What do Turkish, Spanish, and Pakistani medical students value in specialty training positions? A discrete choice experiment

© The Authors 2022. This document is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by /4.0/ This document is the Accepted version of a Published Work that appeared in final form in BMC Medical Education. To access the final edited and published work see https://doi.org/10.1186/s12909-022-03798-6The aim of this study was to find out specialty training preferences of senior medical students from three medical schools in Turkey, Spain, and Pakistan.Methods:A Discrete Choice Experiment was carried out using an electronic form for students in three countries in 2021–2022 term. Each choice set in the form consisted of two hypothetical specialty training positions. The attributes were location, earnings, working conditions, personal perspective, quality of education, probability of malpractice, and prestige. Conditional logit model was used to estimate participants’ preferences and “willingness to accept” values.Results:The most valued attribute was “personal perspective on specialty area” for Turkish and Spanish students, while this attribute was not meaningful for Pakistani students. Turkish students needed a 204% of change in their income for a swap between the specialty that they like and not like. This tradeoff necessitated a 300% change for Spanish students. The most valued attribute for Pakistani students, which was “working conditions”, necessitated a 97% increase in income to switch from working in good conditions to working in poor conditions.Conclusion:In this first multinational DCE study in the medical education literature, we found the preferences of medical students in Turkey, Spain, and Pakistan are affected to various extents by several factors

COVID-19 vaccine hesitancy and Its relationship with illness risk perceptions, affect, worry, and public trust: An online serial cross-sectional survey from Turkey

Objective: A better understanding of public attitudes towards vaccination and recognition of associated factors with vaccine hesitancy or refusal is important regarding the control of the pandemic. Our aim was to analyze the public's attitudes toward COVID-19 vaccines and to identify factors affecting them. Materials and Methods: Data were drawn from the Turkish COVID-19 Snapshot Monitoring, between July-December 2020, a serial online cross-sectional survey. The sample comprised 3888 adult respondents. Attitudes to vaccines and trust were investigated in 3 periods corresponding to the timeline of pandemic-related events in Turkey. Results: In the third period of our study, in parallel with the increase in the spread of COVID-19, vaccine hesitancy/refusal increased significantly from 43.9% to 58.9% (P < .001). The significant predictors of vaccine refusal were female gender, being elder, and conspiracy thinking. Having a chronic illness, worrying more about loved ones and the health system being overloaded were significant predictors of vaccine willingness. Less compliance with preventive measures, less knowledge of prevention, reduced risk perception, and higher perception of media hype were COVID-19 variables that correlated with vaccine refusal. Trust in the Ministry of Health and medical professional organizations (e.g., Turkish Medical Association) was the lowest in the third period and vaccine refusal was significantly related to the decreased trust (P < .001, P = .002). Conclusion: Most respondents (approximately 60%) refused or hesitated to get a COVID-19 vaccine, though acceptability should be monitored when a vaccine becomes available. Health authorities should consider public trust, risk perception, and behavioral factors to improve COVID-19 vaccine acceptability

Behaviors and pandemic-related knowledge, perceptions, worry content, and public trust in a Turkish sample

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18–30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required

National Undergraduate Medical Core Curriculum in Turkey: Evaluation of Residents

Background: There is very little information available on self-perceived competence levels of junior medical doctors with regard to definitions by the National Core Curriculum (NCC) for Undergraduate Medical Education. Aims: This study aims to determine the perceived level of competence of residents during undergraduate medical education within the context of the NCC. Study Design: Descriptive study. Methods: The survey was conducted between February 2010 and December 2011; the study population comprised 450 residents. Of this group, 318 (71%) participated in the study. Self-assessment questionnaires on competencies were distributed and residents were asked to assess their own competence in different domains by scoring them on a scale of 1 to 10. Results: Nearly half of the residents reported insufficient experience of putting clinical skills into practice when they graduated. In the theoretical part of NCC, the lowest competency score was reported for health-care administration, while the determination of level of chlorine in water, delivering babies, and conducting forensic examinations had the lowest perceived levels of competency in the clinical skills domain. Conclusion: Residents reported low levels of perceived competency in skills they rarely performed outside the university hospital. They were much more confident in skills they performed during their medical education

Tıpta Profesyonelizm ve Tıp Eğitimine Entegrasyonu

The paper focuses on professionalism in medicine and its integration into the medical curriculum. The review highlights that while there is no universally accepted definition of professionalism, it is widely recognized as a dynamic process involving high levels of knowledge, skills, and specialization. The article explores the historical background of professionalism in medicine, emphasizing the enduring ethical principles established by Hippocrates. It also discusses the changing values associated with professionalism over time. The review emphasizes the importance of teaching professionalism in medical schools and notes the increasing interest in studying effective teaching methods. However, it acknowledges a lack of successful implementation examples and emphasizes the need for further research. The article briefly touches on teaching models used in professionalism education and the different components of the medical curriculum: formal, informal, and hidden. Overall, the review aims to contribute to the Turkish literature on professionalism in medicine and provides an overview of the current state of research in this field. Son yıllarda tıpta profesyonelizm kavramı ile ilgili literatürde çok fazla çalışma göze çarpmaktadır. Bu çalışmalarda profesyonelizmin herkes tarafından kabul gören bir tanımı mevcut değildir, birçok tanımı yapılmaktadır. Ayrıca yapılan çalışmalar tıp fakültesi mezunlarında profesyonel mesleki davranışların oluşturulmasında öğretimin önemi konusunda nettir. Bu amaca ulaşmada yardımcı olabilecek birçok öğretim stratejisi ve değerlendirme aracıyla da karşılaşmak mümkündür. Bu nedenlerle derlememizde tıpta profesyonelizm ve müfredata entegrasyonu literatüre dayanılarak açıklanmış ve Türkçe alan yazına katkıda bulunması amaçlanmıştır. Yöntem: Geleneksel derleme yöntemi ile hazırlanmıştır. Profesyonelizm kavramının etimolojik kökeni açıklanmış, daha sonra tıp tarihinde profesyonelizm kavramı özetlenmiştir. Literatürdeki profesyonelizm tanımları tartışılmıştır. Sonraki bölümde tıp eğitimine profesyonelizm entegrasyonundaki adımlardan bahsedilmiş, kullanılabilecek öğretim yöntemleri özetlenmiştir. Bulgular: Profesyonelizm kavramı literatürde çeşitli tanımlamaları yapılan, ortak bir tanımın yapılamadığı bir kavram olarak göze çarpmaktadır. Ancak kısaca profesyonelliği dinamik bir süreç olarak tanımlayabilir, belirli bir alanda yüksek oranda bilgi, uygulama becerisi ve uzmanlaşma olarak adlandırılabiliriz. Hekimlik de eski çağlardan beri var olan sayılı profesyonel mesleklerdendir. Hala günümüzde Hipokrat tarafından gündeme getirilmiş bir takım etik ilkeler varlığını sürdürmektedir. Tarihsel olarak da hekimlikten profesyonelizm temelinde beklenen değerler zaman zaman değişiklik göstermiş, hekimlik profesyonelliği üstüne eklenen veya kaybedilen değerlerle günümüze dek gelmiştir. Sonuç: Güncel literatürde de artık profesyonelliğin tıp fakültelerinde öğretilmesi gerektiği ve nasıl öğretilebileceği ile ilgili yapılan çalışmalar artmaktadır. Ancak ilginin artmasına rağmen başarılı uygulama örneklerindeki yetersizlik göze çarpmaktadır. Bu nedenle tıp eğitiminde profesyonelizm entegrasyonunun nasıl yapılabileceği ile ilgili güncel literatürü de dikkate alarak tıpt a profesyonelizm tanımından, profesyonelizm eğitimde sıklıkla kullanılan öğretim modellerinden, resmi, yazılı olmayan ve örtük müfredattan yazımızda kısaca söz ettik. Literatürde yapılan önemli ölçüde çalışmalar bulunmaktadır, biz de bunları kısaca gözden geçirdik. Ancak buna rağmen konu ile ilgili çok daha fazla araştırmaya ihtiyaç olduğu açıktır. </p

Measuring awareness about child abuse and neglect: Validity and reliability of a newly developed tool-child abuse and neglect awareness scale.

Altan H, Budakoğlu Iİ, Şahin-Dağlı F, Oral R. Measuring awareness about child abuse and neglect: Validity and reliability of a newly developed tool-child abuse and neglect awareness scale. Turk J Pediatr 2018; 60: 392-399. In this study, we aimed at determining child abuse and neglect awareness of medical students attending one of the top medical schools in Turkey. The study group comprised 350 third-year medical students at Gazi University, School of Medicine, Ankara. The items in the scale were prepared by two experienced pediatricians and revised according to feedback received from two pilot studies and experts in this field of study. A 20-item `Child Abuse and Neglect Awareness` scale (CANA-S) was developed by an expert panel. Exploratory and confirmatory factor analyses were performed. We also measured test-retest reliability and internal consistency. Conformity for factor analysis of the scale`s construct validity revealed a Kaiser-Meyer-Olkin sample concordance coefficient of 0.799. For the Bartlett Sphericity test, χ2 value was 1157.750 (p < 0.01). Based on these analyses, the scale explains 44.9% of the total variance and consists of 20 items and 4 subscales. Cronbach`s alpha value and correlation coefficient were 0.768 and r=0.204 (p=0.045), respectively. This scale is a valid and reliable measurement tool for evaluating awareness about child abuse and neglect among the medical students

ContExtended Questions (CEQ) to Teach and Assess Clinical Reasoning: A New Variant of F-Type Testlets

This study introduces ContExtended Questions (CEQ), which is a toolboth to teach and assess clinical reasoning particularly in the preclinical years,and the web-based program to implement. CEQ consists of text-based case-basedmultiple-choice questions that provide patient data in a fixed and predeterminedsequence. It enables the examinees to develop and reshape their illness scripts byusing feedback after every question. Feedback operates to transform theexaminee’s failure into a “productive failure”. The preliminary results of therandomized controlled experiment of teaching clinical reasoning to preclinicalstudents through CEQ is quite satisfactory. In the medical education literature,this would be the first time that students, who have no or very limited clinicalexperience, developed their illness scripts just by taking formative multiple-choicetests. The approach would be named “test-only learning”. The complete results ofthe experiment and then more experiments in other contexts and domains arenecessary to establish a more powerful assessment tool and software.Furthermore, by changing the content of the questions, it is possible to use CEQ inevery period of medical education and health professions education

ChatGPT to generate clinical vignettes for teaching and multiple-choice questions for assessment: A randomized controlled experiment

This study aimed to evaluate the real-life performance of clinical vignettes and multiple-choice questions generated by using ChatGPT. This was a randomized controlled study in an evidence-based medicine training program. We randomly assigned seventy-four medical students to two groups. The ChatGPT group received ill-defined cases generated by ChatGPT, while the control group received human-written cases. At the end of the training, they evaluated the cases by rating 10 statements using a Likert scale. They also answered 15 multiple-choice questions (MCQs) generated by ChatGPT. The case evaluations of the two groups were compared. Some psychometric characteristics (item difficulty and point-biserial correlations) of the test were also reported. None of the scores in 10 statements regarding the cases showed a significant difference between the ChatGPT group and the control group (p > .05). In the test, only six MCQs had acceptable levels (higher than 0.30) of point-biserial correlation, and five items could be considered acceptable in classroom settings. The results showed that the quality of the vignettes are comparable to those created by human authors, and some multiple-questions have acceptable psychometric characteristics. ChatGPT has potential in generating clinical vignettes for teaching and MCQs for assessment in medical education.</p