Cosmetic procedures among youths: a survey of junior college and medical students in Singapore

INTRODUCTION

Although cosmetic procedures have become increasingly popular among the younger population in recent years, limited research on this subject has been done in the Asian context. We aimed to explore the views and knowledge regarding cosmetic procedures among junior college (JC) and medical students in Singapore.

METHODS

In the first phase of the study, a cross-sectional, self-administered survey of 1,500 JC students aged 16–21 years from six JCs was conducted in 2010. The same survey was then conducted on a random sample of Year 2–5 medical students from an undergraduate medical school in 2011.

RESULTS

In total, 1,164 JC and 241 medical students responded to the surveys. There was an overall female to male ratio of 1.3:1. Of all the respondents, 2.5% of the JC students and 3.0% of the medical students admitted to having undergone cosmetic procedures. Among those who claimed to have never had cosmetic procedures done, 9.0% and 44.0% of the JC and medical students, respectively, responded that they would consider such procedures in the future. Those who disapproved of their peers undergoing cosmetic surgery comprised 35.0% of JC students and 56.8% of medical students. Among the JC and medical students, 52.0% and 36.1%, respectively, were unaware of any risks associated with cosmetic procedures.

CONCLUSION

The younger population is increasingly accepting of cosmetic procedures. However, there is a general lack of understanding of the risks associated with such procedures. Education of both the general public and medical students may help prevent potential medicolegal issues.     

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.     

Towards semantic search and inference in electronic medical records: An approach using concept--based information retrieval

Background

This paper presents a novel approach to searching electronic medical records that is based on concept matching rather than keyword matching.

Aim

The concept-based approach is intended to overcome specific challenges we identified in searching medical records.

Method

Queries and documents were transformed from their term-based originals into medical concepts as defined by the SNOMED-CT ontology.

Results

Evaluation on a real-world collection of medical records showed our concept-based approach outperformed a keyword baseline by 25% in Mean Average Precision.

Conclusion

The concept-based approach provides a framework for further development of inference based search systems for dealing with medical data.     

Dimensions of physical wellness among medical students of public and private medical colleges in Pakistan

Objectives:

To determine adherence to dimensions of physical wellness among medical students of public and private medical colleges in Pakistan.

Methods:

This cross-sectional study was carried out from January to July 2011 among 820 students of private and public medical colleges in Karachi, Pakistan.

Results:

Overall, medical students scored low in dimensions of physical wellness. Private medical colleges students were fond of vigorous activities such as aerobics and swimming, whereas public medical colleges students were involved in moderate intensity activities such as walking and use of stairs (p<0.0001). Private students reported to consume more fast food (p=0.0001), had less sleep (p=0.0001), but attended regular annual medical checkups (p=0.009) as compared with their public institute counterparts. Safe practices such as avoidance of tobacco were almost the same.

Conclusion:

Comprehensive adherence to all dimensions of physical wellness was lacking among medical students.Health is professed as a state of wellness of mind, body, and spirit.1 The physical aspect of wellness is related to taking physical care of the body so as to reduce the risk of illness, fatigue, and injury. Physical wellness (PW) is therefore, based on an assortment of healthy foods, adequate intake of water, ample exercise, and safe practices throughout life2 to sustain quality of life and perform routine activities without exhaustion. Physical benefits ultimately result in psychological benefits such as improved self-esteem, better self-control, and sound judgment to identify the effects of healthful habits and activities.1 Physical activity (PA) can be defined as the movement of the body using energy. Only moderate activities such as brisk walking, cycling, and games that improve heart rate or vigorous exercises such as swimming, aerobics, and so forth, that increase both heart rate and breathing are examples of PA with health benefits. It is recommended that adolescents with age range of 12-17 years should take part in moderate-to-vigorous physical activity (MVPA) ≥60 minutes/day to avoid obesity, and the health related disorders due to obesity.3 The healthy life style factors such as adequate PA, healthy diet, non-smoking, and sufficient sleep help to acquire PW and lower risks of composite cardiovascular disease.4 In Pakistan, there are public and private sets of medical colleges (MCs), each having its own criterion to induct medical students.5 The wellness issues become imperative for all MC students due to high levels of stress as a result of the rigors of the medical curriculum, necessary adjustments to the forthcoming challenges, and expectations from the family. It is anticipated that these stresses may result in health impairments, relationship dilemmas, depression, and even death.5 The awareness of PW at this point may enable these students to be careful on vital signs and cautionary symbols of minor ailments so as to cultivate accountability for their health and seek expert medical assistance when required. The objective of the study was to compare dimensions of PW in both sets of medical students in terms of PA, lifestyle choices, and safe practices. The results of our present study are expected to be helpful in continuation of efforts to make emerging doctors, responsible for their own health, of their family, as well as community.     

Objective structured clinical examination vs traditional clinical examination: An evaluation of students’ perception and preference in a Nigerian medical school

Background:

Method of testing clinical competence of medical students in this setting has been controversial. This report evaluates the perceptions and preferences of 5^th and 6^th year medical students about traditional clinical examination (TCE) and objective structured clinical examination (OSCE).

Materials and Methods:

A cross-sectional study using a structured questionnaire, administered to 156 students, who had been previously exposed to TCE and OSCE.

Results:

There were 110 (70.5%) males and 46 (29.5%) females, with median age group of 26–30 years. One hundred and thirty-one respondents (84%) felt TCE is more difficult and 20 (12.8%) felt OSCE was more difficult. One hundred and forty-two (91%) felt OSCE was easier to pass, 8 (5.1%) felt TCE was easier to pass and 6 (3.8%) were undecided. Majority of the 5^th and 6^th year students (95.5% and 100%, respectively) preferred OSCE for assessment. In relation to validity and reliability of OSCE, 124 (79.5%) of all the students felt it provides a true measure of essential clinical skills, 130 (83.3%) felt its scores are standardised, 143 (91.7%) felt it is a practical and useful experience and 135 (86.5%) felt students’ personality, ethnicity and gender will not affect OSCE scores. Overall, there were no significant differences in preference and perceptions between 5^th and 6^th year students and between males and females.

Conclusion:

Students preferred OSCE as method of assessing clinical competence and considered it a more valid and reliable method of examination.     

Student attitude towards communication skills learning in a Caribbean medical school

Background

Medical student attitudes towards communication skills are important for curriculum planners and teachers. Xavier University School of Medicine (XUSOM) is a private medical school admitting students mainly from the United States and Canada.

Aims

Attitude of students towards communication skills has not been previously studied in the institution. Hence the present study was carried out.

Method

The study was carried out among the first, second, third and fourth semester undergraduate medical (MD) students at XUSOM, Aruba during July 2013 using the communication skills attitude scale (CSAS). Respondents’ age, gender, nationality, occupation of parents, place of residence of family, semester of study were noted. The positive and negative attitude scale scores were calculated and compared among different subgroups of respondents (p<0.05).

Results

Fifty-one of the seventy-three students (69.9 per cent) participated. The majority were between 20 to 25 years of age, of American nationality, from metro cities and had excellent or good self-perceived verbal and written communication skills. The mean positive attitude scale (PAS) score was 47.65 (maximum being 65) and the mean negative attitude scale (NAS) score was 31.06 (maximum 65). PAS score was significantly higher among respondents whose fathers were not in health related professions. NAS scores were significantly lower among the third and fourth semester respondents.

Conclusion

Students overall had a positive attitude towards communication skills but negative attitudes were also noted Based on results of the study and a review of literature we are planning to start communication skills learning in the institution right from the first semester and students will be provided opportunities for supervised practice during early clinical exposure, hospital observership and with standardised patients. The medical humanities module will be expanded and communication skills learning will continue during the clinical years with higher order skills being taught.     

Effectiveness of early cardiology undergraduate learning using simulation on retention,application of learning and level of confidence during clinical clerkships

INTRODUCTION

This study aimed to assess the effectiveness of the use of a cardiopulmonary patient simulator in the teaching of second-year medical students. Effectiveness was measured in terms of the extent of knowledge retention and students’ ability to apply the skills learned in subsequent real-life patient contact.

METHODS

In this study, ten third-year medical students who had previously undergone simulator training as part of their second-year curriculum underwent an objective structured clinical examination (OSCE) and a multiple-choice question (MCQ) test to assess their ability to apply the knowledge gained during the simulator training when dealing with real patients. The performance of this group of students was compared with that of a group of ten fourth-year medical students who did not undergo simulation training.

RESULTS

Although the third-year medical students performed well in the OSCE, they were outperformed by the group of fourth-year medical students, who had an extra year of clinical exposure. The MCQ scores of the two groups of students were similar. Post-simulation training survey revealed that students were generally in favour of incorporating cardiopulmonary simulator training in the preclinical curriculum.

CONCLUSION

Cardiopulmonary simulator training is a useful tool for the education of preclinical medical students. It aids the translation of preclinical knowledge into real-life clinical skills.     

Simulated surgical workshops enhance medical school students’ preparation for clinical rotation

Background

A major focus of the medical school curriculum is to ensure medical students are well prepared prior to entering clinical rotations, which includes the compulsory surgical rotation.

Aims

The objective of this research was to design and formally evaluate a set of real-life surgical workshops aimed at better preparing medical students for their clinical rotation in surgery. These workshops would be incorporated into the pre-clinical medical school curriculum.

Method

Dedicated surgical workshops were introduced into the preclinical component of the Bachelor of Medicine/Bachelor of Surgery (MBBS) program at our University in 2009. These workshops encompassed training in the clinical skills needed in the perioperative and wider hospital setting. A survey comprising of eight to nine ranked questions (utilising a five-point Likert Scale) as well as three short answer questions was administered to the medical students after they completed their compulsory surgical clinical rotation.

Results

The overall response rate to the survey evaluating the surgical workshops was 79% (123/155). The mean of the ranked questions ranged from 4.05 to 4.89 which indicated that the students found the workshops useful. When evaluating the short answer questions (via topic coding), additional information was provided that supported and explained the survey findings and also included suggestions for improvements.

Conclusion

The findings of the medical student survey demonstrated the value of incorporating dedicated preparatory surgical workshops in the medical school pre-clinical curriculum. However, further research is warranted to determine if this inclusion translated into improved student performance during the clinical surgical rotation.     

Student feedback on problem-based learning processes

Background

Problem-based learning (PBL) sessions consist of a brainstorming phase, search phase, individual study, and reporting phase. At the Xavier University School of Medicine, Aruba, PBL is a new learning modality first introduced in May 2013.

Aims

PBL processes have not been studied previously at the Xavier University School of Medicine, hence the present study was carried out to obtain information about the PBL processes and note differences, if any, among different groups of students.

Method

The study was conducted among first- to fourth-semester undergraduate medical students during July 2014 using a previously validated PBL processes instrument developed by van den Hurk et al. Information about gender, semester, weekly hours of study, and learning resources used was obtained. Respondents’ agreement with a set of 23 statements was noted using a Likert-type scale, which was scored as 1=totally disagree with the statement, 2=disagree, 3=neutral, 4=agree, and 5=totally agree with the statement. Mean scores were compared among different groups of respondents.

Results

Fifty-one of the 58 students (87.9 per cent) participated. The weekly average study time was 29.9 hours. Lecture handouts and textbooks were commonly used information sources. The mean scores (scale 1 to 5) for learning-issue-driven searching, and extensiveness of searching were 3.49 and 3.45, respectively. The score for explanation-oriented preparation was 3.94, while those for breadth and depth of discussion were 3.75 and 3.62, respectively. Most scores were higher among second-semester students, but the difference was not significant.

Conclusion

The self-reported scores were comparable to those reported in previous studies done using the same PBL processes instrument in other medical schools. At Xavier University School of Medicine interactive lectures are the major teaching method and topics covered during PBL are also likely to be covered during lectures, which could influence the scores. The findings of our study providing information about how students function during PBL brainstorming and presentation sessions and how they use different learning resources would be of interest to other medical schools worldwide following a hybrid curriculum. Further studies are required.     

Introducing geriatric health in medical training in Ajman,United Arab Emirates: A co-curricular approach

Background

Medical students’ knowledge and understanding of the elderly will affect the quality of care to the rising population of older adults which points to a need to identify geriatric health training methods appropriate for the region and curriculum. Therefore the study assessed the effect of a co- curricular introductory workshop on knowledge regarding geriatric health and attitude towards the elderly among fourth year medical students in a medical university

Method

A quasi-experimental before-after study, with control was conducted at Gulf Medical College among 60 medical students from discipline-based curriculum in year IV during May-June 2010 of whom 16 had opted (attendees) to undergo the introductory course, a five day workshop of 10 hours duration. Pre- and post-testing used self-administered questionnaires for demographic variables: age, gender, nationality, close contact with older people; a quiz on old people’s health, and Kogan’s Old People Scale (KOPS) for attitude. The difference in scores on quiz and KOPS were compared for the attendees and 26 non-attendees who participated in both pre and post testing.

Results

The attendees group had 38% male and 62% female participants and the non-attendees group had 21% and 79% respectively. The groups were not significantly different in age, sex, nationality and close contact with the elderly. The scores on the quiz and KOPS showed no statistically significant difference between the two groups before or after the workshop. Almost all the participants evaluated the workshop very positively especially the interaction with healthy elderly and inmates of old people’s home.

Conclusion

A 10-hour introductory co-curricular workshop made no significant change in the knowledge on geriatric health or attitude of fourth year medical students though they reported it as a very enriching experience. A reflective report may have been a better assessment tool and the impact on their clinical practice cannot be predicted.     

Cerumen impaction: Challenges and management profile in a rural health facility

Background:

Cerumen impaction is a worldwide problem. It constitutes a significant proportion of health problems in many settings and its prevalence varies. Very few studies were done in this region with none from our center. The aim of this study is to review the challenges and management profile of cerumen impaction in a rural health facility in Nigeria.

Materials and Methods:

This was a 3-year retrospective study of all patients that were managed for cerumen impaction from June 2008 to May 2011, in the Department of Otorhinolaryngology, Federal Medical Centre, Ido-Ekiti, Nigeria.

Results:

A total of 239 patients, aged 3–98 years were managed for cerumen impaction. The male: female ratio was 1.6:1. The age group 1–20 years was mostly affected in 29.3%. Major complaints were hearing impairment in 120 cases. Both ears were mostly affected in 48.5% of the patients. Olive oil was a major ceruminolytic agent used in 95.4%. Ear syringing was carried out in 91.2% of cases. Major complications were bruises of external auditory canal and otalgia in 7.3% of cases each. Forty-two (17.8%) of our patients were asymptomatic, and they did not complained of ear problem. Out of those patients that were symptomatic, 44.3% had visited general medical practitioners and non-otolaryngologist, while 27.6% had self-medication or visited chemist for their ear complaints. Only 3.7% of them had been seen by ear, nose, and throat (ENT) specialist in the past.

Conclusion:

Cerumen impaction is a common otolaryngological problem that presents to ENT surgeon, children, and elderly are more affected. Hearing impairment is the major complaint which may increase the burden of disability on society. Syringing is the most common mode of treatment of our patients. Continuing medical education, proper otological examination by the non-otolaryngologist and public health education to improve the low level of awareness on danger of self-medication is essential.     

Impact of focused training on communication skills of final-year medical students in a medical school in India

Background

Although communication skills are important for a good physician-patient relationship, Indian medical curricula give very little emphasis on training medical students in this aspect.

Aims

To determine the change in communication skills of final-year medical students following focused training.

Methods

This was an educational interventional study done at Pondicherry Institute of Medical Sciences, a tertiary care teaching hospital in South India, to assess communication skills among final-year MBBS students. Fifty-two students (24 males and 28 females) participated in the study. A pre-test was conducted in the form of an objectively structured clinical examination (OSCE), followed by focused training for four hours. The same OSCE was administered as post-test. A comparison between the pre-test and post-test scores was done using Wilcoxon Signed Ranks Test.

Results

Ninety-six per cent of participants (50 out of 52) showed improvement in their performance after the focused training. The mean marks of the pre-test and post-test were 10.77± 3 and 18.04±2, respectively, out of a maximum mark of 20 (p<0.05). One out of 52 participants did not show any improvement, and one participant scored less in the post-test compared to the pre-test. There was no significant difference in the performance between male and female students.

Conclusion

Focused training can enhance the communication skills of medical students. Hence, it may be included in the curriculum of undergraduate medical teaching programmes in India.     

The effectiveness of self-directed learning (SDL) for teaching physiology to first-year medical students

Background

Self-directed learning (SDL) has become popular in medical curricula and has been advocated as an effective learning strategy for medical students to develop competence in knowledge acquisition.

Aims

The primary aim was to find out if there was any benefit of supplementing self-directed learning activity with a traditional lecture on two different topics in physiology for first-year medical students.

Method

Two batches of first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) (Batch A and Batch B) comprising 125 students each, received an SDL session on Morphological classification of anaemia. The students belonging to Batch A received a one-hour lecture on the same topic three days prior to the SDL session. The students were given a 10 multiple choice questions (MCQ) test for a maximum of 10 marks immediately following the SDL session. The next topic, Conducting system of the heart, disorders and conduction blocks was taught to both batches in traditional lecture format. This was followed by an SDL session on the same topic for Batch A only. The students were evaluated with a MCQ test for a maximum of 10 marks.

Results

The mean test scores on the first topic were 4.38±2.06 (n=119) and 4.17±1.71 (n=118) for Batch A and Batch B, respectively. The mean test scores on the second topic were 5.4± 1.54 (n=112) and 5.15±1.37 (n=107) for Batch A and Batch B, respectively. There was no significant difference between the groups.

Conclusion

For first-year medical students, SDL is an effective teaching strategy for learning physiology. However, no additional benefit is gained by supplementing SDL with a lecture to facilitate learning physiology.     

Does medical students’ clinical performance affect their actual performance during medical internship?

INTRODUCTION

This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships.

METHODS

This retrospective study involved 63 applicants of a residency programme conducted at Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with their clinical performance during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while their clinical performance as fourth-year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE).

RESULTS

The performance of the applicants as interns was positively correlated with their clinical performance as fourth-year medical students, as measured by the CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interaction items addressing communication and interpersonal skills in the CPX.

CONCLUSION

The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills through actual encounters with patients or simulated encounters using manikins, to enable them to become more competent doctors.     

Diabetes management in Australian rural aged care facilities: A cross--sectional audit

Background

There is gap in the literature regarding the current practice of diabetes management of the elderly in Australia and its compliance with available Australian diabetes practice guidelines.

Aims

The aims of this study were to describe the pharmacological management of elderly residents with diabetes living in aged care facilities and to identify areas for improvement in the current management as recommended by the current diabetes management guidelines in Australia.

Method

Residents with diabetes from three rural aged care facilities were identified by nursing staff. A cross-sectional medical record audit was carried out to obtain data of residents diagnosed with diabetes.Thirty-four medical records were audited from three aged care facilities.Data including demographics, medical histories and medications were collected and analysed.

Results

This study had two key findings; Firstly, it showed that about a third of residents with type 2 diabetes are managed with diet only. Secondly, of the residents who are managed with medications, less than half of those audited (41%) were managed according to the current diabetes guidelines in terms of pharmacological treatment which included anti- hypertensive, lipid lowering and anti- platelet therapies. Of those patients with a history of CVD, all were receiving an antihypertensive medication, 71% were not managed for their lipids and 20% were not on any prophylactic anti- platelet therapy.

Conclusion

Management of patients with diabetes living in rural aged care facilities is inconsistent with the current management guidelines. Educational interventions targeting health professionals and patients might be beneficial to increase compliance with the current diabetes guidelines.     

How are our medical students using the computer and internet? A study from a medical college of north India

Background:

In today''s world, use of Internet has become indispensable. Medical students have much to gain from the Internet technology that has revolutionized the medical field. There is a very rapid change in the way communication technology is being handled and our medical students should also be ready to embrace it. Very few studies have been done on this topic in India. The aim was to find out the knowledge, practice, and barriers of Internet use among the medical undergraduates of Subharti Medical College, Meerut.

Materials and Methods:

A cross-sectional study was conducted among the MBBS students belonging to the first, second, third, and fourth years of their course during August to October 2009. A pretested questionnaire was used collecting information on their Internet usage patterns, knowledge about information technology, and barriers to using it. Data were entered in Microsoft Excel and appropriate statistical tests were applied for analysis.

Results:

The proportion of respondents having a laptop were more in cohort of students belonging to the admission year 2009 (65.8%) followed by 2008 (54.7%), 2007 (53.0%), and 2006 (38.0%), i.e., a gradual increase in newer cohorts. About half (57.4%) of the students had some sort of formal training in computer and Internet use. Knowledge about Internet was more among the junior cohorts compared to the senior cohorts (P<0.0001). Only about one-fifths of the respondents used Internet for searching literature for projects from medical journals on the Internet. Majority of the respondents accessed Internet for less than 3 hours per week. About one-tenth (8.0%) of the students felt that Internet is totally useless in medical field. The major barrier (54.4% of the respondents) to using Internet was lack of time.

Conclusions:

Further research should focus on designing and implementing computer and Internet training for medical students.     

Infection control practices in health care: Teaching and learning requirements of medical undergraduates

Background

Compliance and implementation of infection control guidelines have been recognized as efficient means to prevent and control hospital acquired infections.

Objectives

To evaluate knowledge and practices about infection control guidelines amongst medical students and to explore their education needs as perceived by them and faculty.

Methods

A total of 160 final year students and 100 faculty members of one of the top medical colleges in India were selected by simple random sampling in each group as per sample size of 143 students (alpha 0.05, error 7%, prevalence 60%) and 99 (error 7.5%) faculty. Data collected by pilot-tested, unlinked, anonymous questionnaire.

Results

Amongst students, knowledge (77.50%; 95% CI, 70.24–83.72) was mixed with misconceptions. Only 31.25% always followed hand hygiene procedure; 50% recapped needles; disposal of hazardous material into designated containers always was low (sharps 20%, contaminated items 25%). Despite experiencing needle stick injury (6.25%) and splashes (40%), less than 30% reported these as 44% were unaware of reporting procedure. The discord between the perceptions of faculty regarding students and students'' own perceptions was clearly evident (all Kappa values less than 0.50). Students and faculty agreed on workshops (58.13% and 58%) and reinforcement by colleagues (51% and 54%) but not on on-job training (51% and 34%) and part of curriculum (48% and 40%) for teaching–learning infection control.

Conclusion

Tackling disconnect between students and faculty perceptions and empowering students with knowledge and skills in infection control is important. Approach needs to be researched and formulated as current methods seem to be inadequate.