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.     

The status of tobacco use and knowledge, and attitudes relating to smoking among female students in a Bengbu medical school

Objective: To learn the status of tobacco use, and the knowledge, attitudes, and behaviors among female students in Bengbu Medical College. Methods: In a cross-sectional survey, questionnaires were completed by 634 female students in the medical college in 2007,including the prevalence of current smoking, their knowledge of the effects of tobacco use on health, and attitudes towards the smoking behaviors of young women. Results: Only 6.9% of female medical students were former smokers, and 4.9% of them were current smokers. There was no significant difference in the current smoking rate among the students from each department surveyed. Female students from urban areas were more likely to be current or attempted smokers than those from rural areas. The proportion of the students who were aware of the health risks of smoking was less than 45%. The students from the Department of Nursing had more knowledge regarding the harmful health effects of smoking than those from the other departments. There was no significant difference in attitudes towards the smoking behaviors of young women among the students from each department. Compared with female students from rural areas, the female students from urban areas were significantly more likely to think that a young woman who smoked was cool, mature and charming. Conclusion: The smoking prevalence of the female students in Bengbu Medical College is high. They are not aware of the smoking related risks and have erroneous beliefs and perceptions about female smoking behaviors.     

某医学院大学生吸烟行为现况调查

目的:了解某医学院大学生吸烟现状及对控制吸烟的态度,分析该人群吸烟行为的影响因素,为今后教育和干预措施提供科学理论依据。方法:整群抽取某医学院一到四年级在校学生787名,采用自填调查问卷的方法来调查学生的一般特征和吸烟相关的知识、信念、行为。结果:787名调查对象中总吸烟率为18.0%,其中男生为30.6%,女生为2.0%,男生吸烟率高于女生(P<0.001);随着年级的升高,吸烟率呈上升趋势(P<0.05),好奇、社交需要、周围朋友是影响学生吸烟的主要因素;吸烟者与不吸烟者在对吸烟有害健康和被动吸烟有害健康的知识知晓方面有差异(P<0.01),对肺癌、高血压的知晓率有差异(P<0.05);吸烟者与不吸烟者对于遭受被动吸烟时的态度、对不同人群吸烟的态度、对公共场所禁烟的态度和向未成年人售烟的态度都具有差异性(P<0.001)。结论:医学生吸烟现状不容乐观,社会和学校必须采取积极有效的综合措施加以干预。     

妇产科患者对见习医学生合作态度的调查分析

目的 评估妇产科患者对见习医学生的合作态度及其影响因素.方法 通过问卷调查方法 ,了解中山大学附属第一医院妇产科学临床教学中患者对见习医学生的合作态度,并对其相关影响因素进行统计学分析.结果 本研究共发出450份调查问卷.收回382份有效问卷,有效问卷回收率84.9%.69.9%的患者对见习医学生进行体检持拒绝态度,拒绝者的比例在年轻(20岁～29岁)、未婚、初诊与门诊的患者中更高.67.0%的患者希望示教能够在自己知情的前提下进行.87.0%的患者希望与见习医学生合作过程中有临床医生在场.希望见习医学生成为医生助手、诊疗过程的积极参与者和表示不知道的患者比例分别为46.6%、30.1%和23.3%,该比例与患者的年龄、婚姻状况、学历、是否首诊以及就诊部门(门诊或住院部)呈相关性.结论 患者对见习医学生的合作态度与一些自身特征有关,同时患者是否事先知情和见习医学生的举止仪表也会对其产生影响.因此,在合适的患者人群中选择示教病例并于事先进行充分的沟通,将有助于改善医患关系,提高妇产科学临床见习的质量.     

Changes in undergraduate attitudes toward medical ethics

To detect any change in medical students' attitudes toward medical ethics, students from the same class were given a questionnaire on their first day of medical school and again near the end of their fourth year of study. The results showed a strong shift away from the students' initial expectations that they would rely on specialists or scholarly sources in the future; the need for a medical ethics course in the curriculum, while still felt, was less important to them by the fourth year. The reasons for these changes were not apparent, for the students' levels of knowledge and perceptions of the role of ethics in medicine in the first and fourth years did not differ. It is recommended that medical school faculty actively reinforce the initially positive attitudes of students during clinical supervision.     

中国大学生吸烟行为和吸烟态度研究

目的:对我国大学生的吸烟现状进行调查;并检验“吸烟态度与吸烟行为具有一致性”的假设。方法:用问卷法对805名中国大学生进行了研究。结果:大学生中有19.1％的人为当前吸烟者;男生吸烟普遍性显著高于女生;吸烟的普遍性随着年级的增高而增高;大学生对尼古丁没有依赖性;不吸烟者抗烟态度强,吸烟者抗烟态度弱。结论:吸烟态度与吸烟行为具有一致性。     

Whose information is it anyway? Informing a 12-year-old patient of her terminal prognosis

OBJECTIVE: To examine students' attitudes and potential behaviour towards informing a 12-year-old patient of her terminal prognosis in a situation in which her parents do not wish her to be told, as they pass through a modern medical curriculum. DESIGN: A cohort study of students entering Glasgow University's new medical curriculum in October 1996. METHODS: Students' responses obtained before year 1 and at the end of years 1, 3, and 5 to the "childhood leukaemia" vignette of the Ethics in Health Care Survey Instrument (EHCI) were examined quantitatively and qualitatively. Analysis of the students' multichoice answers enabled measurement of the movement towards professional consensus opinion. An analysis of their written justifications for their answers helped to determine whether their reasoning was consistent with professional consensus and enabled measurement of changes in knowledge content and recognition of the values inherent in the vignette. Themes on the students' reasoning behind their decision to tell the patient or not were also identified. RESULTS: Unlike other vignettes of the EHCI in which autonomy was a main theme, few students chose the consensus answer before year 1 and there was no significant movement towards consensus at any point during the course. In defence of their decision to withhold information, the students expressed strong paternalistic opinions. The patient's age was seen as a barrier to respecting her autonomy. CONCLUSIONS: It is important to identify students' perceptions on entry to medical school. Transformative learning theory may provide the basis for an approach to foster doctors who consider the rights of young people. Small-group teaching is most conducive to this approach. The importance of positive role modelling is also emphasised.     

Knowledge and attitudes regarding smoking: a health education experiment with Malay college students

This study investigated whether knowledge and attitudes of Malay college students regarding smoking can be positively influenced by educational intervention. The experiment included a pretest to assess the students knowledge and attitudes regarding smoking, a lecture on the health risks associated with smoking, and a posttest given six weeks later to assess whether any changes had occurred. A profile of the typical Malay student smoker was also elicited. Twenty-seven percent of the study population were smokers. Of the men in the sample, 44% were smokers, while less than 4% of the women were smokers. T-tests indicated that knowledge of the health risks associated with smoking was significantly improved for most groups, while attitudes towards smoking were essentially unchanged.     

Sex and the surgery: students' attitudes and potential behaviour as they pass through a modern medical curriculum

OBJECTIVE: To examine students' attitudes and potential behaviour to a possible intimate relationship with a patient as they pass through a modern medical curriculum. DESIGN: A cohort study of students entering Glasgow University's new learner centred, integrated medical curriculum in October 1996. METHODS: Students' pre year 1 and post year 1, post year 3, and post year 5 responses to the "attractive patient" vignette of the Ethics in Health Care Survey instrument were examined quantitatively and qualitatively. Analysis of students' multi-choice answers enabled measurement of the movement towards professional consensus opinion. Analysis of written justifications helped determine whether their reasoning was consistent with professional consensus and enabled measurement of change in knowledge content and recognition of the values inherent in the vignette. Themes on students' reasoning behind their decision to enter a relationship or not were also identified. RESULTS: No significant movement towards consensus was found at any point in the curriculum. There was little improvement in students' performance in terms of knowledge content and their abilities to recognise the values inherent in the vignette. In deciding to enter a relationship with the patient the most frequently used reasoning was that it could be justified if the patient changed their doctor. CONCLUSIONS: Teaching on the subject of sexual or improper relationships between doctors and patients, including relationships with former patients requires to be made explicit. Case based teaching would fit in with the ethos of the problem based, integrated medical curriculum.     

Personality differences between smokers and nonsmokers

Findings from a study of differences in personality traits among smoking and nonsmoking former Johns Hopkins University medical students are evaluated. Results of the long-term, cross-sectional comparisons indicate that individuals with different smoking habits were aware of reacting to stress in different ways. Scale scores for anxiety under stress increased significantly, on the average, with the quantity of cigarettes smoked daily. The scale scores for anger under stress showed a similar trend, but did not reach significance. Comparisons based on smoking habits over time indicate that continuing smokers differed significantly from lifetime smokers. Light continuing smokers showed more anxiety, and heavy continuing smokers showed more anger under stress, with former smokers in an intermediate position. When their strong vocational interest blanks were compared, the profiles of heavy smokers were significantly different from those of nonsmokers while they were medical students. When longitudinal comparisons were made later between former heavy smokers and continuing heavy smokers, 10 of the 11 occupational scales which significantly differentiated the nonsmokers from the heavy smokers in medical school also differentiated the former smokers from continuing smokers in the same direction. It is concluded that the habits of nervous tension, occupational profiles, and behavioral patterns related to heavy smoking reflect personality characteristics which are associated with difficulty in stopping smoking, while the characteristics of nonsmokers are related to personality dimensions which either make smoking distateful in the 1st place, or make it easy to stop.     

医科研究生对学术道德失范的态度调查

目的调查医科研究生对学术道德失范的态度,为相关教育决策部门提供参考。方法应用自制问卷,比较某医科大学研究生总体以及不同类别之间对课堂道德失范、考试道德失范、科研道德失范的态度。结果研究生对迟到早退、旷课、课堂上与学习无关行为、考试作弊、学术造假和不诚信行为持反对态度的比例分别为63.8%、61.9%、62.5%、79.1%和79.5%。不同类别研究生的态度大多有统计学差异。结论医科研究生总体对学术道德失范有较清醒的认识和态度;要关注态度不端正的群体,不断加强其学术道德教育。     

医学和工科院校大学生心血管疾病知识、相关态度及行为对比调查

目的:了解医学和工科院校大学生的心血管疾病知识、态度及行为状况,以便及时发现问题并采取相应的指导措施。方法:对二年级的医学生和工科生进行随机问卷调查。结果:对于心血管疾病常识性的问题,工科生回答的正确率都较高,医学生好于工科生,但差异无显著性。而对于医学专业性强的问题,工科生回答的正确率较低,医学生显著高于工科生(P<0.05);在态度、行为方面体现为医学生知道自己血压水平和血压升高及时治疗的比例都显著高于工科生(P<0.05)。医学生饮酒的比例显著低于工科生(P<0.05)。结论:应加强对工科类院校大学生的健康知识教育。     

Teaching medical ethics: what is the impact of role models? Some experiences from Swedish medical schools

The goal of the present study was to elucidate what influences medical students' attitudes and interests in medical ethics. At the end of their first, fifth and last terms, 409 medical students from all six medical schools in Sweden participated in an attitude survey. The questions focused on the students' experience of good and poor role models, attitudes towards medical ethics in general and perceived effects of the teaching of medical ethics. Despite a low response rate at some schools, this study indicates that increased interest in medical ethics was related to encountering good physician role models, and decreased interest, to encountering poor role models. Physicians involved in the education of medical students seem to teach medical ethics as role models even when ethics is not on the schedule. The low response rate prevents us from drawing definite conclusions, but the results could be used as hypotheses to be further scrutinised.     

Cigarette smoking among school teachers in Tobago

Tobago, until lately, was considered a society with a low prevalence of cigarette smoking. Recent surveys, however, showed an increasing smoking prevalence among school children. To assess whether teachers in Tobago can be credible role models for their pupils, we carried out a cross-sectional survey on their smoking-related attitudes and behaviour in 2002. We distributed anonymous, structured questionnaires to teachers of all 52 primary and secondary schools in the island and conducted structured observations in schools. Of 579 teachers present during the survey, 559 (97%) returned a completed questionnaire; 8.6% of the male and 2.4% of the female teachers reported to be current cigarette smokers; slightly higher proportions had ever been daily smokers. Teachers were well aware of the harmful effects of smoking. Significantly more non-smokers than current smokers were in favour of strict school smoking regulations. The vast majority of the teachers perceived anti-smoking education as their duty. None of the schools had dedicated smoking rooms for teachers, and we found no cigarette butts in or around teachers' rooms. In Tobago, teachers have a lower reported prevalence of cigarette smoking than their pupils. Thus, most teachers can be credible role models with regard to smoking prevention and should be encouraged to become more active in school-based preventive activities.     

Attitudes that predict antinuclear-war activity in medical students

The possibility of nuclear war may be the most significant threat to health in the world. Medical practitioners have played, and should continue to play, a leading role in raising awareness of this danger. In the present study, the attitudes that predict a specific antinuclear-war behaviour (that is, signing a letter to the Prime Minister of Australia to request more active political effort to prevent nuclear war) were studied in a group of 143 undergraduate medical students. Attitudes towards that particular behaviour were assessed by means of a questionnaire, and the differences in attitude between students who chose to sign and those who chose not to sign the letter were analysed statistically by means of discriminant analysis. The key differences in attitude between signers and non-signers of the letter was in their belief that such an action would achieve tangible positive outcomes. The results are discussed in terms of the need to target strategies of change for the specific attitudes which are likely to modify behaviour and to promote antinuclear behaviours in medical practitioners, which in turn may alter the behaviour of politicians.     

Relationship between smoking, weight and attitudes to weight in adolescent schoolgirls.

A total of 1,932 schoolgirls aged 11-18 from seven schools in the South London area were surveyed using questionnaires which addressed eating patterns, body weight history, attitudes to body weight and shape, menstrual history and current smoking behaviour. They were also weighed and their height was measured. Twelve per cent of the girls were regular smokers and 10% smoked seven or more cigarettes over a 4 day period. Amongst girls aged 14 and over, 15% smoked regularly and a further 9% occasionally. A significant relationship was found between smoking and weight. Smokers were more likely to be moderately overweight in relation to their peers and to have been worried about their weight at some stage. There were differences between girls in state schools and those in independent schools with regard to smoking behaviour and weight. The findings have implications for anti-smoking strategies and health education generally.     

深圳市中小学生吸烟行为及影响因素的调查研究

目的 通过对深圳市中小学生吸烟行为及影响因素的调查，为探讨适合深圳市中小学生特点的控制吸烟方案提供依据。方法采用整群随机抽样的方法，选取深圳市10所中小学校学生共5000名，用统一的调查表进行问卷调查。结果中学生吸烟率比小学生吸烟率高，尝试第1次吸烟以小学阶段占比例最高(50％)，尝试吸烟后仍想吸则以中学阶段占比例最高(85．4％)。在中、小学生吸烟者中，尝试戒烟成功的只占34．9％，表示会复吸烟的占25．6％，认为促使自己吸烟影响最大的主要是朋友、同学、父亲，大多数在无聊、朋友聚会和心情烦闷时吸烟；没有参加过预防吸烟活动的占78．0％，其中认为学校或班级没有组织过预防吸烟活动的占52．5％。结论学生吸烟行为与心理发育、周围环境密切相关，他们需要适宜的控烟健康教育，目前学校的控烟健康教育有待完善。     

高等医学院校学生干部综合能力的调查分析

高等医学院校应该在结合高等医学教育特殊性的基础上,科学合理地引导医学生选择适合自身的学生组织,并做好＂学生干部生涯规划＂,使之成为医学生锻炼自身综合能力的重要平台。     

吸烟医务人员控烟知识、态度、行为及其影响因素分析

目的为了解云南省男性吸烟医务人员吸烟控烟的知识、态度和行为及其影响因素 ,为有关控烟政策的制定提供科学的背景资料和决策依据。方法采用自行设计的调查表对云南省六地区 981名男性吸烟医务人员吸烟控烟知识、态度及行为进行调查 ,对调查结果进行单因素、多因素分析。结果 ( 1)吸烟者知识得分最高 ,态度得分次之 ,行为得分最低 ,形成知与行相互分离的特点。( 2 )不同民族吸烟医务人员在知识、态度得分上有显著性差异 ;不同文化程度吸烟医务人员在知识得分上有显著性差异 ;随着开始吸烟年龄的后移 ,吸烟者知识、态度和行为得分逐渐增加 ,差异有显著性。( 3 )吸烟者知识得分、态度得分、是否采取戒烟行为得分受多个因素的影响。结论云南男性吸烟医务人员在吸烟问题上知而不信、信而不行 ,不利于我省控烟运动的开展。     

The impact of legal medicine education on medical students' attitudes toward law

Physicians' negative attitudes toward law and the legal system derive in part from the physician's lack of understanding of basic legal principles relating to medical practice. Required legal medicine education at the medical school level offers a vehicle for changing these attitudes while at the same time clarifying physicians' rights and responsibilities under the law. The authors in this study assess the impact of required curriculum programming in legal medicine at Southern Illinois University School of Medicine on medical students' attitudes toward law and the legal system. A total of 80 students completed a survey instrument prior to and immediately following required instruction in legal medicine. This instrument enabled the authors to gather information regarding students' attitudes toward law and the legal system as well as students' perceptions of ther medical/legal knowledge. The results suggest that legal medicine education has a favorable impact on the attitudes of medical students toward law and the legal system.