Erosion in medical students' attitudes about telling patients they are students.
(17/2287)
OBJECTIVE: To study the attitudes of preclinical and clinical medical students toward the importance of telling patients they are students, and to compare their attitudes with those of patients. METHODS: We conducted a cross-sectional survey of medical students from five Philadelphia medical schools, and a longitudinal follow-up in one medical school, to assess the importance students place on telling patients they are medical students before interacting with them. We asked similar questions of 100 general medical outpatients from two academically affiliated hospitals. MAIN RESULTS: In total, 2,603 students (58%) responded to the cross-sectional survey, 74 (50%) responded to the longitudinal survey, and 100 patients responded to our interview survey (94% response rate). In the cross-sectional survey, there were negligible differences in the importance that patients and medical students placed on informing alert patients that they are interacting with students in nonsurgical settings. In surgical settings involving anesthetized patients, patients placed significantly more importance on being informed of students' roles in their surgery than did students, and preclinical students placed more importance on this than did clinical students. Results from the cross-sectional survey were supported by the longitudinal survey, in which fourth-year medical students placed significantly less importance on informing patients of their student status than the same cohort had done 2 years previously. CONCLUSIONS: Medical students place less importance on informing patients about their student status than patients desire, especially in surgical settings in which the patient is to be anesthetized. Medical students already having completed a clinical rotation stray further from patient ideals than preclinical medical students. These findings suggest that, as medical students advance in their training, they suffer an erosion in their attitudes about telling patients they are students. (+info)
Medical students and AIDS: knowledge, attitudes and implications for education.
(18/2287)
Second year medical students at a large midwestern university were surveyed about their attitudes regarding AIDS. Results indicated: (1) students with homosexual and/or HIV-positive friends were significantly more tolerant toward AIDS patients, (2) over half the students believed that treating AIDS patients may be hazardous and that their education had not prepared them to treat these patients safely, (3) one-third believed they had the right to refuse to treat AIDS patients, and (4) AIDS-phobia was significantly associated with homophobia. These data suggest that medical educators may need to help students overcome AIDS-phobia before some students will be able to incorporate instruction about AIDS since AIDS-phobia may inhibit this learning. Didactic instruction must be coupled with modeling by educators of non-prejudicial attitudes and strict adherence to medical professionalism. (+info)
Tuberculin-purified protein derivative-, MPT-64-, and ESAT-6-stimulated gamma interferon responses in medical students before and after Mycobacterium bovis BCG vaccination and in patients with tuberculosis.
(19/2287)
QuantiFERON-TB (QIFN) (CSL Limited) is a whole-blood assay for the recognition of infection with Mycobacterium tuberculosis. QIFN measures gamma interferon (IFN-gamma) production when purified protein derivatives (PPDs) of mycobacteria are incubated with venous blood samples. The specificity of QIFN in medical students before and after BCG immunization was assessed, and sensitivity in patients with tuberculosis was assessed. Antigens were PPD derived from M. tuberculosis and two M. tuberculosis-specific proteins, ESAT-6 and MPT-64. Of 60 medical students, all of whom had 0-mm tuberculin skin tests (TSTs) at study entry, 58 (97%) were initially classified as negative for M. tuberculosis infection by PPD QIFN. Five months after BCG immunization, 7 of 54 students (13%) had a TST result of >/=10 mm and 11 of 54 students (20%) tested positive by PPD QIFN. ESAT-6- and MPT-64-stimulated IFN-gamma responses in the medical students were negative prior to and after BCG immunization. For patients with active tuberculosis, 12 of 19 (63%) were positive by PPD QIFN, 11 of 19 (58%) were positive by ESAT-6 QIFN, and 0 of 12 were positive by MPT-64 QIFN. In conclusion, PPD QIFN was negative in 97% of a low-risk population who had not received BCG and who had negative TSTs. The specificities of both the TST and PPD QIFN were reduced following BCG immunization. PPD QIFN and ESAT-6 QIFN were of similar and moderate sensitivity in patients with active tuberculosis, but ESAT-6 QIFN is likely to be more specific because it is not influenced by past BCG exposure. (+info)
Design features of on-line anatomy information resources: a comparison with the Digital Anatomist.
(20/2287)
In order to update the design of the next generation of the Digital Anatomist, we have surveyed teaching assistants who have used the Digital Anatomist for learning and teaching anatomy as medical students, and have also examined available anatomy web sites with sufficient content to support learning. The majority of web sites function in an atlas mode and provide for the identification of structures. These atlases incorporate a variety of features for interactivity with 2D images, some of which are not available in the Digital Anatomist. The surveys suggest that the greatest need is for on-line access to comprehensive and detailed anatomical information and for the development of knowledge-based methods that allow the direct manipulation of segmented 3D graphical models by the user. The requirement for such interactivity is a comprehensive symbolic model of the physical organization of the body that can support inference. (+info)
Student and faculty performance in clinical simulations with access to a searchable information resource.
(21/2287)
In this study we explore how students' use of an easily accessible and searchable database affects their performance in clinical simulations. We do this by comparing performance of students with and without database access and compare these to a sample of faculty members. The literature supports the fact that interactive information resources can augment a clinician's problem solving ability in small clinical vignettes. We have taken the INQUIRER bacteriological database, containing detailed information on 63 medically important bacteria in 33 structured fields, and incorporated it into a computer-based clinical simulation. Subjects worked through the case-based clinical simulations with some having access to the INQUIRER information resource. Performance metrics were based on correct determination of the etiologic agent in the simulation and crosstabulated with student access of the information resource; more specifically it was determined whether the student displayed the database record describing the etiologic agent. Chi-square tests show statistical significance for this relationship (chi 2 = 3.922; p = 0.048). Results support the idea that students with database access in a clinical simulation environment can perform at a higher level than their counterparts who lack access to such information, reflecting favorably on the use of information resources in training environments. (+info)
Analysis of information needs of users of the Stanford Health Information Network for Education.
(22/2287)
OBJECTIVE: To examine the information needs of users of the Stanford Health Information Network for Education (SHINE), an integrated information retrieval (IR) system. METHODS: A subset of queries from the SHINE log were categorized into one or more of 33 categories. RESULTS: Drugs and infectious disease accounted for 25% of categorizations, and otherwise the distribution of categorizations was quite broad. CONCLUSIONS: Attention should be paid to the selection of drug information resources in medical knowledge information retrieval systems. The distribution of query categorizations also suggests that IR systems include a wide range of knowledge resources. (+info)
Medical student database development: a model for record management in a multi-departmental setting.
(23/2287)
Student records flow through medical school offices at a rapid rate. Much of this data is often tracked on paper, spread across multiple departments. The Medical Student Informatics Group at the University of Utah School of Medicine identified offices and organizations documenting student information. We assessed departmental needs, identified records, and researched database software available within the private sector and academic community. Although a host of database applications exist, few publications discuss database models for storage and retrieval of student records. We developed and deployed an Internet based application to meet current requirements, and allow for future expandability. During a test period, users were polled regarding utility, security, stability, ease of use, data accuracy, and potential project expansion. Feedback demonstrated widespread approval, and considerable interest in additional feature development. This experience suggests that many medical schools would benefit from centralized database management of student records. (+info)
Photographic memory, money, and liposuction: survey of medical students' wish lists.
(24/2287)
OBJECTIVES: To examine whether medical students made fewer altruistic wishes and more money oriented wishes in later years of the medical course than students in earlier years. DESIGN: Anonymous questionnaire survey. SETTING: Auckland University School of Medicine. PARTICIPANTS: 520 medical students from 6 years of the course responded to the questionnaire item "If you had three wishes what would you wish for?" MAIN OUTCOME MEASURES: Proportion of wishes in various categories. RESULTS: The three most popular categories of wishes were happiness (34% of students), money (32%), and altruistic wishes (31%). Rates of altruistic wishes (odds ratio=1.05, 95% confidence interval 0.94 to 1.18; P=0.36) and wishes for money (odds ratio=0.96, 0.86 to 1.08; P=0.52) did not vary over the years of the course. Female medical students were more likely than males to make altruistic wishes (36% v 26%; chi(2)=5.68, P=0. 02), intimacy wishes (25% v 18%; chi(2)=3.74, P=0.05), and happiness wishes (42% v 26%; chi(2)=18.82, P=0.0001). Men were more likely than women to make sexual wishes (5% v 0.8%; chi(2)=7.34, P=0.01). CONCLUSIONS: We found no evidence that students were less altruistic and more money oriented in the later years of the medical course. (+info)