Differences in medical students' attitudes to academic misconduct and reported behaviour across the years--a questionnaire study

OBJECTIVES: This study aimed to determine attitudinal and self reported behavioural variations between medical students in different years to scenarios involving academic misconduct. DESIGN: A cross-sectional study where students were given an anonymous questionnaire that asked about their attitudes to 14 scenarios describing a fictitious student engaging in acts of academic misconduct and asked them to report their own potential behaviour. SETTING: Dundee Medical School. PARTICIPANTS: Undergraduate medical students from all five years of the course. METHOD: Questionnaire survey. MAIN MEASUREMENTS: Differences in medical students' attitudes to the 14 scenarios and their reported potential behaviour with regards to the scenarios in each of the years. RESULTS: For most of the scenarios there was no significant difference in the response between the years. Significant differences in the responses were found for some of the scenarios across the years, where a larger proportion of year one students regarded the scenario as wrong and would not engage in the behaviour, compared to other years. These scenarios included forging signatures, resubmitting work already completed for another part of the course, and falsifying patient information. CONCLUSION: Observed differences between the years for some scenarios may reflect a change in students' attitudes and behaviour as they progress though the course. The results may be influenced by the educational experience of the students, both in terms of the learning environment and assessment methods used. These differences may draw attention to the potential but unintentional pressures placed on medical students to engage in academic misconduct. The importance of developing strategies to engender appropriate attitudes and behaviours at the undergraduate level must be recognised.     

医学生专业选择的调查与分析

本研究采用问卷调查方法,调查并分析了北京大学医学生选择医学专业的动因、入学后对专业的满意程度、学习兴趣以及毕业后的打算等。调查结果显示,医学生填报志愿时对有关专业不够了解,受老师、家长的影响较大,考虑因素较多;部分学生入学后对专业满意度较低,对所学课程兴趣不足,影响将来在本专业的发展。建议重视医学生专业兴趣的培养,采取有效措施改善不利的状况。     

Perceived stress in medical, law, and graduate students

Students in the medical and law schools and graduate students in chemistry and psychology at a single institution were asked to complete a questionnaire about events and activities related to their educational programs which they perceived to be stressful. The questionnaire was designed to elicit information about stress associated with academic activities, personal relationships, time pressures, and financial concerns. Information was also obtained about time utilization, health behaviors, crises, and support systems. The authors' hypothesis that medical students would report higher perceived stress levels than students in the other programs was not supported, as the highest total stress score was reported by law students. Factor analysis of a 31-item stress scale produced six separate factors pertaining to the sources of stress: academic concerns, time concerns, fear of failing, classroom interactions, economic issues, and world issues. Time restrictions and economic and academic issues had the highest mean stress scores. The hypotheses by the authors that students would report program-specific stresses and that utilization of support services would differ among the four groups of students were both supported. Implications of these findings are discussed.     

在医学生中开展死亡教育的意义及方式

死亡教育肇始于西方,目前在中国内地尚处于教育的盲区。医学生因其专业的特殊性,更有必要开展死亡教育。死亡教育可以使医学生真正地思考生命与死亡,在提高自己的生命品质的同时也能更好地开展医疗服务,特别是开展临终关怀服务。医学生的死亡教育需要整合多学科理论,形成持续、开放、多元、实用的教育方式。     

Student evaluation of accelerated program at the University of Miami

The University of Miami School of Medicine has an accelerated, six-year B.S.-M.D. program called the Honors Program in Medicine (HPM). In 1985 the HPM and traditional program students were surveyed at the end of their first year in medical school regarding their opinions about accelerated medical education. Eighty-seven percent of the traditional students felt that HPM students had ability equal to that of the average medical student (that is, neither more nor less ability), but 41 percent felt that the HPM students were less mature than the average class member. The traditional students felt the HPM students were required to follow a rigid collegiate curriculum (76 percent) and had an inadequate nonscience background (68 percent) and that the HPM would negatively affect both the future professional competence of HPM participants (59 percent) and the medical profession (34 percent). A larger percentage of the HPM than the traditional students (63 versus 48 percent) reported earning more than a minor in nonscience subjects, and fewer HPM than traditional students (9 versus 36 percent) felt that pressure to maintain a high grade-point average limited their selection of college courses. The HPM students felt that they were well prepared for medical school academically (82 percent) and emotionally (91 percent). The HPM students excelled academically in college and in the preclinical curriculum.     

198名卫校护生的职业意向调查

目的了解护理专业受喜爱的程度和发展前景,为巩固专业的稳定性和促进专业的发展提出相应对策。方法对198名初中起点的大中专学生进行了开放式问卷调查,采用X^2检验,分析在各个问题中男女分布的差异。并对调查结果和存在的社会现象进行综合分析。结果男女护生在职业选择上未存在差异（P〉0．05）,大部分学生是基于就业压力和护理专业的实用性而选择此专业,喜爱该专业的人不足8％,职业抱怨在该行业中普遍存在。结论学校应对护生的生源选择有所要求：要有对该专业的基本了解和喜爱、要有较好的文化素质以及对学生进行职业自豪感教育。     

医学生学风现状调查与对策研究

目的通过调查医学生学风现状,为改进医学生学风建设提供依据。方法以天津市某医科大学512名本科生作为调查对象,采用自填式问卷进行调查,有效问卷499份。调查内容主要是学生学习目标、学习态度和学习方法、教学水平和教学设施、学校培养制度和管理制度等。采用Epidata3．02完成数据录入,用SPSS13．0统计软件进行统计分析,用百分比对数据进行描述。结果把考研、通过英语四六级、获得文凭等作为学习主要目的人数超过50．00％。学生课余时间主要用于上自习的占81．96％（404／499）,上课记笔记的学生占98．40％（4911499）,而课后经常会与教师讨论学术问题的学生仅占8．62％（43／499）。70．54％（352／499）的学生表示参加过学校组织的学术讲座并从中获得了很大帮助。非常渴望获得奖学金的学生占40．88％（204／499）。超过50．00％的学生对就业持不乐观态度,应引起教育者的关注。78．56％（392／499）的学生认为医学专业教师具备较高的授课水平,有26．65％（133／499）的学生认为学校的教学设施有待进一步完善。结论为加强和改进医学生学风,应进一步调动学生的学习主观能动性,发挥教师的主导作用,以教风促学风;健全学风建设的规章制度,加强医学院校硬件设施建设。     

White coat ceremonies: a second opinion

A "white coat" ceremony functions as a rite of passage for students entering medical school. This comment provides a second option in response to the earlier, more enthusiastic, discussion of the ceremony by Raanan Gillon. While these ceremonies may serve important sociological functions, they raise three serious problems: whether the professional oath or "affirmation of professional commitment" taken in this setting has any legitimacy, how a sponsor of such a ceremony would know which oath or affirmation to administer, and what the moral implications of this "bonding process" are. I argue that the initiation oath is morally meaningless if students are not aware of its content in advance, that different students ought to commit to different oaths, and that bonding of students to the medical profession necessarily separates them from identification with lay people who will be their patients.     

Medical student abuse. Incidence, severity, and significance

In a survey of the incidence, severity, and significance of medical student abuse as perceived by the student population of one major medical school, 46.4% of all respondents stated that they had been abused at some time while enrolled in medical school, with 80.6% of seniors reporting being abused by the senior year. More than two thirds (69.1%) of those abused reported that at least one of the episodes they experienced was of "major importance and very upsetting." Half (49.6%) of the students indicated that the most serious episode of abuse affected them adversely for a month or more; 16.2% said that it would "always affect them." Students identified various types of abuse and proposed a number of measures for the prevention and management of abuse in medical school. We conclude that medical student abuse was perceived by these students to be a significant cause of stress and should be a major concern of those involved with medical student education.     

Smoking behaviour, knowledge and opinion of medical students

On the basis of a questionnaire on smoking behaviour, knowledge and attitudes administered to medical students in the University of Malaya in July 1987, the prevalence of smoking was found to be low (10%) among medical students. Smokers and non-smokers were equally well informed about common smoking complications. Most students, irrespective of smoking status, felt that they would as future doctors, often advise sick smokers against smoking. In contrast, less than half would do so for healthy smokers who do not themselves raise the question of smoking. The students' personal smoking behaviour also influenced their view of their professional role. Appropriate values, attitudes and a preventive approach towards smoking need to be further developed in the medical students' thinking and behaviour.     

Unprofessional behaviour of junior doctors: a retrospective analysis of outcomes by the Singapore Medical Council disciplinary tribunals

INTRODUCTIONThis is a retrospective analysis of outcomes by Singapore Medical Council (SMC) disciplinary tribunals in cases involving junior doctors. We aimed to classify the types of unprofessional behaviour and consider appropriate measures for remediation and prevention.METHODSSMC’s annual reports from 1979 to 2017 and published grounds of decision from 2008 to 2017 were examined using two screening levels to identify cases involving junior doctors. Cases were sorted into five outcome categories: (a) professional misconduct; (b) fraud and dishonesty; (c) defect in character; (d) disrepute to the profession; and (e) acquitted.RESULTSA total of 317 cases were identified, of which 13 (4.1%) involved junior doctors: 4 (30.8%) cases involved professional misconduct, 4 (30.8%) cases involved fraud and dishonesty, 3 (23.1%) cases saw an acquittal, and one case each involved defect in character and disrepute to the profession. The four cases of professional misconduct highlight the need to differentiate medical errors due to systems factors from those due to individual culpability, by applying analytical tools such as root cause analysis and Unsafe Act Algorithms. Disciplining the individual alone does not help prevent the recurrence of similar medical errors. We found that fraud and dishonesty was an important category of unprofessional behaviour among junior doctors.CONCLUSIONWhile the frequency of unprofessional behaviour among junior doctors, as determined by the SMC disciplinary tribunal, is low (4.1%), this study highlights that complaints against medical doctors often involve systems issues and individual factors. Unprofessional behaviours related to fraud and dishonesty need special attention in medical school.     

医学生生命意义感现状调查研究：以首都医科大学为例

目的了解医学生生命意义感的现状。方法使用生命意义感量表,对我校300名学生进行生命意义感问卷调查,分析医学生生命意义感现状和影响因素。问卷数据统计分析采用两独立样本t检验、单因素方差分析和多元线性回归分析。结果被调查医学生群体生命意义感平均得分为84。在生命意义感各维度,生活目标和生命价值维度得分相对较高,生活态度和生活自主维度得分较低。在生命意义感量表得分方面,高年级学生高于低年级学生（P=0．003）,本科生高于专科生（P=0．021）,来自城市城镇的学生高于来自农村的学生（P=0．004）,担任学生干部的学生高于不担任学生干部的学生（P=0．001）,喜欢本专业的学生高于不喜欢本专业的学生（P=0．003）。结论医学生生命意义感的形成受到多种因素的影响,医学院校需要抓住学生成长的重要时期,有针对性地开展教育活动。同时,还需要加强对医学生专业思想和自我认同感的教育,引导学生正确看待社会存在的问题,提升其生命意义感水平。     

Complementary medicine seminar for medical undergraduates at the University of the West Indies,Mona

Use of complementary medicine by the general public is increasing. It is therefore apt that doctors in training learn more about it. For several years, medical students doing their Year III Community Health clerkship have had one afternoon devoted to the subject. In advance, they are given reading materials and are asked to prepare short presentations relating to definitions, types of therapies available, principles underlying some of these therapies, extent of usage of complementary medicine, expenditure on it, appropriate research methods to evaluate effectiveness, and opinions of the public and the profession regarding its use. A demonstration of one kind of complementary medicine by a practising therapist forms part of the activities.     

Socio demographic profile and career aspirations of medical students in a new medical school

All fifty-two pioneer medical students in a new medical school (The College of Medicine of Lagos State University), participated in a cross sectional survey to identify their socio-demographic profile and career intentions. A self-administered structured questionnaire was used to collect data. The students were observed to be mature. Their mean age was 23.6 years +/- 3.8. A third were graduates with at least a first degree, while 23% had parents with medical background. Factors influencing their choice of medicine as a career were desire to serve mankind (91%), primary interest in the profession (90%) and parental influence (84%). Sixty-seven per cent of them would want to specialize while the most frequently chosen fields were obstetrics and gynaecology (28.6%) and surgery (25.7%). The main reasons influencing specialisation were primary interest in the specialty (91%), service to humanity (91%) and job satisfaction (85.7%). A desire to specialize was evident even in these medical students who were just starting medical school.     

Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students' attitudes

OBJECTIVE: To explore the attitudes of Australian medical students to the balance between work, family and other aspects of lifestyle, within a broader exploration of the issues that they regard as important to their decisions about future career. DESIGN: Qualitative study using semistructured focus groups and individual interviews. SETTING: The three medical schools in New South Wales and a national conference for students interested in rural practice. PARTICIPANTS: First- and final-year medical students who volunteered for focus groups held between March and August 2002 (82 students in 10 groups) or for individual interviews held between July and December 2003 (48 students). MAIN OUTCOME MEASURES: Emergent themes relating to the balance of work, family and other aspects of lifestyle. RESULTS: Most students referred to a balance of work, family and lifestyle as an important factor in their career decisions. While indicating they were committed to medicine, they were unwilling to work to the exclusion of all else. Most saw family commitments as a high priority, and many saw "time out" as important in maintaining their health. Female students spoke of part-time work as essential for future happiness, while some male students expressed a preference for working part-time. They would seek to achieve balance by choosing to work in disciplines, locations and structures where limited-hours work is available, and would negotiate support from their partners and parents in caring for children. CONCLUSIONS: It is important that the medical profession continue to develop working and training structures that allow a balance of work, family and lifestyle.     

Social media and the medical profession

Use of social media by doctors and medical students is common and growing. Although professional standards and codes of ethics that govern the behaviour of medical practitioners in Australia and New Zealand do not currently encompass social media, these codes need to evolve, because professional standards continue to apply in this setting. Inappropriate use of social media can result in harm to patients and the profession, including breaches of confidentiality, defamation of colleagues or employers, and violation of doctor-patient boundaries. The professional integrity of doctors and medical students can also be damaged through problematic interprofessional online relationships, and unintended exposure of personal information to the public, employers or universities. Doctors need to exercise extreme care in their use of social media to ensure they maintain professional standards.     

从教师视角与学生认知看医学生职业素质的培养

根据各个国际组织制定的医学教育标准和我国出台的《本科医学教育标准——临床医学专业(试行)》的相关规定,本科医学教育培养的学生除了必须具备一定的医学理论知识和基本医学技能外,还应具备良好职业精神等其他非智力性职业相关综合素质.为了解我国医学院校本科生对医学职业综合素质的认知以及我国医学院对本科生职业综合素质教育的情况,复旦大学上海医学院医学教育研究室选取了3所不同类型“985工程”综合性大学医学院和2所非综合性大学医学院,就本科医学生必备的职业综合素质涉及的15项内容,通过问卷方式调查了这些医学院教师、临床教师和各年级临床医学专业本科生.通过教师对学生综合素质或核心能力的总体评价以及学生对这些内容的认知,比较两者之间的差距,研究分析了我国医学院校对本科生职业综合素质和能力的培养及其存在的问题.     

医学伦理学教学目标和教学内容改革的思考

社会经济和医学科学的发展使得医学伦理学在内涵和外延上都有了极大的拓展,若仍以“职业思想品德教育”鉴定学科教学目标和教学内容则过于狭窄。从学科发展和学生的实际需求出发定位教学目标,组织教学内容与教学活动,强化利益观、价值观和法律意识教育,使学生在形成良好的职业道德品质的同时,具有分析与解决医学伦理问题的能力,促进学生医德教育,是当前医学伦理学教学与改革的重要课题。     

临床医学专业（全科医学方向）学生社区卫生实践能力提升效果评价

目的：探讨全科医学人才培养的新途径。方法：选取2010年9月至2013年6月期间在基层医疗卫生机构参与社区卫生实践的2010级临床医学专业（全科医学方向）633名学生作为调查对象,对学生利用假期和课余时间在基层医疗卫生机构接触公共卫生和基本医疗的实践能力和服务能力提升效果进行分析和评价。结果：社区卫生实践活动有利于促进学生对专业的热爱,对省情、乡情和医情的了解,对职业道德、社会责任感等的理解,对团队协作、人际沟通等的意识培养,有利于提升学生的创新意识和能力,强化学生综合素质的培养。结论：学生早期开展社区卫生实践是培养全科医学人才的重要途径。     

Possible impact of increase in female medical student admissions in Nepal: Findings from a qualitative study among medical undergraduates

Background

In Nepal, a developing country in South Asia, the number of female medical students has increased significantly.

Aims

The present study was carried out to explore perceived perceptions for this increase, study the perceived impact on teaching-learning activities, medical school infrastructure and possible perceived changes in the doctor-patient relationship.

Method

First, second and third year students were invited to participate in focus group discussions (FGDs). Fifty-four students were willing to participate. Twenty-five were from the first year, 20 from the second and 9 from the third year. The FGDs conducted over a 90 minute period were voice and video recorded. The groups consisted of both males and females from a particular intake. The findings were transcribed verbatim.

Results

Participants felt more female students were taking up medicine in the country because of more colleges opening in the cities and towns making it easier for female students to enrol in the course. Also parents consider medicine as a safe, noble and dignified profession for their daughters. Participants suggested women are more empathetic doctors and the doctor-patient relationship might become more patient-focused. Women doctors can serve as a source of inspiration and the overall impact on Nepal would be positive.

Conclusion

Participating students perceived the increasing number of female medical students may be due to changes in Nepalese society. This study was carried out only among three batches of students in a single medical school. Further studies among different batches of students and among interns in other medical schools are required. Studies among postgraduate students and doctors are also needed.