Are multiple choice tests fair to medical students with specific learning disabilities?

The purpose of multiple choice tests of medical knowledge is to estimate as accurately as possible a candidate’s level of knowledge. However, concern is sometimes expressed that multiple choice tests may also discriminate in undesirable and irrelevant ways, such as between minority ethnic groups or by sex of candidates. There is little literature to establish whether multiple choice tests may also discriminate against students with specific learning disabilities (SLDs), in particular those with a diagnosis of dyslexia, and whether the commonly-used accommodations allow such students to perform up to their capability. We looked for evidence to help us determine whether multiple choice tests could be relied upon to test all medical students fairly, regardless of disability. We analyzed the mean scores of over 900 undergraduate medical students on eight multiple-choice progress tests containing 1,000 items using a repeated-measures analysis of variance. We included disability, gender and ethnicity as possible explanatory factors, as well as year group. There was no significant difference between mean scores of students with an SLD who had test accommodations and students with no SLD and no test accommodation. Virtually all students were able to complete the tests within the allowed time. There were no significant differences between the mean scores of known minority ethnic groups or between the genders. We conclude that properly-designed multiple-choice tests of medical knowledge do not systematically discriminate against medical students with specific learning disabilities.     

Are Asian international medical students just rote learners?

A wide variety of countries are seeking to attract international medical students. This could be due to the fact that their universities not only receive the economic benefit from these students, but also because they recognise the issues of cultural diversity and pedagogical practice. This review paper draws on literature to understand more fully the learning process of Asian international students. Whereas views on learning are different across cultures, medical school teachers must understand how Asian international students learn based on their culture. Two general themes emerged from the literature review: firstly culture’s influence on learning and secondly memorisation versus understanding, both of which relate to the learning process of Asian international students. This study shows that Asian international students have a different approach to learning, which is not just about rote learning. Changes in attitudes towards Asian international students may stimulate the internationalisation of a more culturally sensitive form of medical education. The paper suggests further work on the area of appreciative thinking in order to identify the epistemological and ontological dimensions for a flexible approach to learning.     

Did the nutrition of Slovak medical students change? A comparison after 15 years.

OBJECTIVE: Authors aimed at positive and negative changes evaluation in nutrition and nutritional status of university-medical students comparing the situation in years 1984 and 1999. They were trying to determine, how was the nutrition of current medical students influenced by food consumption changes in the Slovak population and price liberalization of the food-stuffs as well. MATERIAL AND METHODS: Seven day reports from the year 1984 (199 students) and from the year 1999 (228 students) were processed using Food Research Institute, Food Composition Database and Programme. The quantity and quality of consumed food-stuffs and beverages were evaluated as well as energy and biologic value of students nutrition. Nutritional status of students was assessed by BMI (body mass index--kg/m2). Men and women (years 1999 vs. 1984) were separately evaluated by standard statistical methods. RESULTS: Lower energy, fat, cholesterol, animal protein and salt intake were observed in students in the year 1999; on the contrary, carbohydrates, sucrose, fibre, magnesium, vitamins C and E intake increased in comparison with the year 1984. The differences were mostly significant in women. Big changes in food consumption (1999 vs. 1984) were observed. Current students eat less meat (less pork, beef, fish, but more poultry), eggs and potatoes and women also less milk and dairy products than in the year 1984. On the contrary, the consumption of vegetable, fruits, legumes and non-alcoholic beverages increased. Alcohol intake decreased significantly. Students eat the most on Sunday, the least on Friday; women eat more rationally. Nutritional status in man was not changed, the percentage of slim women increased (p < 0.05). CONCLUSION: The food of current students (1999) is more varied, with the balanced content of plant and animal sources and with lower energy density than in the year 1984. Negative consequences of price liberalization in medical student nutrition are lower in comparison with Slovak global nutritional trends and they reflect the higher health awareness, eventually better socio-economic family background.     

Are interpretations of other people’s arguments value-impregnated? A pilot study among medical students

Analogously to Kuhn’s and Hanson’s understanding of observation as theory-impregnated, we try to test the hypothesis that observation and interpretation might also be value-impregnated. We use a written examination task for medical students who were asked to read and interpret a text where the authors provide arguments pro et contra euthanasia. Afterwards the students were asked to provide their own reflected opinion on the issue. We found that medical students who were against and indecisive provided interpretations of the text which accorded with their own reflected opinions (P = 0.02), indicating that their interpretations were influenced by their own values. When including those who were pro euthanasia, the association was no longer significant. Although the present investigation was a small pilot-study, we obtained partial support for our hypothesis and have adjusted it to read as follows: observations and interpretations might be value-impregnated for respondents who have rather strong value-based attitudes. We think the adjusted hypothesis deserves to be further examined.     

Are routine preoperative medical tests needed with cataract surgery?

OBJECTIVE: The objective of this study was to investigate whether routine medical testing before cataract surgery reduces the rate of complications during the perioperative period in adults. METHODS: The study was carried out in an academic medical center in Brazil, between 10 February 2000 and 10 January 2001. The scheduled cataract operations were randomly assigned to one of two groups: 1) to be preceded by routine testing (the "routine-testing group") or 2) not to be preceded by routine medical testing (the "selective-testing group"). If the patient was assigned to the selective-testing group, it was requested that no preoperative testing be performed unless the patient presented with a new or worsening medical problem that would warrant medical evaluation with testing. In the case of patients assigned to the routine-testing group, three tests were requested: a 12-lead electrocardiogram, a complete blood count, and measurements of serum glucose. RESULTS: The sample of 1,025 patients scheduled to undergo cataract surgery was comprised of 512 assigned to the routine-testing group and of 513 assigned to the selective-testing group. The two groups had similar proportions of operations canceled and not subsequently rescheduled, 2% in each group. The cumulative rate of medical events was similar in the two groups, 9.6% in the routine-testing group and 9.7% in the selective-testing group (P = 0.923). The types of medical events were also similar in both groups. DISCUSSION: The results of this study suggest that routine medical testing before cataract surgery does not reduce the rate of complications during the perioperative period. The results also suggest it would be more efficient not to request routine preoperative tests unless indicated by patient history or physical examination.     

Emotional intelligence in medical students: does it correlate with selection measures?

Context Much attention and emphasis are placed on the selection of medical students. Although selection measures have been validated in the literature, it is not yet known whether high scores at selection are indicative of high levels of interpersonal aptitude. Emotional intelligence (EI) is reported to be a predictor of the interpersonal and communications skills medical schools are looking for in applicants. Objectives This study describes EI scores in medical students and explores correlations between EI and selection scores at the University of Western Australia. Methods Senior medical students from a 6‐year undergraduate curriculum completed the online MSCEIT^® (Mayer–Salovey–Caruso Emotional Intelligence Test) survey. Scores for EI were described and correlations between EI and Undergraduate Medicine and Health Sciences Admission Test (UMAT), Interview and Tertiary Entrance Rank (TER) scores were analysed. Results Mean scores of the 177 respondents (58%) reflected the normal distribution of scores (mean 98, standard deviation [SD] 15.0) in the general population. Males had higher EI scores than females and Asian students demonstrated higher EI Total and branch scores than White students. The highest and lowest EI scores were obtained for the branches Understanding Emotions (mean 110, SD 19.0) and Perceiving Emotions (mean 94, SD 15.6), respectively. No significant correlations were found between EI Total or EI branch scores and any of the selection scores (UMAT, TER and Interview). Discussion This study offers information that can be used to compare the EI scores of medical students with those of other health professionals. No relationship was identified between cognition (measured by the UMAT) and skill (measured by the MSCEIT^®) in the interpersonal domain and EI. Further studies are required to explore whether UMAT Section 2 is measuring EI, if there are associations between EI and academic performance and if EI can be used to predict the performance of junior doctors.     

Are social norms associated with smoking in French university students? A survey report on smoking correlates

Background  

Knowledge of the correlates of smoking is a first step to successful prevention interventions. The social norms theory hypothesises that students' smoking behaviour is linked to their perception of norms for use of tobacco. This study was designed to test the theory that smoking is associated with perceived norms, controlling for other correlates of smoking.     

Does medical school cause health anxiety and worry in medical students?

OBJECTIVES: The aim of this study was to investigate the self-reported experience of health anxiety and worry in medical students compared with control subjects. It was hypothesised that medical students would experience more health anxiety as a consequence of being exposed to medical education, compared to students who are not routinely exposed to such knowledge. DESIGN: The design was cross-sectional. SETTING: Participants were recruited from London University (Guy's, King's & St Thomas' School of Medicine and King's College). PARTICIPANTS: Medical students (n = 449) and non-medical students (n = 485) were recruited across Years 1-4. Questionnaires relating to health anxiety and worry were completed at the end of their lectures. MAIN OUTCOME MEASURES: Health anxiety was measured using a questionnaire known as the Health Anxiety Questionnaire (HAQ). Worry was assessed using the Anxious Thoughts Inventory (ANTI). RESULTS: Health anxiety was significantly lower in medical students in Years 1 and 4 than in controls (P = 0.017 and P < 0.001, respectively). Worry was significantly lower in the medical students in all years of study. CONCLUSIONS: Medical students are not a cohort of preselected health-anxious people, nor are they 'worriers'. Medical education at a clinical level was shown to mitigate health anxiety in the medical student population.     

What do medical students read and why? A survey of medical students in Newcastle‐upon‐Tyne,England

OBJECTIVES: There is increasing interest in the role of medical humanities within the undergraduate curriculum, but we know little about medical students' views on this or about their reading habits. Our study explored the reading habits of medical students, and their attitudes towards literature and the introduction of humanities into the curriculum. DESIGN: Self-completion questionnaire survey. SETTING: Newcastle University and Medical School. SUBJECTS: All first-, second- and third-year undergraduate medical students (384), biology students (151) and a random sample of law students (137) were sent a self-completion questionnaire to assess reading levels, attitudes towards literature and the medical humanities (medical students) and the perceived benefits of reading. RESULTS: Medical students read widely beyond their course and articulate a range of benefits from this, including: increasing awareness of life outside their experience; introspection or inspiration; emotional responses; and stimulation of an interest in reading or literature. Of the medical students, 40% (103/258) read one or more fiction books per month, but 75% (193) read fewer non-curricular books since starting university, largely because of time pressures, work, study or academic pressures and restricted access to books. A total of 77% (194) thought that medical humanities should definitely or possibly be offered in the curriculum, but of these 73% (141) thought it should be optional and 89% (172) that it should not be examined. CONCLUSIONS: Medical students read literature for a variety of very positive and valued reasons, but have found leisure reading harder to maintain since starting university. They support inclusion of the humanities in medical education, but have mixed views on how this should be done.     

What does ‘disability’ mean for medical students? An exploration of the words medical students associate with the term ‘disability’

CONTEXT: Disability teaching is a core theme in undergraduate medical education. Medical students bring a range of experiences of disability to their medical training. AIM: The principal aim of this study was to explore the words that medical students associate with the term "disability" and to consider how the resulting information could inform teaching. A secondary aim was to see if a short disability course changed the word associations. METHODS: Students were asked to write down 2 words that came to mind when they heard the word "disability", before and after a 4-day course in disability. Words from 4 cohorts were analysed by frequency and the following word dichotomies: visual icons/personal attributes; loss/enabling, and medical model/social model. A random sample of students took part in focus groups at the beginning and end of the course. RESULTS: A total of 381 students provided 667 before-course words and 189 students provided 336 after-course words. Before the course, words denoting visual icons of disability, and loss were prominent, accounting for 85% of the words, and 74% of the words describing personal attributes were negative. Focus group responses at this stage reflected an eagerness to help but patronising terms were prominent, along with concern about political correctness. Students also expressed nervousness about encountering disabled people. In response, teaching was adapted to make it more learner-focused, to offer a safe environment in which students can test out their language, to build on the positive associations and to develop a range of pre-course creative activities with disabled people. After the course a considerable and significant shift in emphasis was observed, with a reduction in the use of visual icon words, an increase in words denoting enablement, and an increase in words relating to the social model of disability and to positive personal attributes (P < 0.001). Focus group participants at this stage reported greater confidence in approaching disabled people but continued to question political correctness. CONCLUSIONS: Medical students associate disability predominantly with depersonalised or negative words. A short disability course appears to change these associations. Reasons for this and implications for teaching are discussed.     

Are socially disadvantaged neighbourhoods deprived of health-related community resources?

BACKGROUND: Recent work in a number of countries has identified growing geographical inequalities in health between deprived and non-deprived neighbourhoods. The health gaps observed cannot be entirely explained by differences in the characteristics of individuals living in those neighbourhoods, which has led to a concerted international public health research effort to determine what contextual features of neighbourhoods matter. This article reports on access to potentially health-promoting community resources across all neighbourhoods in New Zealand. Prevailing international opinion is that access to community resources is worse in deprived neighbourhoods. METHODS: Geographical Information Systems were used to calculate geographical access to 16 types of community resources (including recreational amenities, and shopping, educational and health facilities) in 38,350 small census areas across the country. The distribution of these access measures by neighbourhood socioeconomic deprivation was determined. RESULTS: For 15 out of 16 measures of community resources, access was clearly better in more deprived neighbourhoods. For example, the travel time to large supermarkets was approximately 80% greater in the least deprived quintile of neighbourhoods compared with the most deprived quintile. CONCLUSIONS: These results challenge the widely held, but largely untested, view that areas of high social disadvantage have poorer access to community resources. Poor locational access to community resources among deprived neighbourhoods in New Zealand does not appear to be an explanation of poorer health in these neighbourhoods. If anything, a pro-equity distribution of community resources may be preventing even wider disparities in neighbourhood inequalities in health.     

Undergraduate medical students: who seeks formative feedback?

OBJECTIVE: This study aimed to monitor which undergraduate students collected formative feedback on their degree essays and to quantify any correlations between gender or summative mark achieved and whether formative feedback was sought. METHODS: We carried out a study at the University of Aberdeen Medical School, involving a total of 360 Year 3 students, comprising all 177 students in the 2004 cohort and 183 in 2005. Data on gender and summative mark were routinely collected during the degree assessment processes in March 2004 and 2005. Students signed on receipt of their feedback. RESULTS: Less than half the students (46%) collected their formative feedback: 47% in 2004, and 45% in 2005. Overall, females were significantly more likely than males to seek formative feedback (P = 0.004). Higher achievers were significantly more likely than lower achievers to seek their feedback (P = 0.020). CONCLUSIONS: Our findings indicate that these medical students, particularly males and poor students, may not use assessment feedback as a learning experience. Female and better students are keener to seek out formative feedback that might be expected to help them continue to do well. We need to explore further why so many students do not access formative feedback, and develop strategies for addressing this issue effectively.