فهرست مطالب

Medical Education - Volume:17 Issue: 4, 2019
  • Volume:17 Issue: 4, 2019
  • تاریخ انتشار: 1398/02/02
  • تعداد عناوین: 7
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  • Nafiseh Abdolahi, Taghi Amiriani, Alireza Norouzi, Zahra Moghaddam, Mahdi Habibi, Koolaee * Pages 203-204
    Discharge summary (DS) is an essential document in patients’ medical records, and its information is critical during the care of patients. So, inaccurate DS increases the risk of medical errors (1, 2).In teaching hospitals with residency programs, residents are usually responsible for writing DSs. Failure to pay attention to the education of writing and creating DS in the curriculum of medicine leads residents to be unfamiliar with the requirements and contents of DSs.However, there is no national instructions or guidelines for creating a complete and accurate DS. Lack of teaching to residents on how to write a DS is the gap in medical education and may jeopardize the continuity of care. A preliminary study on hospital DSs at Golestan University of Medical Sciences (GoUMS) revealed the fact that the quality of the DSs was not appropriate in terms of accuracy and completeness. To overcome this defect, the Internal Medicine Department at GoUMS has developed a program called the “Discharge Conference” for the residents of Internal Medicine.The purpose of “Discharge Conference” is to review the DSs and to teach how to record and document it properly. Contrary to the    morning reports, in which the cases of previous nights are surveyed, at the “Discharge Conference”, the patients’ DSs recorded by residents are  reviewed, critically. From September 2017, the “Discharge Conference” has been held on the first Sunday of each month for about 2 hours. In addition to all residents of Internal Medicine, medical interns also attend the conference. Under the supervision of an attending professor, the DSs are presented by the second year Internal Medicine residents. In each conference, summaries of the discharged patients from Internal Medicine wards (nephrology, rheumatology, endocrinology, gastroenterology, hematology, and pulmonary) are selected, reviewed, and scrutinized, and the requirements of a good DS are taught.After one year of implementing the program, the evaluation of the results showed that the quality of DSs has increased significantly andthis program enhances the residents’ skills to write and create a complete and accurate DS. Several studies have shown that teachinghow to write a discharge summary increases the quality of DSs and the recording skills of residents (1, 3, 4). Therefore, DS curriculum isessential to be included in medical education program, and the lack of appropriate training program in this field can lead to adverse eventsand increase medical errors.In conclusion, if “Discharge Conference” takes place on a planned, targeted, and regular basis, it will be an appropriate educational  program for training residents on how to write DSs. It is suggested that “Discharge Conference” be considered as a part of the residency programs.Conflict of Interest: None Declared.
    Keywords: Medical Education, Medical Residency, Discharge Summary, Curriculum
  • Enjy Abouzeid*, Asmaa Abdel Nasser Pages 205-214
    Background
    Over the last two decades, the focus of curricula has shifted from the acquisition of knowledge to the achievement of competence. The challenge is to improve the assessment scheme to formatively support the development of competence in an integrated, coherent, and longitudinal fashion, and assess them in a summative fashion.
    Objectives
    To investigate the students’ and staff’s perception towards the implementation process of the portfolio in the clinical years at Faculty of Medicine, Suez Canal University.
    Methods
    Two different questionnaires were used to explore the students’ and staff’s perception towards portfolio assessment process.
    Results
    The students’ response rate was 70%. 46.8% of the students agreed on the portfolio’s complementary role to clinical teaching during rotations. They agreed that portfolio stimulated their problem solving and clinical reasoning skills by 38.5%, and 38.2% respectively. 41.1% agreed that it helped them in preparation for their future practice. However, 41% agreed that portfolio workload and time required were excessive. There was no chance to improve those aspects assessed as deficient in feedback. One of the threatening problems is copying the portfolio from others, unfortunately. 34.7% of the students agreed that this was a problem among them. Regarding the staff, they agreed that portfolio helped them to assess students’ competencies and permitted multiple episodes of teaching more effectively than single observations did (75%, and 72.2%, respectively). However, 38.9% felt that it was an exhausting and time-consuming assessment process. They thought that it would be better to have enough time for review the portfolio in detail before the oral discussion, and that was fair if two examiners evaluated it rather than one (64%, and 75%, respectively).
    Conclusion
    The portfolio helps the faculty in assessment of students’ clinical competencies in a continuous manner but for both it was exhausting and time-consuming assessment process.
    Keywords: PORTFOLIO, EVALUATION, PERCEPTION
  • Salma Abdalla Elyasa Elamin, Asim Ahmed Hussein Ahmed, Hadeel Mohammed Mohammed Khair Sovla, Abobaker Ali Hassan Younis *, Wail Nuri Osman Mukhtar Pages 215-221
    Community-based education (CBE) is the means of achieving educational relevance to community needs. The Integrated Field Training, Research and Rural Development Program (IFTRRD) is a course designed to achieve CBE in Faculty of Medicine, University of Gezira since its establishment in 1978.We aimed to study CBE from Gezira medical students’ perspective regarding the IFTRRD course. In this cross-sectional study, 244 medical students at University of Gezira were enrolled during 2016-2017. Most of the participants agreed that their team work and leadership skills had improved (82% and 78.3% respectively). Moreover, 96% of the students agreed that rural stay helped them be engaged with the community. About 91% identified health and health-related problems in the village and 50% of them performed interventions. About 45.9% achieved 75% of the social accountability philosophy.The students gained communication, teamwork and leadership skills. Moreover, they achieved the philosophy of the university in social accountability. They also identified community problems and performed appropriate interventions.
    Keywords: COMMUNITY, COMMUNITY ORIENTATION, STUDENTS’ PERSPECTIVE, SUDAN
  • Salman AlSabah*, Eliana Al Haddad, Fahd AlSaleh Pages 222-229
    Background
    As research becomes one of the cornerstones of modern medicine, medical students are playing a greater role in contributing to its production. While such studies help expand their knowledge, the importance of doctoral supervision is important in effective training, empowerment and the facilitation of young scholars in becoming independent researchers. However, the roles of students and supervisors in the creation of a research paper is still a gray zone.
    Methods
    An online, web-based survey was designed and sent out to medical students, residents and professors. Participants were queried about their background, demographics, position in education, and     attitudes towards research projects. The goal of the questionnaire was to identify students` expectations from supervisors and attitudes toward research projects, and vice versa. Questions were evaluated on a 5-point scale, with 1 being ‘strongly disagree’ and 5 being ‘strongly agree’
    Results
    Ultimately, 194 participants responded to the questionnaire, of which 82% were medical students. Most students believed that it is the supervisors that should be cited as first authors, and that it was the students’ responsibility to ensure that the work done on the research topic is completed by the submission deadline. Contrarily, when taking the supervisors point of view, they believed that it was their responsibility not the students’. In general, the supervisors believed they had a bigger role to play when it came to laying out the research project and ensuring its progression.
    Conclusion
    The perception of the roles of supervisors and students when it comes to producing a research project differ quite significantly. Supervisors believe that they should have much more minute responsibilities involving overall project management, while students believe that the time management of the projects is more of their responsibilities, with supervisors guiding and overseeing the project as a whole.
    Keywords: STUDENTS, SUPERVISORS, MEDICAL, RESEARCH PROJECTS
  • Srivastava Dhiraj Kumar *, Bansal Manoj, Gour Neeraj, Srivastava Monika, Jain Pankaj Kumar Pages 230-237
    Background
    Medical professionals are prone to different forms of stress. These stresses start right from the beginning of medical professions. Most of the time such stresses have a negative impact on the psychological and physiological health.
    Objectives
    To assess the prevalence of stress among medical students. To identify the possible stressors in medical students.
    Methods
    The present study was a cross-sectional one carried out for a period of one month in Nov 2017 among medical students of 6th & 7th semesters. Assessment of stress was done using Medical Student Stress Questionnaire (MSSQ).The test of association was applied between the level of stress and sociodemographic profile of the participants.
    Result
    A total of 122 students participated in the study. The prevalence of moderate to severe stress was 55.7%. It was more in female students compared with their male counterparts. There was no statistically significant difference in the levels of stress between male and female students among different stressors. Statistically significant association was noted between Academic Related Stressor and sex of the participants and fathers’ occupation. Significant association was also noted between Teaching and Learning Related Stressor and fathers’ occupation. Reliability analysis showed that overall Cronbach’s alpha for MSSQ for Indian students was 0.907.
    Conclusion
    Moderate to severe stress is common among medical students and more common in female students. Most common source of these stresses is academic related issues. Fathers’ occupation is also a potential source of stress.
    Keywords: PSYCHOLOGICAL STRESS, DEMOGRAPHIC FACTOR, MEDICAL STUDENTS
  • Madeline Richter, Natasha Keric *, Paul Kang, Ara J. Feinstein Pages 238-248
    Background
    Following the trend of residency programs, more medical schools are offering night float (NF) schedules for clerkships and sub-internship rotations. The efficacy of this structure to educate students and prepare them for residency was evaluated.
    Methods
    Twenty individuals were surveyed after a month-long 4th year NF elective in Trauma and Emergency Surgery.
    Results
    Thirteen participants responded (65%), reporting more bedside procedures (84.7%) and oneon-one teaching with residents (84.7%), when compared to daytime shifts. Six (46.2%) experienced more operative procedures and contact with the attending physician. All participants (100%) reported: increased autonomy; that this elective better prepared them for their surgical residencies; and that theywould recommend this type of program to other students considering a career in surgery.
    Conclusion
    Overall the NF surgical sub-internship was an effective and well-received experience for 4th medical students, with increased autonomy, more frequent procedures, and added resident-led education, when compared to a traditional daytime surgical clerkship/sub-internship. A NF schedule can be a valuable learning experience that prepares medical students for surgical residency.
    Keywords: NIGHT FLOAT, TRAUMA SURGERY, SUB-INTERNSHIP, CURRICULUM
  • Caitlin M. Marshall*, Sarah Hopkins, Carolyn Wu, Matthew Boles, Robert K.Smith, Kenneth Harris, Paul Brisson Pages 249-255
    Background
    There is currently no standard recommendation among osteopathic medical schools for appropriate obstetrics and gynecology (OB/GYN) surgical procedure videos for third-year medical students (OMS III) in preparation for their OB/GYN rotations. OMS III student doctors will very likely participate in an OB/GYN procedure on their very first day of clinical rotations. In an effort to adequately prepare medical students for the procedural portion of their clinical rotations, videobased instruction is necessary. According to a recent study, YouTube is the most frequently accessed educational video source when students are preparing for surgical-based rotations and procedures. We hypothesized that there is a lack of ideal surgical videos to sufficiently prepare the third-year medical student for two common OB/GYN procedures.
    Methods
    Utilizing input from two faculty OB/GYN physicians and four OMS II medical students, a checklist of essential components of the ideal instructional video for a third-year medical student was developed for two common procedures, cesarean section and robotic hysterectomy. Upon completion of the checklist, YouTube videos were selected by entering the search phrase, “Step by step cesarean section procedure” and, “Step by step robotic laparoscopic total hysterectomy procedure”. The top 20 instructional videos to appear upon entering the search criteria for each procedure were selected for evaluation. Binary data was collected on whether each video met each checklist item (yes or no).
    Results
    No single video met all checklist items. Every video lacked two or more critical elements. 30/40 videos (75%) met less than 50% of the checklist items.
    Conclusion
    The hypothesis that there is a lack of ideal videos for a third-year medical student entering their OB/GYN rotation was true based on our ideal video checklist. Our findings suggest that students are unlikely to find the ideal resource on the commonly accessed video platform which may have a negative impact on student preparation for clinical rotations. Our checklist can provide a guideline for the development of OB/GYN procedural videos for OMS III students.
    Keywords: OBSTETRICS, GYNECOLOGY, VIDEO-BASED INSTRUCTION, CLINICAL ROTATIONS, MEDICAL EDUCATION, YOUTUBE, CESAREAN SECTION, ROBOTIC HYSTERECTOMY, OMS III, THIRD-YEAR MEDICAL STUDENT