Showing papers in "Canadian medical education journal in 2010"
TL;DR: The authors examined differences in perfectionism, depression, anxiety, and academic performance between pre-medical and non-premedical undergraduate students, and found that self-critical perfectionism was positively correlated with depression and anxiety, with comparable effect sizes.
Abstract: This study examined differences in perfectionism, depression, anxiety, and academic performance between premedical (N = 104) and non-premedical (N = 76) undergraduate students. Results indicated that premedical students did not differ significantly from non-premedical students in perfectionistic self-criticism, personal standards perfectionism, depression, or anxiety. Perfectionistic high standards were not correlated with depression or anxiety for either group. Self-critical perfectionism was positively correlated with depression and anxiety, with comparable effect sizes, for both groups of students. Premedical students and non-premedical students drastically differed in their reported academic performance (GPA). For premedical students, PS perfectionism was related to higher GPA, however PS perfectionism in non-premedical students had a negligible effect in increasing GPA. The implications of these results for interventions and future research are discussed.
17 citations
TL;DR: Findings support other findings indicating the SC test format can be used to differentiate between the clinical reasoning skills of novices, intermediates and experts in paediatrics.
Abstract: Background: The Script Concordance (SC) approach was used as an alternative test format to measure the presence of knowledge organization reflective in one’s clinical reasoning skills (i.e., diagnostic, investigation and treatment knowledge). Methods: The present study investigated the reliability and validity of a 40-item paediatric version of the SC test with three groups representing 53 medical students (novices), 42 paediatric residents (intermediates) and 11 paediatricians (experts). Results: A comparison between scoring techniques based on experts’ ratings of the items showed internal reliability coefficients from .74 for the one-best answer up to .78 for alternative scoring techniques. An ANOVA showed an increase in test performance from medical students through to expert paediatricians ( F (2,103) = 84.05, p < .001), but did not differentiate between the postgraduate year 1 to 3 paediatric residents . A large effect size (Cohen’s d ) difference of 1.06 was found between medical students and residents total SC test scores. Conclusions: These results support other findings indicating the SC test format can be used to differentiate between the clinical reasoning skills of novices, intermediates and experts in paediatrics. An alternative scoring method that includes one best answer and partial marks was also supported for grading SC test items.
9 citations
TL;DR: The first issue of the Canadian Medical Education Journal is presented, with the trepidation that has come from the many challenges of starting a new journal.
Abstract: We are proud to bring you the inaugural issue of the Canadian Medical Education Journal. While we embarked on this adventure with some trepidation a couple of years ago, we are very pleased to launch this initiative. The trepidation has come from the many challenges of starting a new journal. These include establishing an editorial board, the need for high quality submissions of manuscripts, seeking help from expert peer reviewers, and the work required for manuscript selection, preparation and distribution of the issues of the journal as well as the need for resources, time and finances. Notwithstanding, we are pleased to present the first issue of the CMEJ.
5 citations
TL;DR: IMGs who participated in a clinically relevant educational program improved their English language proficiency, clinical skills and professionalism for medical practice in a host country.
Abstract: Background: To assess the efficacy of a 16 week, intensive, full-time medical communication and clinical skills educational program – Medical Communication Assessment Project (M-CAP) – at the Universities of Calgary and Alberta for improving medical communication, clinical skills and professionalism of international medical graduates (IMGs). There is an 8 week didactic course (language instructors, standardized clinical case scenarios) and an 8 week supervised clinical placement. Method: In Study 1, 39 IMGs (mean age = 35.6) participated in the M-CAP program and were assessed in English language proficiency in a pre- post-test design and on an in training evaluation report (ITER) by practicum physicians. In Study 2, there were 235 IMGs (mean age = 39.2). In addition to the pre- post-test design, there was a comparison group analysis on OSCE data employing multivariate analysis of variance (MANOVA). Pre- post-test data were also collected on ITERs during the practicum as was IMG reported program efficacy data. Results: The findings show that the participants in the M-CAP program have 1) very large gains in language proficiency (listening and speaking, reading and writing; p < .001), and 2) high ratings on scales from the practicum physicians. The between group analyses showed that M-CAP participants outperformed the non M-CAP participants on clinical skills and professionalism ( p < .05). The IMGs gave very positive ratings to the M-CAP program. Conclusions: IMGs who participated in a clinically relevant educational program improved their English language proficiency, clinical skills and professionalism for medical practice in a host country.
5 citations
TL;DR: Medical students may be particularly vulnerable to commercial influences, as they have had little or no training in commercial biases and generally believe what they read in textbooks.
Abstract: Background: To study whether medical textbooks are sponsored by drug or device companies, and if so, whether they have tried to influence their contents. Methods : Cross-sectional study of the medical textbooks written in Danish for graduate clinical courses at the University of Copenhagen and anonymous web-based survey of editors. For sponsored books, we also contacted the authors. Results : Eleven of 71 medical textbooks (15%) were sponsored. We contacted 11 editors, and for 8 books that had authors that were not editors, we also contacted one author. Ten editors and 5 authors replied. One editor was contacted 5 times by the various sponsors concerning the content of specific chapters and in another case the sponsor had the content of a chapter changed regarding its own drug. Two of the authors noted that they did not know that the book was sponsored. Conclusions : Sponsorship of medical textbooks was not uncommon and may lead to lack of academic freedom. Medical students may be particularly vulnerable to commercial influences, as they have had little or no training in commercial biases and generally believe what they read in textbooks.
3 citations
TL;DR: It is suggested that improving biomedical knowledge of students should improve their performance on electrolyte problems and the performance of experienced physicians may also be improved.
Abstract: I ntroduction. If physicians apply clinical rather than biomedical knowledge when diagnosing, why do we use the basic sciences as the foundation for clinical teaching? In this study we evaluated the contribution of biomedical knowledge to diagnostic performance when solving electrolyte problems. Method. We asked 13 medical students and 19 nephrologists to solve electrolyte problems while thinking aloud, and determined biomedical knowledge application by protocol analysis. We used logistic regression to study the association between biomedical concepts, clinical experience, and performance. Results. Students and nephrologists applied a similar number of biomedical concepts per case (1.8 (±1.1) vs. 1.8 (±1.2), respectively, p = 0.8), but nephrologists were more successful (86.8% vs. 63.5%, p = 0.003). We found a significant interaction between expertise and applying biomedical concepts ( p < 0.05). For students the odds of success increased significantly with applying biomedical concepts (odds ratio 4.66 [2.07, 10.48], p < 0.001), whereas for nephrologists there was only a trend towards improved performance (odds ratio 1.72 [0.94, 3.11], p = 0.07). Conclusions. Our results suggest that improving biomedical knowledge of students should improve their performance on electrolyte problems. The performance of experienced physicians may also be improved, but this requires further study before teaching recommendations can be made.
3 citations
TL;DR: It is recommended that heart sound simulation is introduced at medical student level as the standard for teaching cardiologic auscultation findings and as preparation for auscULTation of live patients.
Abstract: Background - Despite continued curriculum reform, the clinical skills competencies of medical graduates at all levels are steadily declining within a training system, where bedside opportunities become a luxury and the laboratory tests prevail over the clinical skills. While high-fidelity expensive simulators are being embraced by high-procedure volume specialties, low-fidelity and relatively inexpensive simulators, such as the heart sounds simulators remain under-utilized in medical training. Methods - We used a commercially available heart sound synthesizer in 2-hour training sessions with students and residents. Pre-post testing was completed at the beginning of the training session and three weeks after the session; participant responses were recorded by audience interactive response system. Results - Data analysis was accomplished with statistical software SPSS 17.0 utilizing paired t-test, and showed a statistically significant difference in learners’ knowledge and skills attainment 3 weeks after completion of the simulation training (p<0.0001). Conclusions - Based on our findings and the review of literature, we recommend that heart sound simulation is introduced at medical student level as the standard for teaching cardiologic auscultation findings and as preparation for auscultation of live patients. We also suggest that training with digitally simulated heart sounds is similarly beneficial in resident training.
3 citations
TL;DR: Since PD are largely involved in curriculum development for their respective specialties and since MS are also well positioned to assess residents’ teaching performance, it is suggested that PD, residents and MS should all be consulted locally before organizing any intervention for teaching curricula.
Abstract: Background : Despite the important number of teaching-skills programs described in the literature, previous needs assessment of such curricula have examined primarily residents’ perceived learning needs in this field. The purpose of this study was to identify the optimal content and format of a resident teaching-skills training curriculum and compare the perspective of medical students (MS), residents and residency program directors (PD). Methods : This needs assessment was an observational study with a cross-sectional design. Online or printed questionnaires were used to assess the preferred format and content for this curriculum among MS, residents from most postgraduate medical training programs, and PD from Faculte de medecine de l’Universite Laval. Results : The questionnaires were completed by 26 PD (response rate 72.2%), 146 residents (response rate 21.9%) and 154 MS (response rate 15.7%). Among the list of potential subjects that could be included in the curriculum, Learning styles , Working with students in difficulty and Self-directed learning were scored high by both residents and PD. MS favored Learning styles , Teaching in the ambulatory care setting , Teaching health promotion and prevention , Teaching with time constraints and Direct supervision strategies . PD also favored Teaching conflict management and Teaching professionalism , however these were both among the residents’ lower scores. The preferred formats were One half-day , One day and Online learning for PD and One day , Two consecutive days and A few one-day sessions over several months for residents. Conclusion : The PD and MS perception of the optimal format and content for residents’ teaching-skills training showed some discrepancies when compared with residents’ preferences. Since PD are largely involved in curriculum development for their respective specialties and since MS are also well positioned to assess residents’ teaching performance, we suggest that PD, residents and MS should all be consulted locally before organizing any intervention for teaching curricula.
1 citations
TL;DR: Americans, compared to the Israelis, are significantly more satisfied with their medical studies, consider fewer alternatives to future careers in clinical medicine, feel less of a workload, and hold a more positive opinion of physician characteristics.
Abstract: Background: Cultural differences have been discussed as a potential factor influencing students' perception and motivation towards their studies. At the Sackler Faculty of Medicine, Tel-Aviv University, two separate programs coexist for American and Israeli medical students. Both are taught at the same sites and by the same faculty, thus enabling cultural comparisons. Our aim was to examine the differences of two medical student groups, American and Israeli, regarding their satisfaction with studies, view of the educational workload, and their perceptions of physician characteristics. Methods: During the academic year 2007-2008 we administered an anonymous questionnaire to the two groups immediately after their first clinical clerkship in internal medicine. The response rate was 82% (90 out of 110) for the Israelis and 93% (53 out of 57) for the Americans. Results : Americans, compared to the Israelis, are significantly more satisfied with their medical studies, consider fewer alternatives to future careers in clinical medicine, feel less of a workload, and hold a more positive opinion of physician characteristics. Conclusions: Cultural differences affect students' perception of their studies, mentors and future careers. Medical educators should be sensitive to the effects of students' background which influence academic and professional attitudes and find ways to strengthen their commitment to the profession.
1 citations
TL;DR: An initiative to teach medical students health advocacy skills at Political Action Day helps fulfill the health advocacy competency objectives, and requires minimal curriculum time and resources for integration.
Abstract: Background : Health advocacy is a critical aspect of the competent physician's role. It is identified as a core competency by several national physician regulatory organizations, yet few formal training programs exist. We developed an initiative to teach medical students health advocacy skills. Methods: At Political Action Day, students from Alberta medical schools lobbied the provincial government. A day of training seminars preceded Political Action Day that focused on teaching health advocacy and communication strategies. The following day, medical students met with elected representatives at the Legislative Assembly. An entry and exit survey was administered to students. Results: On October 26-27th, 2008, 40 students met with 38/83 (46%) elected representatives including the Minister of Health and Wellness. Feedback from students and politicians suggests the event was effective in teaching advocacy skills. This initiative inspired students to be politically active in the future. Conclusions : Political Action Day helps fulfill the health advocacy competency objectives, and requires minimal curriculum time and resources for integration. It is an effective tool to begin teaching advocacy, and should be further expanded and replicated at other Canadian medical schools.
1 citations
TL;DR: The results help support the decision of curriculum committees to incorporate the use of community practice settings and inform students and faculty as to the validity of distributed medical education within the field of pediatric medical education.
Abstract: Background: Medical student rotations in community practice settings are increasingly common within pediatric clerkship curricula yet little evidence exists to support the quality of the educational exposure. Purpose: To assess the impact of clerkship site (community setting vs. exposure to an Academic Health Sciences Center) on the following educational outcomes: 1. Clinical Performance; 2. Examination Performance; 3. Written Assignment Performance; and 4. Successful Matching to a Canadian Pediatric Residency Program. Methods: 340 medical students from the graduating classes of 2007 and 2008 at the University of Toronto, Canada were studied. Rotation performance (clinical assessment, examination mark, and written assignment mark) and acceptance into a Canadian pediatric residency program were assessed in relation to clerkship rotation site. These outcomes were assessed while controlling for the following potential confounders: 1) Pre-clerkship career preference and 2) Pre-rotation site preference as expressed by each medical student. Results: 172 medical students completed rotations that included exposure to an academic health sciences center, while 168 medical students had exclusive exposure to the community setting. Students who completed exclusively community-based pediatric rotations received slightly higher clinical evaluations (p=0.006), but not exam marks (p=0.812) nor written assignment marks (p=0.086). Students who had expressed an interest in paediatrics as a career prior to beginning their clerkship performed better during paediatric clerkship regardless of site (p= .0003) and were more likely to choose a clerkship setting that included exposure to an Academic Health Sciences Center (p=.052). Clerkship setting was not found to impact on successful matching to a Canadian pediatric residency program (p=0.171). Discussion: These results help support the decision of curriculum committees to incorporate the use of community practice settings and inform students and faculty as to the validity of distributed medical education within the field of pediatric medical education.
TL;DR: The potential costs and benefits of implementing a widespread 3 year medical curriculum across the country are addressed, but there is not enough compelling evidence to advocate switching all medical schools in Canada to a 3 yearmedical program.
Abstract: Background: This paper addresses the potential costs and benefits of implementing a widespread 3 year medical curriculum across the country. Methods: We compared differences in curriculum, costs, workforce production, competency, exposure to experiences, timing of career choices, and maturity of students and physicians between 3 and 4 year programs. We accessed this information from 5 school’s online course outlines and by performing a broad search of the literature. Results- Three and four year medical programs have very similar curricular content. The most significant cost savings in a 3 year medical program are due to these students entering the workforce a year earlier. A 3 year program would add more physicians to our workforce initially; however, more doctors are produced over the long term by expanding class sizes. Test scores of graduates from 3 year programs in Canada and the US are similar to graduates from 4 year medical programs. A shorter program could limit the exposure of students to extra curriculars and force them to make earlier career decisions; however, time spent in electives appears to be similar. Conclusions: We do not find enough compelling evidence to advocate switching all medical schools in Canada to a 3 year medical program.