Informed consent learning: Needs and preferences in medical clerkship environments.

PURPOSE:Limited information exists regarding students' routine educational needs in support of ethics and professionalism practices faced in real clinical practice. As such the authors aimed to explore medical students learning needs and preferences for informed consent and relevant ethical issues in the clerkship environments. MATERIALS AND METHODS:A cross-sectional study using a self-administered, printed survey distributed to final year clinical clerks. RESULTS:84% completed the survey. Students indicated the need for more attention to all topics related to informed consent (mean = 7.1 on a scale of 0 to 9; ±1.2). Most additional instructional attention was requested for topics raised in discussions with patients concerning the risks, benefits and alternatives to recommended treatments (7.3 ±1.4). The cohort expressed the need for education in the care of vulnerable patients (7.2 ±1.2) with a maximum score for the care of abused children. Women perceived greater need for education concerning informed consent than male respondents (p>0.05). There were significant differences between students who scored high or low on the item "being treated in professional manner" and "endorsement of educational needs for care of adolescents" (p = 0.05). CONCLUSION:There was heightened perception among final year medical students of the need for greater attention to be paid to informed consent education

Relationships and boundaries: Learning needs and preferences in clerkship medical environments.

PurposeRelationship boundaries recognition is an essential element of medical practice. The aim of the study was to assess final year medical students' perceived need for education regarding professional boundaries.Materials and methodsThis was a cross-sectional study. An anonymous paper questionnaire was distributed to 128 final year medical students. Standard descriptive statistics, unpaired t-test to evaluate differences between male and female groups and Pearson correlation to determine relationships between variables were used.ResultsThe survey was completed by 84.4% of students who identified the need for more emphasis in the curriculum for all of topics during training and practice pertaining to boundaries and relationships (mean 6.61±1.32 on a scale of 0 to 9; and 6.66±1.27 respectively). Topics with a high interest ranking requiring additional attention were mistreatment of medical students (mean 7.22±1.96), coping with mistakes in clinical care (mean 7.25±1.63), reporting of medical mistakes (mean 7.58±1.36), and gender bias in clinical care (mean 7.10±1.82). Women perceived a greater need for attention to all topics in the curriculum. Significant differences between the perceptions of female and male students were observed regarding topics such as responding to an impaired colleague (pConclusionMedical students recognized the need for more education and training in the undergraduate medical ethics curriculum regarding patient-physician relationship boundaries

Outcome Analysis of Visual Acuity and Side Effect after Ruthenium-106 Plaque Brachytherapy for Medium-sized Choroidal Melanoma.

PURPOSE: The purpose of this study is to report on treatment outcomes for medium-sized choroidal melanoma treated with Ruthenium-106 (Ru-106) plaque brachytherapy. METHODS: A retrospective case series of 28 patients received Ru-106 brachytherapy treatment for choroidal melanoma. The prescribed tumor dose was 85 Gy to a depth of 5 mm. RESULTS: Median follow-up was 31.2 months. At 12 and 24-month postirradiation, the best corrected visual acuity ≥20/70 (LogMar ≥-0.54) was 53.8% and 64.2%, respectively. Median time to tumor regression was estimated to be 10 months (95% CI = 9-18 months), with 100% of response rate by 32 months. Radiation-induced side effects were limited, and there were no postradiation enucleations. CONCLUSIONS: The majority of patients maintained good visual acuity, with no enucleations and minimal side effects. In this cohort, the Ru-106 plaque brachytherapy proved to be an efficacious and safe treatment option for patients with medium-sized choroidal melanomas with a maximal tumor height of 5 mm

Ethics teaching in a medical education environment: preferences for diversity of learning and assessment methods

Background: Ethics and professionalism are an integral part of medical school curricula; however, medical students’ views on these topics have not been assessed in many countries. Objective: The study aimed to examine medical students’ perceptions toward ethics and professionalism teaching, and its learning and assessment methods. Design: A self-administered questionnaire eliciting views on professionalism and ethics education was distributed to a total of 128 final-year medical students. Results: A total of 108 students completed the survey, with an 84% response rate. Medical students reported frequently encountering ethical conflicts during training but stated only a moderate level of ethics training at medical school (mean = 5.14 ± 1.8). They noted that their education had helped somewhat to deal with ethical conflicts (mean = 5.39 ± 2.0). Students strongly affirmed the importance of ethics education (mean = 7.63 ± 1.03) and endorsed the value of positive role models (mean = 7.45 ± 1.5) as the preferred learning method. The cohort voiced interest in direct faculty supervision as an approach to assessment of knowledge and skills (mean = 7.62 ± 1.26). Female students perceived greater need for more ethics education compared to males (p = < 0.05). Students who claimed that they had experienced some unprofessional treatment had a more limited view of the importance of ethics as a subject (P = 0.001). Conclusion: Medical students viewed ethics education positively and preferred clinically attuned methods for learning

Intraoperative sonographically assisted radioactive iodine 125 plaque brachytherapy for choroidal melanoma: visual acuity outcome.

OBJECTIVES: The purpose of this study was to present a retrospective series of cases from a single Canadian academic center assessing visual acuity outcomes after intraoperative sonographically assisted iodine 125 ((125)I) plaque brachytherapy treatment. METHODS: The cases of 28 patients (16 male and 12 female; mean age ± SD diagnosis, 62.3 ± 15 years) with choroidal melanoma treated with (125)I plaque brachytherapy using intraoperative sonography between 1997 and 2002 were reviewed. RESULTS: The mean longitudinal, transverse, and depth dimensions were 11.4, 10.6, and 4.7, respectively. The median follow-up was 48 months (range, 3-102 months) for our cohort of patients. The prescribed dose was 85 Gy to a height of 5 mm (for an apex height ≤5 mm) or to the tumor apex (for an apex height \u3e5 mm). Five years after (125)I plaque brachytherapy, all tumors had regressed in their longitudinal, transverse, and depth dimensions. The prebrachytherapy tumor depth (P = .023) and sclera dose (P = .036) were found to significantly affect visual acuity after plaque brachytherapy at 24 months. One recurrence was recorded 6 years after plaque brachytherapy. CONCLUSIONS: This study supports (125)I plaque brachytherapy as an efficacious treatment for patients with choroidal melanoma, and intraoperative sonography may help with optimizing tumor control. In addition, to our knowledge, this study is the first to report the sclera dose as a significant predictor of visual acuity

Health professions students’ approaches towards practice-driven ethical dilemmas; a case-based qualitative study

Abstract Background In healthcare practice, ethical challenges are inevitable and their optimal handling may potentialy improve patient care. Ethical development in medical education is critical for the transition from a medical and health sciences student to an ethical healthcare practitioner. Understanding the health professions students’ approaches towards practice-driven ethical dilemmas could harness i the effective ethical development in their medical education. This study attempts to identify the health professions students’ approaches towards practice-driven ethical dilemmas. Methods An inductive qualitative evaluation was conducted on six recorded videos of health professions students’ case-based online group discussions, followed by a one-hour online ethics workshop. The online ethics workshop was organized with students from the College of Medicine, College of Dental Medicine and College of Pharmacy at the University of Sharjah, and the College of Medicine at the United Arab Emirates University. . The recorded videos were transcribed verbatim and imported to the qualitative data analysis software of MAXQDA 2022. Data were analyzed applying four stages of review, reflect, reduce and retrieve and two different coders triangulated the findings. Results Six themes emerged from the qualitative analysis of the health professions students’ approaches to the practice-based ethical dilemmas; (1) emotions, (2) personal experiences, (3) law and legal system, (4) professional background, (5) knowledge of medical research and (6) inter-professional education. In addition, during the case-based group discussions in the ethics workshop, students efficiently applied the relevant ethical principles of autonomy, beneficence, non-maleficence and justice in their reasoning process to reach an ethical decision. Conclusion The findings of this study explained how health professions students resolve ethical dilemmas in their ethical reasoning process. This work sheds light on ethical development in medical education by gaining students’ perspectives in dealing with complex clinical scenarios. The findings from this qualitative evaluation will aid academic medical institutions in developing medical and research-based ethics curriculum to transform students to ethical leaders