = 79, 20 minutes of individual studying) condition. No baseline differences were identified between the two groups. Findings revealed a significant main effect for group, and when compared with the control group, participants in the treatment group showed significant decreases from pre-test to post-test in perceived stress, homesickness (dislike), and homesickness (attachment), and significant improvements in sense of school belonging. Interestingly, control group scores on homesickness (dislike) also differed significantly from pre-test to post-test, with the means increasing from pre-test to post-test. After controlling for pre- and post-test scores, there were no significant differences on any of the self-report measures between participants in the treatment and control groups at follow-up. Findings are discussed within the contexts of animal-assisted therapy and on-campus stress reduction initiatives.     

Patient Safety in Medical Education: Students’ Perceptions,Knowledge and Attitudes

Patient safety is a new and challenging discipline in the Iranian health care industry. Among the challenges for patient safety improvement, education of medical and paramedical students is intimidating. The present study was designed to assess students’ perceptions of patient safety, and their knowledge and attitudes to patient safety education. This cross-sectional analytical study was conducted in 2012 at Urmia University of Medical Sciences, West Azerbaijan province, Iran. 134 students studying medicine, nursing, and midwifery were recruited through census for the study. A questionnaire was used for collecting data, which were then analyzed through SPSS statistical software (version 16.0), using Chi-square test, Spearman correlation coefficient, F and LSD tests. A total of 121 questionnaires were completed, and 50% of the students demonstrated good knowledge about patient safety. The relationships between students’ attitudes to patient safety and years of study, sex and course were significant (0.003, 0.001 and 0.017, respectively). F and LSD tests indicated that regarding the difference between the mean scores of perceptions of patient safety and attitudes to patient safety education, there was a significant difference among medical and nursing/midwifery students. Little knowledge of students regarding patient safety indicates the inefficiency of informal education to fill the gap; therefore, it is recommended to consider patient safety in the curriculums of all medical and paramedical sciences and formulate better policies for patient safety.     

The Effect of Motivation on Movement: A Study of Bradykinesia in Parkinson’s Disease

Background

Bradykinesia is a cardinal feature of Parkinson’s disease (PD). Despite its disabling impact, the precise cause of this symptom remains elusive. Recent thinking suggests that bradykinesia may be more than simply a manifestation of motor slowness, and may in part reflect a specific deficit in the operation of motivational vigour in the striatum. In this paper we test the hypothesis that movement time in PD can be modulated by the specific nature of the motivational salience of possible action-outcomes.

Methodology/Principal Findings

We developed a novel movement time paradigm involving winnable rewards and avoidable painful electrical stimuli. The faster the subjects performed an action the more likely they were to win money (in appetitive blocks) or to avoid a painful shock (in aversive blocks). We compared PD patients when OFF dopaminergic medication with controls. Our key finding is that PD patients OFF dopaminergic medication move faster to avoid aversive outcomes (painful electric shocks) than to reap rewarding outcomes (winning money) and, unlike controls, do not speed up in the current trial having failed to win money in the previous one. We also demonstrate that sensitivity to distracting stimuli is valence specific.

Conclusions/Significance

We suggest this pattern of results can be explained in terms of low dopamine levels in the Parkinsonian state leading to an insensitivity to appetitive outcomes, and thus an inability to modulate movement speed in the face of rewards. By comparison, sensitivity to aversive stimuli is relatively spared. Our findings point to a rarely described property of bradykinesia in PD, namely its selective regulation by everyday outcomes.     

Medical Students’ Opinions About the Commercialization of Healthcare: A Cross-Sectional Survey

There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients’ best interests in the face of market demands.     

Study on the Effect of Kidney Transplantation on the Health of the Patients’ Offspring: A Report on 252 Chinese Children

Even though the incidence of pregnancies in the female recipients is lower and also chronic renal disease in male patients is associated with impaired spermatogenesis, the health of the children born to these patients was not studied. In this report, we discuss information on the growth and development of offspring of 248 male and female kidney recipient patients. Physical and routine clinical measurements of the 252 offspring (129 male and 123 female) born to these transplantation patients were made along with the intelligence tests. In some of these children chest X-ray and immune indices were assessed. Among the recipients, 219 males fathered 223 children with an average birth weight of 3,255 ± 374 g and 29 female recipients gave birth to 29 children with an average birth weight of 2,923 ± 551. While most of these children were normal, we noticed a case of soft double toe, a case of short tongue tie, five cases of marginal mental retardation, three cases of proteinuria, six cases of microscopic hematuria, 15 cases of low hemoglobin, and 21 cases with recurrent respiratory tract infections. We conclude that kidney transplantation has no significant impact on the growth, development, health, and intelligence of the offspring born to recipients.     

Effect of Supervised Students' Involvement on Diagnostic Accuracy in Hospitalized Medical Patients �� A Prospective Controlled Study

Background

During internships most medical students engage in history taking and physical examination during evaluation of hospitalized patients. However, the students'' ability for pattern recognition is not as developed as in medical experts and complete history taking is often not repeated by an expert, so important clues may be missed. On the other hand, students'' history taking is usually more extensive than experts'' history taking and medical students discuss their findings with a Supervisor. Thus the effect of student involvement on diagnostic accuracy is unclear. We therefore compared the diagnostic accuracy for patients in the medical emergency department with and without student involvement in the evaluation process.

Methodology/Principal Findings

Patients in the medical emergency department were assigned to evaluation by either a supervised medical student or an emergency department physician. We only included patients who were admitted to our hospital and subsequently cared for by another medical team on the ward. We compared the working diagnosis from the emergency department with the discharge diagnosis. A total of 310 patients included in the study were cared for by 41 medical students and 21 emergency department physicians. The working diagnosis was changed in 22% of the patients evaluated by physicians evaluation and in 10% of the patients evaluated by supervised medical students (p = .006). There was no difference in the expenditures for diagnostic procedures, length of stay in the emergency department or patient comorbidity complexity level.

Conclusion/Significance

Involvement of closely supervised medical students in the evaluation process of hospitalized medical patients leads to an improved diagnostic accuracy compared to evaluation by an emergency department physician alone.     

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.     

Children’s Opinions about Zoos: A Study of Portuguese and Spanish Pupils

In this study, we analyzed the opinions of primary-school children from Portugal and Spain about zoos. The sample consisted of 560 pupils, mean age 11.38 years and in the 6th grade of schooling. For the purpose of this study, a two-part questionnaire was designed. In the first part, children were asked to name up to three positive and negative aspects of these institutions. Special attention was given to aspects related to animal welfare. In the second part, they had to express their opinion about 18 statements relating to different perspectives toward zoos: six were anthropocentric statements (in favor of zoos), six were biocentric (against zoos), and six ecocentric (partially supporting their existence). The results were analyzed for the whole sample but also according to the children’s country, gender, and type of visit (with school or exclusively with parents and relatives). Children tended to highlight the facilities and the amusements on offer, but the contact with animals and the way animals are treated were also in evidence. On the whole, the children supported the existence of zoos, and disagreed more often with the biocentric statements. Even so, the Spanish children, as compared with the Portuguese, were more in agreement with the biocentric perspective. However, children who went to zoos in a formal context (school visit) tended to be more anthropocentric than the ones who went with family/relatives. This tendency may be related to the fact that school contents tend to highlight the educational and conservationist roles of zoos and focus less on the controversial dimension associated with these places. But this tendency needs further research.     

Impact of Routing Flexibility on the Performance of an FMS—A Simulation Study

The evolving manufacturing environment is characterized by a drive toward increasing flexibility. One possible manifestation of flexibility within an FMS is in the form of routing flexibility. Providing this typically is an expensive proposition, and system designers therefore aim to provide only the required levels commensurate with a given set of operating conditions. This paper presents a framework based on a Taguchi experimental design for studying the nature of the impact of varying levels of routing flexibility on the performance of an FMS. Simulation results indicate that increases in routing flexibility, when made available at the cost of an associated penalty on operation processing time, is not always beneficial. There is an optimal flexibility level, beyond which system performance deteriorates, as judged by the makespan measure of performance. It is suggested that the proposed methodology can be used in practice for not only setting priorities on specific design and control factors but also for highlighting likely factor level combinations that could yield near-optimal shop performance.     

Examining Students’ Perception of Classroom Openness as a Predictor of Civic Knowledge: A Cross-National Analysis of 38 Countries

Civic knowledge is critical to interpreting various policy and candidate issues that are necessary to participating in certain political activities, such as voting in elections or attending public demonstrations. Various studies have examined students’ perceptions of classroom openness, which reflects perceived levels of political discussion supported by peers in the classrooms, to understand how this measure relates to students’ civic behaviors. This study analyzes data from the 2009 International Civic and Citizenship Education Study, in which approximately 134,000 students were sampled from 38 countries across Europe, Asia, and Latin America. Results from three-level hierarchal linear modeling suggest that students’ perceptions of classroom openness are strongly related to their civic knowledge scores. Further analyses indicate that the relationship strength between these two measures do not vary across students from different socioeconomic backgrounds. These findings reaffirm the importance of curricular approaches that emphasize political discussions in classrooms to prepare students for active citizenship.     

Students’ Alternative Conceptions about the Lotus Effect: To Confront or to Ignore?

At the botanical garden of the University of Würzburg, we conducted practical lessons on bionics, focused on the lotus effect, with 260 students. Those approx. 14 years old, 8th-grade mid-level students were divided into two groups. During an instructional discussion about the topic, one group was confronted with their alternative conceptions (AC), whereas the other group was not (NAC). Both groups were treated equally, following the experimental phase and results discussion. Questionnaires were used to measure conceptual change in a pre-, post- and retention test design. Both groups changed their conceptions in short-term similarly. Over a long-term period, the NAC group showed significantly higher knowledge than the AC group. We discuss that the methodology of the alternative conception confrontation should be selected very carefully by the teacher, as this step is the most delicate within the whole conceptual change process.     

Empathy among Medical Students: Is There a Relation with Quality of Life and Burnout?

Background

We aimed to assess medical students'' empathy and its associations with gender, stage of medical school, quality of life and burnout.

Method

A cross-sectional, multi-centric (22 medical schools) study that employed online, validated, self-reported questionnaires on empathy (Interpersonal Reactivity Index), quality of life (The World Health Organization Quality of Life Assessment) and burnout (the Maslach Burnout Inventory) in a random sample of medical students.

Results

Out of a total of 1,650 randomly selected students, 1,350 (81.8%) completed all of the questionnaires. Female students exhibited higher dispositional empathic concern and experienced more personal distress than their male counterparts (p<0.05; d≥0.5). There were minor differences in the empathic dispositions of students in different stages of their medical training (p<0.05; f<0.25). Female students had slightly lower scores for physical and psychological quality of life than male students (p<0.05; d<0.5). Female students scored higher on emotional exhaustion and lower on depersonalization than male students (p<0.001; d<0.5). Students in their final stage of medical school had slightly higher scores for emotional exhaustion, depersonalization and personal accomplishment (p<0.05; f<0.25). Gender (β = 0.27; p<0.001) and perspective taking (β = 0.30; p<0.001) were significant predictors of empathic concern scores. Depersonalization was associated with lower empathic concern (β = −0.18) and perspective taking (β = −0.14) (p<0.001). Personal accomplishment was associated with higher perspective taking (β = 0.21; p<0.001) and lower personal distress (β = −0.26; p<0.001) scores.

Conclusions

Female students had higher empathic concern and personal distress dispositions. The differences in the empathy scores of students in different stages of medical school were small. Among all of the studied variables, personal accomplishment held the most important association with decreasing personal distress and was also a predicting variable for perspective taking.     

Slovenian Students’ Knowledge and Opinions about Wild Boar (Sus Scrofa L.)

ABSTRACT

Wild boar are present almost throughout Slovenia, causing similar problems as in many other countries, mainly damage to agriculture. Dealing with these problems also involves children. The aim of this study was to assess the effects of age, gender, and farm residence on knowledge, attitudes, and opinions about wild boar management in 11- and 15-year-olds (n = 478) attending schools in/near areas of high wild boar densities, via an anonymous closed-ended questionnaire. Only 52.4% of the questions on factual knowledge were answered correctly, although a relatively high proportion of students (38.3%) reported having seen wild boar in their natural environment. The majority of students (81.4%) expressed affection toward animals in general, while only 11.3% stated that they liked wild boar. The main source of information about these animals was home (40.0%), followed by school (26.1%). Logistic regression analysis revealed that students’ age and gender usually predicted their response (p < 0.05), while living on a farm influenced only the source of information and one attitude question: farm residents were more likely to express affection toward wild boar. The older students were more likely to know more about wild boar, but they also were more likely to be indifferent toward the species. Boys and girls did not differ in their knowledge, but girls were more likely to express fear/dislike of wild boar. In general, older students and girls were more likely to be undecided in their responses. Since we found almost no effect of farm residence on students’ knowledge and opinions, it can be concluded that wild boar problems are recognized generally, not only in agriculture. Because information from home can be biased, we propose that teachers be encouraged to include wild boar topics in their teaching, educating young people properly about wild boar problems and consequently influencing their adult behavior concerning management issues.     

Simulation Study of the Effect of Surface Plasmon Coupling on Förster Resonance Energy Transfer Behavior

Plasmonics - The effect of surface plasmon (SP) coupling of an Ag sphere on the behavior of the Förster resonance energy transfer (FRET) from a donor dipole into an acceptor nearby is...     

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.     

Telemedicine’s Potential to Support Good Dying in Nigeria: A Qualitative Study

Objectives

This qualitative study explores Nigerian health care professionals’ concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice.

Materials and Methods

Supported by the Centre for Palliative Care Nigeria (CPCN) and the University College Hospital (UCH) in Ibadan, Nigeria, the authors organized three focus groups with Nigerian health care professionals interested in palliative care, unstructured interviews with key role players for palliative care and representatives of telecom companies, and field visits to primary, secondary and tertiary healthcare clinics that provided palliative care. Data analysis consisted of open coding, constant comparison, diagramming of categorizations and relations, and extensive member checks.

Results

The focus group participants classified good dying into 2 domains: a feeling of completion of the individual life and dying within the community. Reported barriers to palliative care provision were socio-economic consequences of being seriously ill, taboos on dying and being ill, restricted access to adequate medical–technical care, equation of religion with medicine, and the faulty implementation of palliative care policy by government. The addition of telemedicine to Nigeria’s palliative care practice appears problematic, due to irregular bandwidth, poor network coverage, and unstable power supply obstructing interactivity and access to information. However, a tele-education ‘lite’ scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication.

Discussion

Nigerian health care professionals’ concepts on good dying/a good death and barriers and opportunities for palliative care provision were, for the greater part, similar to prior findings from other studies in Africa. Information for and education of patient, family, and community are essential to further improve palliative care in Africa. Telemedicine can only help if low-tech solutions are applied that work around network coverage problems by focusing on non-synchronous online communication.     

A Comprehensive,Simulation-Based Approach to Teaching Clinical Skills: The Medical Students’ Perspective

The purpose of this study was to determine if third-year medical students participating in a mandatory 12-week simulation course perceived improvement in decision-making, communication, and teamwork skills. Students participated in or observed 24 acute emergency scenarios. At 4-week intervals, students completed 0-10 point Likert scale questionnaires evaluating the curriculum and role of team leader. Linear contrasts were used to examine changes in outcomes. P-values were Bonferroni-corrected for multiple pairwise comparisons. Student evaluations (n = 96) demonstrated increases from week 4 to 12 in educational value (p = 0.006), decision-making (p < 0.001), communication (p = 0.02), teamwork (p = 0.01), confidence in management (p < 0.001), and translation to clinical experience (p < 0.001). Regarding the team leader role, students reported a decrease in stress (p = 0.001) and increase in ability to facilitate team function (p < 0.001) and awareness of team building (p = <0.001). Ratings demonstrate a positive impact of simulation on both clinical management skills and team leadership skills. A simulation curriculum can enhance the ability to manage acute clinical problems and translates well to the clinical experience. These positive perceptions increase as the exposure to simulation increases.     

Effects of Hydroxylated Carbon Nanotubes on the Aggregation of Aβ16–22 Peptides: A Combined Simulation and Experimental Study

The pathogenesis of Alzheimer’s disease (AD) is associated with the aggregation of amyloid-β (Aβ) peptides into toxic aggregates with β-sheet character. In a previous computational study, we showed that pristine single-walled carbon nanotubes (SWCNTs) can inhibit the formation of β-sheet-rich oligomers in the central hydrophobic core fragment of Aβ (Aβ_16–22). However, the poor solubility of SWCNTs in water hinders their use in biomedical applications and nanomedicine. Here, we investigate the influence of hydroxylated SWCNT, a water-soluble SWCNT derivative, on the aggregation of Aβ_16–22 peptides using all-atom explicit-water replica exchange molecular dynamics simulations. Our results show that hydroxylated SWCNTs can significantly inhibit β-sheet formation and shift the conformations of Aβ_16–22 oligomers from ordered β-sheet-rich structures toward disordered coil aggregates. Detailed analyses of the SWCNT-Aβ interaction reveal that the inhibition of β-sheet formation by hydroxylated SWCNTs mainly results from strong electrostatic interactions between the hydroxyl groups of SWCNTs and the positively charged residue K16 of Aβ_16–22 and hydrophobic and aromatic stacking interactions between SWCNTs and F19 and F20. In addition, our atomic force microscopy and thioflavin T fluorescence experiments confirm the inhibitory effect of both pristine and hydroxylated SWCNTs on Aβ_16–22 fibrillization, in support of our previous and present replica exchange molecular dynamics simulation results. These results demonstrate that hydroxylated SWCNTs efficiently inhibit the aggregation of Aβ_16–22; in addition, they offer molecular insight into the inhibition mechanism, thus providing new clues for the design of therapeutic drugs against amyloidosis.