Consumers as tutors - legitimate teachers?

BACKGROUND: The aim of this study was to research the feasibility of training mental health consumers as tutors for 4th year medical students in psychiatry. METHODS: A partnership between a consumer network and an academic unit in Psychological Medicine was formed to jointly develop a training package for consumer tutors and a curriculum in interviewing skills for medical students. Student attitudes to mental health consumers were measured pre and post the program. All tutorial evaluation data was analysed using univariate statistics. Both tutors and students evaluated the teaching program using a 4 point rating scale. The mean scores for teaching and content for both students and tutors were compared using an independent samples t-test. RESULTS: Consumer tutors were successfully trained and accredited as tutors and able to sustain delivery of tutorials over a 4 year period. The study found that whilst the medical students started with positive attitudes towards consumers prior to the program, there was a general trend towards improved attitude across all measures. Other outcomes for tutors and students (both positive and negative) are described. CONCLUSIONS: Consumer tutors along with professional tutors have a place in the education of medical students, are an untapped resource and deliver largely positive outcomes for students and themselves. Further possible developments are described

Japanese medical student attitudes towards English accents and the implications these attitudes have on teaching medical English conversation

The central questions this paper seeks to address are: 1) What are the attitudes of first year medical students in a Japanese medical school towards the varieties of English that exist in the world? More specifically, do these students consider mother tongue varieties of English to be disproportionately superior to other varieties of English? 2) What implications do those attitudes have on the teaching of English within the context of a medical English conversation class in a Japanese medical school

Family Centered Rounds Simulation and Medical Students\u27 Perceptions

Background: Studies show that family centered rounds (FCR) improve family satisfaction by involving the families in their children’s care. Medical students consistently find FCR beneficial to families but have differing attitudes regarding benefits to the medical team. Some concerns raised by the students include longer rounds, decreased bedside teaching, and lack of opportunities to improve FCR skills. We developed a FCR simulation to aid medical students in FCR presentation. Methods: On the first day of the clerkship, medical students presented a patient admission to two evaluators playing a parent and an attending physician. The patient admission note was emailed to the students prior to the simulation. Students were provided immediate feedback and asked to complete a survey. The survey asked if they thought FCR would benefit family, nurses, physicians, students, and efficiency of rounds. The students provided answers based on five point Likert scale. Finally, they completed a similar survey at the end of the clerkship. Results: The vast majority (95%) of the students had never participated in FCR prior to the simulation. The simulation made students more comfortable presenting in FCR (average score 4.5 on 5 point Likert Scale). There were no significant differences in positive attitudes towards FCR to families, nursing, physician, and medical education in the pre and post clerkship surveys. Most (67%) students’ perception towards FCR changed positively by the end of the clerkship. Discussion: Most of the medical students had never participated in FCR presentation prior to the start of the clerkship, and they found the simulation helpful in preparing for FCR. Although specific attitudes about the benefit of FCR to the family and medical team did not change likely due to ceiling effect, most of the students did have positive perception of FCR by the end of the clerkship

Transgender Healthcare Teaching in the Undergraduate Medical School Curriculum

With increasing recognition of the diverse and specific needs of transgender individuals in a health care setting, lack of knowledge, poor attitudes and prejudice towards transgender patients can result in this population being afraid to access medical care. Educating medical students early in their career in a sensitive and inclusive manner could help change these attitudes. It has been shown that medical undergraduates and post-graduates often feel unprepared or uncomfortable in caring for transgender patients due to lack of training and experience2-4. The aim of this study was to address this through introduction of basic transgender healthcare education into the University of Glasgow undergraduate medical curriculum, with the goal of implementing further interactive and fully inclusive teaching

Changing medical student attitudes to patient safety: A multicentre study

Background: Although patient safety is becoming widely taught in medical schools, its effect has been less rigorously evaluated. We describe a multicentre study to evaluate student changes in patient safety attitudes using a standardized instrument, the Attitudes to Patient Safety Questionnaire3 (APSQ3). Methods: A patient safety training package designed for medical students was delivered in the first year and second year in four Australian medical schools. It comprises eight face-to-face modules, each of two hours. Seminars start with an interactive introduction using questions, video and role play, followed by small group break-outs to discuss a relevant case study. Groups are led by medical school tutors with no prior training in patient safety. Students and tutors then reassemble to give feedback and reinforce key concepts. Knowledge and attitudes to patient safety were measured using the APSQ3, delivered prior to safety teaching, at the end of the first and second years and 12 months after teaching ceased. Results: A significant improvement in attitude over time was demonstrated for four of nine key items measured by the APSQ3: value of patient safety teaching; danger of long working hours, value of team work and the contribution patients can make in reducing error. Informal feedback from students was very positive. Conclusion: We showed persistent, positive learning from a patient safety education intervention 12 months after teaching finished. Building on the introduction of patient safety teaching into medical schools, pathways for motivated students such as appropriate electives, option terms and team-based research projects would be of value

Structured Smoking Cessation Training for Medical Students: a prospective study

Introduction: Physician adherence to guideline recommendations regarding the provision of counseling and support for smokers willing to quit is low. A lack of training during undergraduate medical education has been identified as a potential cause. This prospective intervention study evaluated a novel teaching module for medical students. Methods: As part of a 6-week cardiovascular course, 125 fourth-year undergraduate medical students received a multimodal and interactive teaching module on smoking cessation, including online learning material, lectures, seminars, and practical skills training. Short- and medium-term effects on knowledge, skills, attitudes, and self-reported practice were measured using written examinations and an objective structured clinical examination at the end of the module and 6 months later. Results were compared to data obtained from a historical control cohort (n = 70) unexposed to the intervention. Results: At the 6-month follow-up, scores in the knowledge test were significantly higher in the intervention than the control group (61.1% vs. 51.7%; p < .001). A similar pattern was observed in the objective structured clinical examination (71.5% vs. 60.5%; p < .001). More students in the intervention than control group agreed that smoking was a chronic disease (83.1% vs. 68.1%; p = .045). The control group was more likely to report recording smoking status (p = .018), but no group difference was detected regarding the report of advising to quit (p = .154). Conclusions: A novel teaching module for undergraduate medical students produced a sustained learning outcome in terms of knowledge, skills, and attitudes but not self-reported practice. Implications: Studies across the world have identified considerable knowledge gaps and deficits in practical training with regard to smoking cessation counseling in undergraduate medical students. This paper describes a teaching intervention informed by current recommendations for the design of educational activities aimed at enabling medical students to deliver adequate behavior change counseling. The teaching module was tailored to the needs of a specific healthcare system. Given its effectiveness as demonstrated in this prospective study, a rollout of this intervention in medical schools might have the potential to substantially improve medical students’ knowledge, skills, and attitudes in relation to smoking cessation counseling

Does the inclusion of 'professional development' teaching improve medical students' communication skills?

Background: This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations.Methods: Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35) received a traditional pre-clinical curriculum. Group 2 (n = 47) received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported.Results: Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination.Conclusions: Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being an abstract concept. Students in the early years of their medical course may benefit from further opportunities to practise basic communication skills on a one-to-one basis with patients

Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand

Background: The objective of pain medicine education is to provide medical students with opportunities to develop their knowledge, skills and professional attitudes that will lead to their becoming safe, capable, and compassionate medical practitioners who are able to meet the healthcare needs of persons in pain. This study was undertaken to identify and describe the delivery of pain medicine education at medical schools in Australia and New Zealand. Method: All 23 medical schools in Australia and New Zealand in 2016 were included in this study. A structured curriculum audit tool was used to obtain information on pain medicine curricula including content, delivery, teaching and assessment methods. Results: Nineteen medical schools (83%) completed the curriculum audit. Neurophysiology, clinical assessment, analgesia use and multidimensional aspects of pain medicine were covered by most medical schools. Specific learning objectives for pain medicine were not identified by 42% of medical schools. One medical school offered a dedicated pain medicine module delivered over 1 week. Pain medicine teaching was delivered at all schools by a number of different departments throughout the curriculum. Interprofessional learning (IPL) in the context of pain medicine education was not specified by any of the medical schools. The mean time allocated for pain medicine teaching over the entire medical course was just under 20 h. The objective structured clinical examination (OSCE) was used by 32% of schools to assess knowledge and skills in pain medicine. 16% of schools were unsure of whether any assessment of pain medicine education took place. Conclusion: This descriptive study provides important baseline information for pain medicine education at medical schools in Australia and New Zealand. Medical schools do not have well-documented or comprehensive pain curricula that are delivered and assessed using pedagogically-sound approaches considering the complexity of the topic, the prevalence and public health burden of pain

Skills Training in Laboratory and Clerkship: Connections, Similarities, and Differences

Context: During the third semester of a 6 year long curriculum medical students train clinical skills in the skills laboratory (2 hours per week for 9 weeks) as well as in an early, 8 week clinical clerkship at county hospitals. Objectives: to study students’ expectations and attitudes towards skills training in the skills laboratory and clerkship. Subjects: 126 medical students in their 3rd semester. Methods: During the fall of 2001 three consecutive, constructed questionnaires were distributed prior to laboratory training, following laboratory training but prior to clerkships, and following clerkships respectively. Results: Almost all (98%) respondents found that training in skills laboratory improved the outcome of the early clerkship and 70% believed in transferability of skills from the laboratory setting to clerkship. Still, a majority (93%) of students thought that the clerkship provided students with a better opportunity to learn clinical skills when compared to the skills laboratory. Skills training in laboratory as well as in clerkship motivated students for becoming doctors. Teachers in both settings were perceived as being committed to their teaching jobs, to demonstrate skills prior to practice, and to give students feed back with a small but significant more positive rating of the laboratory. Of the 22 skills that students had trained in the laboratory, a majority of students tried out skills associated with physical examination in the clerkship, whereas only a minority of students tried out more intimate skills. Female medical students tried significantly fewer skills during their clerkship compared to male students. Conclusions: Students believe that skills laboratory training prepare them for their subsequent early clerkship but favour the clerkship over the laboratory

Attitudes towards suicide following an undergraduate suicide prevention module: experience of medical students in Hong Kong

OBJECTIVES: To explore qualitative and quantitative changes in attitudes and experiences of medical students following a special study suicide prevention module. DESIGN: Pilot study. SETTING: The University of Hong Kong, Hong Kong. PARTICIPANTS: A 2-week intensive special studies module was delivered to third- and fourth-year medical students in June 2011. The module was elective and involved several modes of teaching. All students filled the Chinese Attitude toward Suicide Questionnaire before and after the course. They also provided written feedback about the module experience. Three students participated in in-depth interviews. RESULTS: In all, 22 students aged 20 to 23 years enrolled in the special studies module; 15 (68%) of whom were male and only one was married. Positive trends were noted in attitudes towards suicide following the participation in the special studies module, namely, reduced negative appraisal of suicide, reduced stigmatisation of the phenomena, and increased sensitivity to suicide-related facts. Feedback of the students suggested inclusion of this module into the main medical curriculum, increased confidence in dealing with issues related to suicide, and appreciation of skills focusing on interviewing in patients. Overall the module was well received by medical students. CONCLUSIONS: A suicide prevention training module seems to have been valued by students and lead to positive attitudes towards understanding suicide. Adopting this initiative as a suicide prevention strategy warrants further exploration.published_or_final_versio