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Background: Medical students are at risk for poor mental health and burnout compared to the general population (Dyrbye et al., 2014). A preponderance of research has examined predictors of mental illness in medical students (Brazeau et al., 2014; Hope & Henderson, 2014). However, few studies have investigated predictors of mental health, and no studies to our knowledge have compared predictors of mental health and burnout in medical students. Further, several studies have assessed physical activity and burnout in medical students but these have neither examined specific intensities of physical activity nor have considered the role of sedentary behaviour in predicting medical student burnout (Dyrbye, Satele, & Shanafelt, 2017b; Wolf & Rosenstock, 2017). Thus, there is a dearth of knowledge on how demographics relate to mental health and burnout, and how mild, moderate, and vigorous physical activity, and sedentary behaviour relate to burnout in medical students. Purpose: To investigate and compare demographic predictors (gender, ethnicity, age, level of education, year of study, and proposed specialty) of mental health and burnout, to examine behavioural predictors (mild, moderate, vigorous, and total physical activity, and sedentary behaviour) of burnout, and to investigate moderate-to-vigorous physical activity as a moderator of the relationship between sitting and burnout in first to fourth year medical students. Methods: The sample consisted of 129 first to fourth year medical students at two large Canadian universities. Participants were recruited through electronic newsletters, medical student Facebook groups, and an in-class announcement. This study used a cross-sectional design. Data were collected through online surveys of validated self-report questionnaires measuring demographics, mild, moderate, vigorous, and total physical activity, sitting, mental health, and burnout. Results: Third year of study was a significant negative predictor of mental health while female gender, ‘other’ ethnicity and third year of study were significant positive predictors of burnout. Moreover, female gender, ‘other’ ethnicity, and fourth year of study predicted mental health differently from burnout. Second and third year of study predicted mental health and burnout similarly. Mild physical activity and sitting were significant negative predictors of burnout. Moderate-to-vigorous physical activity was not a significant moderator of the relationship between sitting and burnout. Conclusions: Findings of this study support Keyes’ Dual Continua Model (2014) and Maslach’s theorization of burnout (Maslach, Jackson, & Leiter, 1996) and can inform targeted programs to prevent poor mental health and burnout in medical students. Future research is recommended on these key topics.

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The central concern of the thesis is to problematise the complexity of the relationship between student learning and the teaching-learning environment in medicine as experienced by students. The thesis argues that learning material presented to students offers only potential for learning. What students make of that potential is influenced by a number of different variables and as such this needs to be investigated empirically. High-quality learning is an important goal for all higher education and previous research together with the empirical findings presented in this thesis convey the importance for students to seek a holistic approach to learning. Such a learning approach encompasses not only learning of facts and theories but also includes exercising an ability to reflect and reason, to organise facts and theories into wholes, and to explore how they relate to each other. Most importantly, it involves the ability to understand the grounds on which facts and theories are chosen for specific purposes depending on context. The thesis explores these issues by drawing on findings from three studies of medical students’ experiences of learning and understanding and how students’ personal understandings of subject content in medicine come to the fore in their work on learning tasks. By applying a context-oriented methodological perspective on learning, focusing on what students actually do in a learning situation, the thesis enables an in-depth investigation of relationships between aspects of content, context and the individual. The results show that the learning environment in the medical programme to a large extent does not make sufficient room for students to express understanding of this dynamic character. In the thesis it is argued that to facilitate such an understanding it is necessary for both students and teachers to increase awareness of the context-dependency of subject content, facts and theories, and the different meanings content takes depending on context of use.

The Resident-Medical Student Shadowing Program is a novel program in which first-year medical students shadowed a first-year resident during their clinical duties. It was developed to enhance the preparedness of medical students for clinical training. To examine the program’s effectiveness, a randomized control trial was conducted within a concurrent triangulation mixed methods study. Student participants were compared to controls using validated questionnaires. Participants’ experiences were further explored using semi-structured interviews. Results indicate that participation gave students an understanding of the clinical environment and their role within it, and taught them the skills and knowledge needed to perform that role. Students’ learning was enhanced by the relationship developed with their resident, facilitated by the residents’ approachability and relatability and their dedication to teaching. Residents, in turn, gained expertise in teaching and learned about professionalism. Suggestions for implementing this program in the future as well as future directions for research are discussed. / Measurement, Evaluation and Cognition

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2004. / Title from first page of PDF document. Includes bibliographical references (p. 45-49).

Made available in DSpace on 2014-06-11T19:29:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-04-04Bitstream added on 2014-06-13T19:58:39Z : No. of bitstreams: 1 guimaraes_kbs_me_assis.pdf: 289823 bytes, checksum: 3d228da5cee258f0108a5e87458220b1 (MD5) / O objetivo deste trabalho foi avaliar a prevalência de estresse no estudante de Medicina. A Faculdade de Medicina de Marília (FAMEMA) foi escolhida por utilizar, desde 1997, no lugar do método tradicional, uma nova metodologia de ensino, a Aprendizagem Baseada em Problemas (ABP). Os sujeitos da pesquisa foram quatrocentos e treze estudantes, do ano de 2003, equivalente a 87,5% dos estudantes matriculados naquele ano. Foi aplicado o Inventário de Sintomas de Stress para Adultos de Lipp aos sujeitos da pesquisa durante os meses de abril a outubro de 2003. Observou-se a presença de estresse em 57,83% dos estudantes. A prevalência de estresse foi menor nos estudantes do primeiro ano em relação aos estudantes dos demais anos, e essas diferenças foram estatisticamente significantes. A prevalência de estresse foi maior no gênero feminino em relação ao masculino (p < 0,05). Nos estudantes que apresentaram estresse, 63,71% apresentaram predominância de sintomas psíquicos, 24,05% de sintomas físicos e 12,24% sem predominância. Nos estudantes que apresentaram estresse, 88,19% encontravam-se na fase de resistência, 4,64% na fase de alerta, 5,06% na fase de quase exaustão e 2,11% na fase de exaustão. Esses resultados sugerem que o curso médico é um agente estressor, mesmo numa faculdade que utiliza em seu currículo a ABP e, também, que há uma associação maior entre o estresse e o gênero feminino. Os resultados obtidos nesta pesquisa fazem considerar a necessidade de repensar o ensino médico, dando condições ao estudante de aprender a lidar com o estresse causado pelo curso, pois a maioria dos estudantes ainda se encontra na fase de resistência, portanto, sem uma doença instalada. / The aim of this study was to evaluate the incidence of stress among medical students of the Faculdade de Medicina de Marília (FAMEMA). This institution was chosen as it utilizes the Problem Based Learning (PBL) method of teaching, instead of the traditional one since 1997. The research subjects were four hundred and thirteen students, equivalent to 87.5% of all registered the students in 2003. Between April and October of this year was applied to the research subjects the Lipp's Inventory of Symptoms of Stress for Adults. It was observed the presence of stress on 57.83% the students. The prevalence of stress was minor in the sophomore students in relations to those of the other years, and these differences were significant. The prevalence of stress was higher on the female genus comparing to the male genus (p < 0.05). Of the students that presented stress 63.71% presented predominance of psychic symptoms, 24.05% physical symptoms, and 12.24% with no predominance. On the students that presented stress, 88.19% were on the resistance phase, 4.64% on the alert phase, 5.06% on the almost exhausted phase and 2.11% on the exhausted phase. These results suggest that the medical course is a stressor agent; even in a College that utilizes on its curriculum the PBL, as well as there is an association between the stress and the female genus. The results obtained in this research make us to considerer the possibility of acting on the medical teaching, giving conditions for the student to learn to struggle with the stress caused by the course, as the majority of the students still are on the resistance phase, consequently, without an installed disease.

Benign paroxysmal positional vertigo (BPPV) is a specific type of short-duration vertigo that is provoked by changes in head position and usually lasts less than one minute. It is a common vestibular pathology that can have significant effects on patient safety, quality of life, and medical costs. Therefore, it is crucial that medical students are educated and trained to facilitate and coordinate care of patients who may have undiagnosed BPPV. Because there is evidence to suggest that physicians—specifically primary care physicians—may not be properly equipped in their education to manage patients with BPPV, the purpose of this study was to investigate medical students’ evaluations of their preparedness to provide evidence-based care in the diagnosis and treatment of BPPV. An anonymous survey was administered via email to medical students in their fourth and final year of medical school at East Tennessee State University’s Quillen College of Medicine. This survey includes statements about the evidence-based Clinical Practice Guideline on BPPV provided by the American Academy of Otolaryngology. Respondents rated the degree to which they agreed or disagreed with how prepared they felt to address each item using a 5-point response scale from “strongly disagree” to “strongly agree.” Of the 70 students in the current fourth year class, 41 (59%) completed the survey. Students felt prepared for some aspects of diagnosing and treating BPPV, especially with regard to their general knowledge of BPPV, its impact on patients’ lives, and the options available to manage it. They felt less prepared to know when or if it is appropriate to recommend additional testing, imaging, or medication. They did not feel confident in their ability to perform the maneuvers to diagnose and treat BPPV. Overall, these results suggest medical students have a good foundation in their knowledge of BPPV. These results also propose topics to support more specialized training during their residencies to build upon the foundational knowledge obtained during their didactic training and optimize diagnosis and management of BPPV.

Background: Learning preference refers to how individuals choose to approach learning situations. Computer-aided instruction (CAI) permits the adaptation of educational content to individual student learning strategies. Methods: To determine if learning preference and computer attitude influence the acquisition of knowledge using CAI materials, a prototype CAI program was developed that incorporated differing learning exercises. Students (n = 180) completed Rezler's Learning Preference Inventory (LPI) and a computer attitude survey (CAS). The LPI uses three sets of paired scales to characterize learning preference and choice of learning situation. The CAS assesses student attitudes toward computers in general (CAS-G), as well as the educational use of computers (CAS-E). After finishing the program students completed a program attitude survey (CAS-P). Immediate comprehension was assessed by pretests and posttests incorporated into the program. Retention was assessed by a repeat of the posttest 4 to 6 weeks after initial program review. Results: Scores (mean ± SEM) on the pretest, posttest, and late posttest were 38.1% ± 1.35%, 70.9% ± 1.24%, and 62.5% ± 1.44%, respectively. There was no correlation between students' learning preferences or computer attitude and test performance. Conclusions: The data indicate that CAI provides a means of delivering educational content that results in an increase in knowledge that is not correlated with computer attitudes or learning preferences.

To achieve Sustainable Development Goal 3 in developing countries, Good health and wellbeing for all, the health workforce is vital however the unpopularity of rural medical practice results in widening healthcare inequalities between urban and rural areas. This study determined the heterogeneity in valuations for rural facility attributes by final year medical students at one South African public university to inform cost-effective recruitment policy recommendations. Focus groups conducted identified facility attributes, a D-efficient design was generated with 15 choice sets, each with two rural hospital alternatives and no opt-out option. An online, unlabelled discrete choice experiment (DCE) was conducted, the results effects coded, and mixed logit models applied. The final sample size was 193 (86,16% of the class), majority female 130 (66.33%), with urban origins 176 (89.80%), unmarried 183 (93.37%) and without children 193 (98.47%). Most had undergraduate rural medicine exposure 110 (56.12%) and intended to specialise 109 (55.61%). The main-effects mixed logit found advanced practical experience, hospital safety, correctly fitted personal protective equipment (PPE) and availability of basic resources the highest weighted attributes with their mean utilities increasing by 0.82, 0.64, 0.62 and 0.52 respectively (p=0.000). In contrast, increases in rural allowance and the provision of housing provided smaller mean utility increases of 0.001 (p<0.01) and 0.09 (p<0.05) respectively. The interaction terms; female, general practise and prior rural medicine exposure, were associated with higher weighting for hospital safety, mean utility increases 1.59, 1.82, 1.42 respectively (p=0.000). Participants were willing to pay ZAR 2636.45 monthly (95%CI: 1398.55;3874.355) to gain advanced practical experience (equivalent to 65.91% of current rural allowance). Medical students’ facility preferences have been found to be influenced by their gender, career aspirations and prior experienced with rural medicine. The policy recommendations derived from this research include publicising rural health facility “draw-cards” among medical graduates, such as the opportunity to gain practical experience, improving the physical and occupational safety at rural health facilities and providing greater transparency about rural facility attributes to medical graduates.