Purpose This study examines various aspects related to medical professionalism in medical students during coronavirus disease 2019 (COVID-19) pandemic, focusing on their medical professionalism attributes, KPA (knowledge, practices, and attitudes) toward COVID-19 and attitudes toward provision of care in pandemic. We assessed whether these aspects related to medical professionalism were varied by their demographics and mental health level.
Methods Six questionnaires related to medical professionalism were distributed online to medical students in six grades at a single medical school. A one-way analysis of variance was used to examine differences in scores related to medical professionalism based on their demographics, for examples, gender, grade, residence, religion, as well as their mental health levels. Pearson correlation analysis was used to examine correlations between each variable.
Results Female students scored higher on medical professionalism attributes and attitudes toward duty-to-care than male students. Medical professionalism attribute scores were higher with higher relationship satisfaction and resilience levels but lower with higher anxiety levels. Furthermore, these scores were significantly associated with attitudes toward COVID-19 preparedness. However, COVID-19 knowledge and practice scores were negatively associated with attitudes toward COVID-19 preparedness and careers after graduation. Meanwhile, students who took the leave of absence related to 2020 doctors’ strike had significantly lower scores on attitudes toward COVID-19 preparedness and duty to care than those who did not.
Conclusion Our findings suggest that mental health of medical students is strongly related to their various aspects related to medical professionalism, especially their attitudes toward COVID-19 preparedness. Good mental health was positively linked to medical professionalism attributes and attitudes toward COVID-19 preparedness. However, knowledge and practice of COVID-19 were negatively associated with willingness to participate in the pandemic response. Additionally, the experience of the 2020 leave of absence impacted the attitudes of medical students toward COVID-19 preparedness (p=0.015) and their duty to care (p=0.012) negatively.
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Purpose Hybrid learning has been chosen as an alternative method in the conduction of clinical skill lectures during coronavirus disease 2019 (COVID-19) pandemic since students need to learn skills applied in emergency situations. This study aims to analyze students’ attitudes between hybrid and online learning methods.
Methods A non-randomized study was conducted between hybrid group (HG) and online group (OG) on three courses (intravenous [IV]-line insertion, nasogastric tube [NGT] insertion, and neonatal resuscitation). We developed a preformed validated questionnaire to assess students’ attitudes in five domains (willingness, understanding, capacity, self-efficacy, and intended behavior). The questionnaire was applied at the pre- and post-intervention.
Results A total of 100 participants were included (n=49 in HG, n=51 in OG). Post-course attitudes were significantly higher in online (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) and hybrid (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) groups compared to their pre-course. There were no significant differences in post-course attitude between groups (IV-line, p=0.072; NGT, p=0.163; resuscitation, p=0.146). Normalized-gain scores of all subjects were higher in HG (IV-line, p=0.012; NGT, p=0.085; resuscitation, p=0.033).
Conclusion In conclusion, hybrid learning could be considered as a better alternative in clinical skill lectures to maximize students’ attitudes, especially during COVID-19 pandemic.
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Purpose Medical educators are central in ensuring future doctors have sufficient public health skills. Attitudes, norms, and perceived control about the significance of teaching a subject determines whether or not it is taught and how well. This qualitative study aims to explore medical educators’ perceptions about what factors influence their intention to teach public health in Indonesian undergraduate medical schools.
Methods Semi-structured interviews were conducted with eighteen medical educators from different Indonesian medical schools. Interviews were analyzed thematically using the Theory of Planned Behavior domains: attitudes, subjective norms, and perceived behavioral control.
Results Five subthemes emerged under these domains: attitudes (defining public health); subjective norms (room in the medical curricula; teaching and assessment); and perceived behaviour control (medical educator confidence; institutional support). Most participants had a limited understanding about the scope of public health. This coupled with an already overcrowded medical curriculum made it challenging for them to incorporate public health into the medical curriculum dominated by clinical and biomedical content. Although believing that public health is important, medical educators were reluctant to incorporate public health because they were not confident incorporating or assessing content.
Conclusion Strong institutional support is to improve public health quality and content in the medical curriculum. Including public health educators in discussions is critical.
Purpose We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output.
Methods Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish.
Results A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341–8.307), age (OR, 1.087; 95% CI, 1.019–1.159), academic standing (OR, 1.730; 95% CI, 1.103–2.715), and confidence (OR, 1.086; 95% CI, 1.009–1.169) were positive predictors of publication in peer reviewed journals.
Conclusion The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance.
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Purpose This study aimed to clarify the attitudes, behaviors, and learning experiences of first-year medical students participating in a nursing practice training aimed at enhancing their professionalism.
Methods A questionnaire survey was conducted among first-year medical students after their nursing practical training to understand their learning experiences. Descriptive statistics was performed for each questionnaire item. For free-text responses, descriptions were grouped by input data with similar content and meaning, and analyzed qualitatively. Others’ evaluation and self-evaluation were analyzed quantitatively.
Results Most students were actively engaged and fulfilled in the training. The free comments generated these categories: “nursing care,” “roles of nurses,” “patient impressions,” “multidisciplinary cooperation,” “communication,” and “what is required of physicians. On the first day, all items evaluated had higher mean scores in the others’ evaluation than in the self-evaluation. On the second day, for “maintains standards of personal appearance (including uniform, hair, and name tag),” the others’ evaluation means were higher than the self-evaluation means. T-tests showed a significant difference in “maintains standards of personal appearance (including uniform, hair, and name tag)” (t=-2.103, degrees of freedom [df]=71.104, p<0.05) and “attends to patients with a polite manner” (t=-2.087, df=74, p<0.05) for both the high and low groups.
Conclusion Greeting, appearance, communication skills, and attitude were found to be the important bases of attitude education in the nursing training ideally involving multidisciplinary professionals. The medical students were able to grasp what is required of doctors and objectively view such position from the viewpoints of nurses and patients.
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Purpose Active involvement of students in their learning process is a recommended andragogical approach to increase student engagement. Many new teaching-learning strategies based on active learning have been implemented, but their efficacies to achieve the proposed benefits of attaining knowledge, skills, and attitude have not been evaluated, especially in the field of medical education. We substituted passive learning in the conventional tutorial classes with an active-learning strategy of Student-Led Seminar Series (SLSS) in the subject of physiology over 4 months and performed program evaluation for the SLSS.
Methods Sixty-four first-year medical undergraduate students volunteered to participate, who were divided into groups to present seminars on the allocated topics under the guidance of a mentor. At the end of 4 months, program evaluation was done using Kirkpatrick’s model of evaluation—levels 1 and 2, which correspond to reaction and learning, respectively.
Results Statistically significant improvement was observed in students’ satisfaction, and the self-perceived increase was observed in knowledge, skills, and attitude.
Conclusion Program evaluation of SLSS not only established the significant impact of SLSS as an andragogical approach but also helped us in the improvisation of the program for the next cycle.
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Results IPAS and SEIEL values increased after the class for MSs in both groups; there were no differences between the groups. IPAS and SEIEL values increased after the class in MSs and NSs in the IP group, and the effect size for IPAS was larger for IP-group NSs than for IP-group MSs. Satisfaction scores exceeded 3.70 in both groups.
Conclusion The UP group showed similar IPE effects as the IP group, as measured by SEIEL and IPAS, in a single IPE program that used role-play and case-based discussion. However, it would be desirable for the UP group to interact with other professions to improve understanding and experience.
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Purpose This study investigated the attitudes of Korean medical students about patient safety to determine which perspectives required increased focus in terms of educational development.
Methods Attitudes were assessed using the Patient Safety Questionnaire, a tool designed to measure attitudes toward patient safety among medical students. Questionnaires were distributed to 580 clinical year students across four medical schools in December 2018.
Results A total of 300 returned questionnaires were used in the final analysis. More than half of all respondents agreed (i.e., gave more than 4 out of 7 points) with most items and thoroughly considered the concept of patient safety. However, many students misperceived several items (e.g., professional incompetence as a cause of errors, disclosure responsibility, the importance of patient safety in the curriculum, and situational awareness).
Conclusion Attitudes toward patient safety are highly important due to their substantial impacts on behavioral decisions in the clinical setting. As such, patient safety education should be designed to place greater emphasis on proper attitude. This study’s findings should be useful for medical instructors who wish to determine the appropriate areas of curricular focus.
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Purpose This study attempted to examine the influence of resilience, life satisfaction, and psychological well-being on attitude to death.
Methods A predictive correlational design was used. The participants were 184 nursing students from three universities of Korea. They responded to a self-report questionnaire, with items on demographics, resilience, life satisfaction, psychological well-being, and attitude to death.
Results The mean score for attitude to death was 2.77±0.39 (range, 1–4), and a significant difference was observed depending on age, grade, and death-related education. Attitude to death was positively correlated with death-related education, resilience, life satisfaction, and psychological well-being. Results of the hierarchical multiple regression analysis indicated that death-related education and psychological well-being were significant predictors of attitude to death, explaining 26.6% of the latter. The most important factor was psychological well-being.
Conclusion Although death-related education and psychological well-being are two of the most influential factors among nursing students, no more than 30.4% of this study’s participants received death-related education. Death-related education is necessary to help nursing students so that they can cope positively with stressful situations by finding positive meaning. It is necessary to develop a systematic curriculum so that these students can establish a positive attitude to death.
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PURPOSE There have been studies on the patient-centeredness of medical students and physicians in South Korea, but no result has presented the patient-centered attitude of patients and doctors. So, this study intended to compare the attitudes of patients and doctors toward the roles that patients and physicians should play in the health care process.
METHODS One hundred and fifteen doctors and 264 patients participated in this survey using a structured questionnaire, including sociodemographic data and Patient Practitioner Orientation Scale (PPOS). The PPOS comprises sharing (sharing information, take part in decision making) and caring (respecting one's feelings, interpersonal relationships) subscales.
RESULTS The PPOS scores of the doctors and patient were 3.02 and 3.20. In detail, the doctors' sharing and caring scores were and 3.02 and 3.48, and the those of patients were 3.14 and 3.12, respectively. This results are enough to demonstrate that patients are likely to be patient-centered with regard to sharing and that doctors tend to be patient-centered in terms of caring.
CONCLUSION The patients' desire to obtain medical information and take part in decision making (sharing) are greater than those of doctors. Doctors had more patient-centered attitude than patients in terms of respects for one's feelings and interpersonal relationships (caring).
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PURPOSE This study aims to compare and investigate the differences in beliefs with regard to the cause of illnesses, medial skepticism, and attitudes toward medical care between medical, Oriental medical, and nonmedical students. METHODS: To this end, we used a structured questionnaire and collected self-reported data from a sample of 667 respondents. RESULTS: First, their beliefs on the causes of illness were markedly different, depending on their specialty. Compared with students from other specialties, Oriental medical students ranked host factors, environmental factors, and natural factors as the highest causes of illness. -the former group regarded supernatural factors as a more influential cause of illnesses compared with the latter. Among Oriental medical students and nonmedical students-who were also subdivided into the aforementioned groups-the upper-grade group regarded host factors as a higher cause of illness than the lower-grade group. Second, Medical skepticism also differed depending on specialty. Compared with the medical students, Oriental medical students were more likely to have high confidence in "overcoming illnesses", "home remedies", "self-decision in treatments", and "understanding their own health". In subdividing medical and Oriental medical students according to grade we observed that the senior group had more confidence in home remedies than the junior group. Third, In an analysis of the students attitudes toward medical care, we found that nonmedical students had the highest score in the "care-oriented" and "cure-oriented" attitude categories.
In the overall results, the care-oriented category ranked highest for the nonmedical students, followed by Oriental medical students and medical students; the cure-oriented category ranked highest for nonmedical students, followed by medical students and then Oriental medical students.
CONCLUSION Based on our results, we conclude that these differences between specialties should be reflected in medical curricula to bridge the gap between patients and doctors in medical education with regard to the causes of illness and attitudes toward medical care.
PURPOSE The implementation of medical professionalism education and evaluation is a recent trend in medical education. Although many studies on this subject have been performed, they have focused specifically on the level of medical student professionalism the perception gaps between medical students and professors on this topic are unresolved. This study attempts to determine whether such gaps exist. METHODS: Three hundred ninety fourth-year medical students and 250 professors who were randomly selected from 41 medical schools were asked to complete a survey on the level of the professionalism of medical students. Using the 31 core professionalism elements that are required for Korean medical students, students self-assessed their level of professionalism, and the professors evaluated the professionalism level of medical students who were graduating. RESULTS: Of the 31 core elements, significant perception gaps were found in 28 elements. The three domains into which the 31 core elements were divided-professional knowledge, professional skills, and professional attitude-all contained perception gaps, and professors' ratings generally were higher than those of the students, a noteworthy observation CONCLUSION: Medical professors need to encourage their students in elevating their professionalism, and what the faculty think they have taught regarding professionalism may not be fully assimilated by students. Further research is necessary to investigate why such gaps exist.
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PURPOSE The purpose of this study was to explore the relationship between the personality types of premedical students and their self-assessed communication skills and attitudes toward a communication skills course.
METHODS The participants were 59 second-year premedical students from Korea University College of Medicine. The Myers-Briggs type indicator (MBTI), which was validated in Korea, was used for evaluating personality types.
Self-reported competency in communication and attitudes toward a communication skills course were measured by questionnaire.
RESULTS Sensing (S) and thinking (T) personality types were predominant in this study group (76%). The relationship between the personality indicator 'Extraversion (E)-Introversion (I)' and the selfreported communication skills was statistically significant for four items of communication skills. Also, the personality indicator 'Thinking (T)-Feeling (F)' significantly correlated with one item: ask if the person has any further suggestions.
Personality 'I' students showed more concern with regard to their communication skills than 'E' types. 'Sensing (S)'-type students had a more positive attitude toward the communication skills course than "iNtuition (N)" types.
CONCLUSION Students' self-assessed competence in communication and attitudes toward the communication skills course varied between personality types. These results suggest that the personality types of students should be considered in developing a communication skills course.
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PURPOSE This study investigated the attitudes of medical students toward physicians and the roles which the doctors and patients should play in the health care process.
METHODS Attitudes toward the patient-doctor relationship of 436 medical students of the K university in Seoul were measured using the Patient-Practitioner Orientation Scale(PPOS), a validated instruments designed to measure individual preferences toward various aspects of the patient-doctor relationship. The PPOS was composed of Sharing(sharing information, take part in decision making) and Caring(respect one's feelings, interpersonal relationship) subscale. Total PPOS scores can range from patient-centered(egalitarian, whole person oriented) to disease- or doctor-centered(paternalistic, less attuned to psychosocial issues). Socio-demographic data including gender, age, school year, marital status, undergraduate major, student's and her/his family medical background and specialty choice were collected and it was investigated the possible impact of socio-demographic factors on students' attitudes.
RESULTS The PPOS score was 3.82. The Sharing and Caring scores were 3.74 and 3.90, respectively. Female gender and students of graduate entry program were significantly associated with patient-centered attitudes. Age, school year, marital status, academic background, student's and her/his family medical background, and specialty choice did not show significant associations with PPOS scores.
CONCLUSION Female and graduate students showed more patient-centered attitudes than male and undergraduate students, respectively. Given the emphasis placed on patient-centered care in the current medical environment, our results suggest further research to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centered care.
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PURPOSE We specifically investigated the young doctor (residents) patient doctor-patient relationship in Korea. A society built on Confucianism, age is expected to affect even the doctor-patient relationship.
METHODS 57 residents participated and answered 6 open-ended questions. 90 patients of various age participated and answered 3 open-ended and 6 close-ended questions.
RESULTS It seems that the general problem of the doctor-patient relationships was related to attitudes and communication skills. Over 80% of the residents felt uncomfortable and received inappropriate verbal expressions and attitudes from their patients simply because they were young or younger than the patients. This negative experience resulted mostly from the residents' self-perceived lack of experience and clinical competence and the patients' distrust of young doctors. As for the patients, over 80% preferred middle-aged doctors to young doctors. Middleaged doctors were thought to be easier to understand, better mannered, more humane, and clinically competent. Most residents expected professional respect from their patients, while patients expected kindness and humility from the young doctors. This shows a gap in the reciprocal expectations between residents and patients.
CONCLUSION Young doctors are perceived as inexperienced and incompetent and, consequently, not trusted by patients in Korea. To improve the resident-patient relationship, improvement in attitude and communication skills is needed.
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PURPOSE Patient-centered communication is known to improve patient satisfaction, compliance, doctor-patient relationship, and health outcomes. The aim of this study is to evaluate medical students patient-centered communication skills and attitudes in medical students after their clerkship. METHODS: To evaluate medical students' communication skills, OSCE was performed on 114 fourth-year medical students who had completed their clerkship. After OSCE, we used structured questionnaires to survey the subjects in assessing attitudes toward communication skill learning and patient-centeredness. RESULTS: The accomplished frequency of patient-centered communication items were as follows: allow patient's narrative thread (88.6%), open-to-closed-ended questions (47.4%), discuss psychosocial and emotional factors (36.0%), elicit patient's concerns and perspectives (36.0%), discuss how health problem affects patient's daily life (21.9%), express empathy (14.0%), negotiate plan of action with patient (68.4%), and ask whether patient has further issues to discuss (33.3%). The students who did medical service as extracurricular activity and were confident with their communication skills performed better patient-centered interviews. There was no significant relationship between medical students' patient-centered attitudes and patientcentered OSCE scores. CONCLUSION: Having completed their clerkship, medical students were still unable to perform a good patient-centered interview.
Current medical curriculum should teach medical students how to communicate in a patient-centered manner. The education method should focus on behavior change initiative.
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PURPOSE There is a negative assumption that patients are reluctant to have medical students be involved in their care. In response, students refrain from revealing to the patients that they are students in order that they may participate in patient-care. The purpose of this study is to determine whether patients' attitudes towards medical students is negative or positive, and to explore the level acceptable by patients of students' involvement in their care. METHODS: The study subjects were 90 inpatients in two university hospitals. The questionnaire consisted of 12 items covering patient's attitude toward student involvement in their care, acceptable patient-care activities in which students could be involved, and preference for being told if caregiver is a medical student. RESULTS: Patients' attitudes towards students' participation in their care were relatively more favorable than expected. 46.8% of patients reported that they would permit students to be involved up to and including simple non-invasive techniques. 76.2% of patients stated that they would allow students to participate in their future in-hospital care. Most patients preferred knowing that the caregiver was a medical student.
CONCLUSION The results of this study are reassuring. A higher than expected percentage of patients surveyed disclosed that they would accept medical students being involved in their care. Medical educators should provide a safe environment for medical students to be able to tell the patients, "I am a student doctor".
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