Evidence of gender bias in True-False-Abstain medical examinations

Background: There is evidence that males and females differ in their attainment on a variety of assessments in general and in medical education. It has been suggested that the True-False-Abstain (TFA) format with negative marking is biased against females. Methods: Eight years worth of examination data from the first two years of an undergraduate medical curriculum was analysed. 359 courses were evaluated for statistically significant differences between the genders using ANOVA. Logistic regression was used to test if subject area, calendar year or exam format predicted that males or females do better (termed male advantage or female advantage). Results: Statistically significant differences between the genders were found in 111 (31%) of assessments with females doing better than males in 85 and males better in 26. Female advantage was associated with a particular year (2001), the Personal and Professional Development strand of the curriculum, in course assessment and short answer questions. Male advantage was associated with the anatomy and physiology strand of the curriculum and examinations containing TFA formats, where the largest gender difference was noted. Males were 16.7 times more likely than females to do better on an assessment if it contained any questions using the TFA format. Conclusions: Although a range of statistically significant gender differences was found, they were concentrated in TFA and short answer formats. The largest effect was for TFA formats where males were much more likely to do better than females. The gender bias of TFA assessments in medical education is yet another reason why caution should be exercised in their use.</p

Written emotional disclosure for improving depression for adults with long-term physical conditions : the case of type 2 diabetes

Depression is twice as prevalent among people with long-term physical conditions (LTPCs), and it confers an increased risk of additional morbidity and early mortality. Psychological interventions such as those based on cognitive behavioural therapy (CBT), can improve outcomes but widespread provision is problematic. Written emotional disclosure (WED) is a brief, inexpensive intervention that may offer a pragmatic solution. Its effects, however, are unclear, since reviews have drawn different conclusions and used inadequate methodology. A methodologically robust systematic review of RCTs, evaluating WEDs effects on psychological health and quality of life (QoL) in adults with LTPCs, concluded that WED may be effective for reducing negative affect including depression, and some associated outcomes. However, future endeavours must improve methodological rigor and explore WED for LTPCs impacted by negative affect. Type 2 diabetes is consistent with this specification yet understudied in WED. An exploratory RCT investigating WED for improving depressive symptom severity, and some secondary outcomes, in adults with Type 2 diabetes was undertaken. A test of WEDs anticipated effect, further exploration of this and an investigation of feasibility was initially intended. However, ethical and recruitment issues necessitated that the objectives be narrowed down to a focus on feasibility and a very much exploratory analysis of the effectiveness of WED. Recruitment was via primary care supplemented with online support groups, albeit secondary care was also attempted. The study identified that WED may be acceptably and feasibly implemented as part of general practice in the UK and for use with LTPCs in this context, specifically Type 2 diabetes. However, ethical and recruitment also issues necessitated delivery of WED to patients with none or very low-level depressive symptoms, for whom it may cause iatrogenic harm. However, a number of methodological issues substantially undermined these findings. Further research addressing the pitfalls associated with previous endeavours is required before consideration of WED in primary care for LTPCs including Type 2 diabetes

A quantitative study of Iranian nursing students' knowledge and attitudes towards pain: Implication for education

It is well documented that pain management and pain assessment is an indispensible part of the nursing care of patients. This study sought to quantify the current knowledge and attitudes of nursing students in Iran about pain management. We conducted a cross-sectional study using a well-validated questionnaire entitled the `Knowledge and Attitudes Regarding Pain Tool', previously used to evaluate undergraduate nursing students. Results from the survey questionnaire showed that there was a severe deficit in knowledge relating to pain and its management. It is argued that there is a real need for improving the content of pain and its management in the undergraduate nursing education curriculum, which might improve the delivery of optimal nursing care of patients. The limitations of the study are discussed and some recommendations are made for reforming pain management education for future practice

Written emotional disclosure for improving depression for adults with long-term physical conditions : the case of type 2 diabetes

Depression is twice as prevalent among people with long-term physical conditions (LTPCs), and it confers an increased risk of additional morbidity and early mortality. Psychological interventions such as those based on cognitive behavioural therapy (CBT), can improve outcomes but widespread provision is problematic. Written emotional disclosure (WED) is a brief, inexpensive intervention that may offer a pragmatic solution. Its effects, however, are unclear, since reviews have drawn different conclusions and used inadequate methodology. A methodologically robust systematic review of RCTs, evaluating WEDs effects on psychological health and quality of life (QoL) in adults with LTPCs, concluded that WED may be effective for reducing negative affect including depression, and some associated outcomes. However, future endeavours must improve methodological rigor and explore WED for LTPCs impacted by negative affect. Type 2 diabetes is consistent with this specification yet understudied in WED. An exploratory RCT investigating WED for improving depressive symptom severity, and some secondary outcomes, in adults with Type 2 diabetes was undertaken. A test of WEDs anticipated effect, further exploration of this and an investigation of feasibility was initially intended. However, ethical and recruitment issues necessitated that the objectives be narrowed down to a focus on feasibility and a very much exploratory analysis of the effectiveness of WED. Recruitment was via primary care supplemented with online support groups, albeit secondary care was also attempted. The study identified that WED may be acceptably and feasibly implemented as part of general practice in the UK and for use with LTPCs in this context, specifically Type 2 diabetes. However, ethical and recruitment also issues necessitated delivery of WED to patients with none or very low-level depressive symptoms, for whom it may cause iatrogenic harm. However, a number of methodological issues substantially undermined these findings. Further research addressing the pitfalls associated with previous endeavours is required before consideration of WED in primary care for LTPCs including Type 2 diabetes.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Empathy in Iranian medical students: A preliminary psychometric analysis and differences by gender and year of medical school

Background: It has been well documented that effective empathic communication in the context of patient care is associated with improved health care outcomes. However, the emphasis given to empathy in medical education in Iran is limited, and the state of such teaching is unknown in many countries. Aims: To determine the psychometric properties of an Iranian translation of the Jefferson Scale of Physician Empathy (JSPE) among medical students, and to examine the differences on mean empathy scores by gender and the different years of medical school. Method: A cross-sectional study was conducted among medical students. Data analysis was based on 181 questionnaires. Principal component analysis (PCA) with Varimax rotation was used to identify the number and composition of components constituting the developed constructs. Results: The PCA yielded three factors: Compassionate care, perspective-taking, and the ability to walk in the patient's shoes. No statistically significant differences in the empathy means scores were found by gender and the different years of medical school. Conclusions: The Persian version of JSPE is a psychometrically sound instrument to measure empathy. Cultural backgrounds and pedagogical practice may influence medical students' attitudes towards empathy. Some recommendations are made, and the study limitations are discussed

'Can you take a student this morning?' Maximising effective teaching by practice nurses

&lt;p&gt;&lt;b&gt;Objectives:&lt;/b&gt; Little is known about the contribution that nurses make to medical student learning. This study set out to explore the nature of practice nurse teaching during the general practice clerkship and to explore ways in which the teacher and learner (the practice nurse and the medical student) can be best supported to maximise learning.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Method:&lt;/b&gt; Mixed focus groups were conducted with general practitioner educational supervisors and practice nurses. Further focus groups were conducted with students on completing a clerkship.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; There is wide variation in the delivery, organisation and expectations of practice nurse teaching. While there is some evidence of a passive learning experience the learning dynamic and the student-nurse relationships are regarded highly.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Time spent with practice nurses is an important part of the clerkship in general practice. The nature of the practice nurse-medical student relationship is different to the educational supervisor-medical student relationship and can be built upon to maximise learning during the clerkship. The experience for the practice nurse, the medical student, and the supervisor can be enhanced through formal preparation for delivering teaching&lt;/p&gt