Background. Despite the key role played by physician-investigators in bridging basic and clinical sciences, their number has declined significantly in the last decades especially in developing countries. Thus, we aimed to investigate attitudes and perceived barriers towards participation in clinical research among medical students in an Egyptian medical school. Methods. We employed a cross-sectional design, in which 420 students from the Faculty of Medicine, Ain Shams University completed a self-administrated questionnaire to assess their attitudes, perceived barriers, and knowledge about clinical research. The results were analyzed considering the students’ gender, year of enrollment, and high school background. Results. Seventy medical students from each year of enrollment participated in the study. The majority of students (74.2%) agree that undergraduates should participate in clinical research. However, only 23.8% reported engagement in related activities. Students showed low knowledge scores of on a scale of six questions. They highlighted several barriers against research participation including lack of time, proper mentoring, and funding. Conclusion. Although the majority of students showed positive attitudes towards clinical research, they reported low participation in related activities, associated with low knowledge scores. Several barriers should be addressed as lack of time, funding, and proper mentoring.

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Attitudes and Perceived Barriers among Medical Students towards Clinical Research: A Cross-Sectional Study in an Egyptian Medical School

Background: The need for increased expertise in evidence-based medicine and concerns about the decreasing numbers of physician-scientists have underscored the need for promoting and encouraging research in medical education. The critical shortage of physician-scientists has assumed a dimension demanding a coordinated global response. This systematic review examined the perceptions of medical students regarding research during undergraduate medical school from a global perspective.

Methods: Articles for this review were searched using PubMed, SCOPUS and Cochrane. Studies published within the last 10 years of the start date of the study that met specified criteria were included. Identified articles were initially screened by title as well as keywords and their abstracts were further screened to determine relevance. Full-text of screened articles were read for validation prior to inclusion.

Results: A total of 26 articles from the literature met the set criteria for final inclusion. Contents of the abstracts and corresponding full-text articles were analyzed for themes on the research perspectives of medical students. The themes derived comprised: research interest, physician-scientist decline and shortage, responses to physician-scientist shortage, curriculum issues, skills (motivation and self-efficacy), research needs, socioeconomic and cultural issues, and barriers.

Conclusion: Despite the wide variations in medical education systems worldwide, the perspectives of medical students on research in undergraduate medical education shared many common themes. Globally, medical students underscored the necessity and importance of research in medical education as reflected by many students reporting positive attitudes and interest in research endeavors. Moreover, a worldwide consensus emerged regarding the decline in the numbers of physician-scientists and the necessity for a reversal of that trend. Various barriers to research engagement and participation were highlighted.

https://www.tandfonline.com/doi/pdf/10.1080/10872981.2018.1537430

Contemporary global perspectives of medical students on research during undergraduate medical education: a systematic literature review.

Introduction: In recent years, an increasing number of medical students have taken time off during medical school in order to conduct research. Schools and students have invested millions of dollars and thousands of person-years on research projects, but little is known as to why students choose to take this time off. We aim to characterize why students take research years during medical school.

Methods: The authors distributed an online survey about research in medical school to students at five medical schools that have highly regarded research programs.

Results: 328 students responded to the survey. The most common reasons students take years off for research are: “increase competitiveness for residency application” (32%), “time to pursue other opportunities” (24%), and “academic interest” (23%). Students who would still take a research year even if they were already assured a position in a residency program of their choice were at 65%, while 35% would not take a research year. Responses varied based on whether students intended to go into a competitive specialty.

Discussion: Medical students take research years for multiple reasons, although they frequently are not motivated by an interest in the research itself. Many student projects consume a substantial amount of time and money despite having little educational value. Medical schools, residency programs, and policymakers should rethink incentives to increase value and help students better pursue their academic interests.

Research in Medical School: A Survey Evaluating Why Medical Students Take Research Years.

High-resolution mapping of cells and tissue structures provides a foundation for developing interpretable machine-learning models for computational pathology. Deep learning algorithms can provide accurate mappings given large numbers of labeled instances for training and validation. Generating adequate volume of quality labels has emerged as a critical barrier in computational pathology given the time and effort required from pathologists. In this paper we describe an approach for engaging crowds of medical students and pathologists that was used to produce a dataset of over 220,000 annotations of cell nuclei in breast cancers. We show how suggested annotations generated by a weak algorithm can improve the accuracy of annotations generated by non-experts and can yield useful data for training segmentation algorithms without laborious manual tracing. We systematically examine interrater agreement and describe modifications to the MaskRCNN model to improve cell mapping. We also describe a technique we call Decision Tree Approximation of Learned Embeddings (DTALE) that leverages nucleus segmentations and morphologic features to improve the transparency of nucleus classification models. The annotation data produced in this study are freely available for algorithm development and benchmarking at: this https URL.

NuCLS: A scalable crowdsourcing, deep learning approach and dataset for nucleus classification, localization and segmentation.

Linking undergraduate medical education to scientific research is necessary for the quality of future health care, and students´ individual research projects are one way to do so. Assessment of the impact of such projects is of interest for both educational and research-oriented segments of medical schools. Here, we examined the scholarly products and medical students’ career preferences 2 years after a mandatory research project course. A prospective cross-sectional questionnaire study. All 581 students registered on a 20-week research project course between September 2010 through September 2012 were e-mailed a questionnaire 2 years after completing the course. In total, 392 students (mean age 27 years; 60% females) responded (67% response rate). 59 students (15%) were co-authors on a scientific paper published in an international journal, 6 students had published in a national journal, and 57 students had co-authored a paper submitted for publication. Totally, 122 scientific papers had been submitted. Moreover, 67 (17%) students had given 107 oral or poster presentations nationally or internationally during the follow-up. Career-wise, 36 students (9%) had been registered as PhD students and an additional 127 students (34%) were planning to register. Those who did not plan doctoral studies were significantly older (p = 0.013) than those who did. However, 35% reported that they would in the coming 5 years prefer to work as clinicians only, and this group was significantly younger than those who envisaged participation in research. There were no significant gender differences. Approximately a third of the students had authored papers and/or public presentations, and a similar fraction had career plans involving a PhD degree. The results indicate that the project course had a positive impact on continued supervisor-student collaboration on a professional level, but also that strategies to encourage young doctors to perform clinical research may be needed.

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Medical students' research productivity and career preferences; a 2-year prospective follow-up study.

Importance 
Despite the rapidly declining number of physician-investigators, there is no consistent structure within medical education so far for involving medical students in research.


Objective 
To conduct an integrated mixed-methods systematic review and meta-analysis of published studies about medical students' participation in research, and to evaluate the evidence in order to guide policy decision-making regarding this issue.


Evidence Review 
We followed the PRISMA statement guidelines during the preparation of this review and meta-analysis. We searched various databases as well as the bibliographies of the included studies between March 2012 and September 2013. We identified all relevant quantitative and qualitative studies assessing the effect of medical student participation in research, without restrictions regarding study design or publication date. Prespecified outcome-specific quality criteria were used to judge the admission of each quantitative outcome into the meta-analysis. Initial screening of titles and abstracts resulted in the retrieval of 256 articles for full-text assessment. Eventually, 79 articles were included in our study, including eight qualitative studies. An integrated approach was used to combine quantitative and qualitative studies into a single synthesis. Once all included studies were identified, a data-driven thematic analysis was performed.


Findings and Conclusions 
Medical student participation in research is associated with improved short- and long- term scientific productivity, more informed career choices and improved knowledge about-, interest in- and attitudes towards research. Financial worries, gender, having a higher degree (MSc or PhD) before matriculation and perceived competitiveness of the residency of choice are among the factors that affect the engagement of medical students in research and/or their scientific productivity. Intercalated BSc degrees, mandatory graduation theses and curricular research components may help in standardizing research education during medical school.

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Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis.

In this work, we describe the extension of Ripley's K-function to allow for overlapping events at very high event densities. We show that problematic edge effects introduce significant bias to the function at very high densities and small radii, and propose a simple correction method that successfully restores the function's centralization. Using simulations of homogeneous Poisson distributions of events, as well as simulations of event clustering under different conditions, we investigate various aspects of the function, including its shape-dependence and correspondence between true cluster radius and radius at which the K-function is maximized. Furthermore, we validate the utility of the function in quantifying clustering in 2-D grayscale images using three modalities: (i) Simulations of particle clustering; (ii) Experimental co-expression of soluble and diffuse protein at varying ratios; (iii) Quantifying chromatin clustering in the nuclei of wt and crwn1 crwn2 mutant Arabidopsis plant cells, using a previously-published image dataset. Overall, our work shows that Ripley's K-function is a valid abstract statistical measure whose utility extends beyond the quantification of clustering of non-overlapping events. Potential benefits of this work include the quantification of protein and chromatin aggregation in fluorescent microscopic images. Furthermore, this function has the potential to become one of various abstract texture descriptors that are utilized in computer-assisted diagnostics in anatomic pathology and diagnostic radiology.

/pdf/extending-ripley-s-k-function-to-quantify-aggregation-in-2-d-335e38l1xa.pdf

Extending Ripley's K-Function to Quantify Aggregation in 2-D Grayscale Images.

One of the most notable recent advances in electron microscopy (EM) was the development of genetically-encoded EM tags, including the fluorescent flavoprotein Mini-SOG (Mini-Singlet Oxygen Generator). Mini-SOG generates good EM contrast, thus providing a viable alternative to technically-demanding methods such as immuno-electron microcopy (immuno-EM). Based on the Mini-SOG technology, in this paper, we describe the construction, validation and optimization of a series of vectors which allow expression of Mini-SOG in the Drosophila melanogaster genetic model system. We constructed a Mini-SOG tag that has been codon-optimized for expression in Drosophila (DMS tag) using PCR-mediated gene assembly. The photo-oxidation reaction triggered by DMS was then tested using these vectors in Drosophila cell lines. DMS tag did not affect the subcellular localization of the proteins we tested. More importantly, we demonstrated the utility of the DMS tag for EM in Drosophila by showing that it can produce robust photo-oxidation reactions in the presence of blue light and the substrate DAB; the resultant electron micrographs contain electron-dense regions corresponding to the protein of interest. The vectors we generated allow protein tagging at both termini, for constitutive and inducible protein expression, as well as the generation of transgenic lines by P-element transformation. We demonstrated the feasibility of Mini-SOG tagging in Drosophila. The constructed vectors will no doubt be a useful molecular tool for genetic tagging to facilitate high-resolution localization of proteins in Drosophila by electron microscopy.

/pdf/vectors-for-genetically-encoded-tags-for-electron-microscopy-33qykngebi.pdf

Marco Man Kin Tsui

Papers

Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis.

Extending Ripley's K-Function to Quantify Aggregation in 2-D Grayscale Images.

Vectors for Genetically-Encoded Tags for Electron Microscopy Contrast in Drosophila