AMP-Student: Challenges for Scientific Publishing

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Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

<p>Abstract</p> <p>Background</p> <p>Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option.</p> <p>Methods</p> <p>Two self-report questionnaires were administered to all 6^thyear students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests.</p> <p>Results</p> <p>153 students (60.8% female) filled in both questionnaires (no dropouts). After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry.</p> <p>However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students.</p> <p>Conclusions</p> <p>The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.</p

Longitudinal evaluation, acceptability and long-term retention of knowledge on a horizontally integrated organic and functional systems course

Undergraduate medical education is moving from traditional disciplinary basic science courses into more integrated curricula. Integration models based on organ systems originated in the 1950s, but few longitudinal studies have evaluated their effectiveness. This article outlines the development and implementation of the Organic and Functional Systems (OFS) courses at the University of Minho in Portugal, using evidence collected over 10 years. It describes the organization of content, student academic performance and acceptability of the courses, the evaluation of preparedness for future courses and the retention of knowledge on basic sciences. Students consistently rated the OFS courses highly. Physician tutors in subsequent clinical attachments considered that students were appropriately prepared. Performance in the International Foundations of Medicine examination of a self-selected sample of students revealed similar performances in basic science items after the last OFS course and 4 years later, at the moment of graduation. In conclusion, the organizational and pedagogical approaches of the OFS courses achieve high acceptability by students and result in positive outcomes in terms of preparedness for subsequent training and long-term retention of basic science knowledge

The World Health Organization Multi-Professional Patient Safety Curriculum: implementation of key modules and its impact on patient safety knowledge, skills, and attitudes of medical students at the University of Algarve

ABSTRACT - Objectives: We attempted to show how the implementation of the key elements of the World Health Organization Patient Safety Curriculum Guide Multi-professional Edition in an undergraduate curriculum affected the knowledge, skills, and attitudes towards patient safety in a graduate entry Portuguese Medical School. Methods: After receiving formal recognition by the WHO as a Complementary Test Site and approval of the organizational ethics committee , the validated pre-course questionnaires measuring the knowledge, skills, and attitudes to patient safety were administered to the 2nd and3rd year students pursuing a four-year course (N = 46). The key modules of the curriculum were implemented over the academic year by employing a variety of learning strategies including expert lecturers, small group problem-based teaching sessions, and Simulation Laboratory sessions. The identical questionnaires were then administered and the impact was measured. The Curriculum Guide was evaluated as a health education tool in this context. Results: A significant number of the respondents, 47 % (n = 22), reported having received some form of prior patient safety training. The effect on Patient Safety Knowledge was assessed by using the percentage of correct pre- and post-course answers to construct 2 × 2 contingency tables and by applying Fishers’ test (two-tailed). No significant differences were detected (p < 0.05). To assess the effect of the intervention on Patient Safety skills and attitudes, the mean and standard deviation were calculated for the pre and post-course responses, and independent samples were subjected to Mann-Whitney’s test. The attitudinal survey indicated a very high baseline incidence of desirable attitudes and skills toward patient safety. Significant changes were detected (p < 0.05) regarding what should happen if an error is made (p = 0.016), the role of healthcare organizations in error reporting (p = 0.006), and the extent of medical error (p = 0.005). Conclusions: The implementation of selected modules of the WHO Patient Safety Curriculum was associated with a number of positive changes regarding patient safety skills and attitudes, with a baseline incidence of highly desirable patient safety attitudes, but no measureable change on the patient safety knowledge, at the University of Algarve Medical School. The significance of these results is discussed along with implications and suggestions for future research.RESUMO - Objetivos: Tentamos demonstrar como a aplicação de elementos-chave da World Health Organization Patient Safety Curriculum Guide Multi-professional Edition no currículo afeta conhecimentos, competências e atitudes em relação à segurança do paciente no curso de Medicina pós-graduado da Universidade do Algarve,Portugal. Métodos: Após reconhecimento formal pela OMS como um Site Complementar e aprovação da comissão de ética organizacional, os questionários pré-curso validados foram administrados ao 2º e 3º ano de um curso de quatro anos (n = 46). Módulos chave do currículo da OMS foram implementadas ao longo do ano letivo utilizando varias de estratégias pedagógicas, incluindo aulas por peritos, sessões de ensino em pequenos grupos baseada em problemas(PBL),tal como sessões de laboratório de simulação seguido por administração de questionários idênticos.O impacto das atividades de aprendizagem foram availadas,tal como a introdução do currículo como ferramenta de aprendizagem neste contexto. Resultados: Um número significativo de inquiridos 47%, (n = 22) relataram algum tipo de formação prévia na área de segurança do paciente. O efeito sobre os Conhecimentos de Segurança do Paciente foram avaliados utilizando a percentagem de respostas certas pré e pós-curso para construir tabelas de contingência 2x2 e aplicando o Teste de Fischers(2 caudas).Não foram detetadas diferenças significativas (P <0,05). Para avaliar o efeito da intervenção em competências e atitudes de Segurança do Paciente, a média e o desvio-padrão foi calculada para as respostas pré e pós-curso, e foi aplicado o teste de Mann-Whitney para amostras independentes. A avaliação de atitudes indicou uma incidência base muito elevada de atitudes desejáveis para a segurança do paciente. Foram detetadas alterações significativas (P <0,05) em relação ao que deveria acontecer no caso de ocorrer um erro (p = 0,016), o papel das organizações de saúde em reportar o erro (p = 0,006) e na ocorrência elevada do erro médico (p = 0,005). Conclusões: A implementação de módulos chave do Curriculum Multiprofissional Segurança do Paciente da OMS foi associado a algumas alterações de atitude positivas em relação à segurança do paciente num grupo com incidênciad e atitudes positivas, de base,já elevada. Não foi mensurável qualquer alteração no nível de Conhecimentos no âmbito de segurança do paciente, neste grupo de estudantes do curso de medicina da Universidade do Algarve. O significado destes resultados é discutido tal como as sugestões para futuras investigações

Comparing empathy in medical students of two Portuguese medicine schools

Background Empathy is paramount in the doctor-patient relationship being a comprehensive and multidimensional concept. Self-ratings of empathy change across the years of medical education only when the Jefferson Scale of Physicians Empathy is used, with a worrying decrease being found throughout the years in Medicine Schools. As there are only few studies on the factors influencing medical student’s empathy, particularly of the curricular model, this study aimed to compare the levels of empathy of medicine students of two Schools with different curricular models in central Portugal, the Faculty of Medicine - University of Coimbra (FMUC) and the Faculty of Health Sciences - University of Beira Interior (FCS-UBI). Methods Cross-sectional observational study with the Jefferson Scale of Physician Empathy – students’ Portuguese version (JSPE – spv) to 1st, 3rd and 6th year students of the 2017/2018 academic year with descriptive and inferential statistical analysis (p < 0.05). Results Size representative sample of 795 students. Higher total empathy score (TES) (p = 0.008) and “Perspective taking” (p = 0.001) in FCS-UBI were found. JSPE-TES was higher in FCS-UBI, 3rd year (p = 0.038). Higher FCS-UBI “Perspective taking” in the 1st year (p = 0.030) and 6th year (p = 0.044), for “Compassionate care” in the 3rd (p = 0.019) and for “Standing in the patient’s shoes” in the 1st year (p = 0.018) and in FMUC for “Compassionate care” in the 1st year (p = 0.037) and the “Standing in the patient’s shoes” in year 3 (p = 0.002) were found. Higher levels of empathy were found in FCS-UBI female students, for JSPE-TES (p = 0.045) and “Perspective taking” (p = 0.001). Conclusion Higher empathy levels in FCS-UBI were found, with different results in the third year suggesting influence of the medical course teaching characteristics between the two Medicine schools, student’s empathy levels being higher when earlier and more intense contact with patients accompanied by skilled tutors was developed.info:eu-repo/semantics/publishedVersio