Class of 2009 Abstract / OBJECTIVES: The purpose of this study is to evaluate and compare the DDI knowledge of pharmacy, medical, and nurse practitioner students who are beginning clinical clerkships. METHODS: This study utilized a prospective evaluation of DDI knowledge among healthcare professional students who were currently enrolled in their final didactic year at the University of Arizona College of Medicine, College of Pharmacy, or College of Nursing’s nurse practitioner course. Students were provided with 15 possible DDI pairs, and asked to select an appropriate management strategy for each pair. Management options included: “Avoid Combination,” “Usually Avoid Combination,” “Take Precaution,” “No Special Precaution,” and “Not Sure.” The primary outcome measure was the ability to correctly categorize each DDI pair into one of the five management responses. The secondary outcome measure was the number of clinically significant DDIs recognized. Analysis of variance was used to evaluate differences between groups. An alpha of 0.05 was set a-priori. RESULTS: Response rates were 61% for medical students (72 of 119), 82% for pharmacy students (64 of 78) and 100% for nurse practitioner students (29 of 29). The mean number correct for management strategies was comparable in the medical students (2.5, SD= 1.9) and nurse practitioner students (3.0, SD= 1.9), while the pharmacy students had a mean score of 6.1 (SD= 2.2) correct answers. There was a significant difference between the groups in correct responses (p< 0.001). In regards to student ability to identify interactions, the mean number correct was 10.1 (SD= 2.6), 5.0 (SD= 3.3), and 4.4 (SD= 3.0) for pharmacy, medicine, and nursing respectively (F= 60.6; p< 0.001). Post hoc analysis demonstrated that pharmacy students performed significantly better than medical and nurse practitioner students in regards to their ability to: 1) select management strategies for DDI pairs; and 2) identify a DDI interaction. No significant differences were found between the medical and nurse practitioner students. CONCLUSIONS: Pharmacy students demonstrated better knowledge than medical and nurse practitioner students with respect to identifying and selecting management strategies for possible DDIs. However, there is much room for improvement for all groups.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / The worldwide scarcity of psychiatrists makes the identification of the factors associated with the intention to choose this specialty an important issue. This study aims to evaluate the association between religious affiliation and the intention to choose psychiatry as a specialty among medical students from 11 Latin American countries. We conducted a cross-sectional, multi-country study that included first- and fifth-year students of 63 medical schools in 11 Latin-American countries between 2011 and 2012. The main outcome and measures were the intention to pursue psychiatry as a specialty over other specialties (yes/no) and religious affiliation (without: atheist/agnostic; with: any religion). A total of 8308 participants were included; 53.6% were women, and the average age was 20.4 (SD = 2.9) years. About 36% were fifth-year students, and 11.8% were not affiliated with any religion. Only 2.6% had the intention to choose psychiatry; the highest proportion of students with the intention to choose psychiatry was among students in Chile (8.1%) and the lowest among students in Mexico (1.1%). After adjusting for demographic, family, academic as well as personal and professional projection variable, we found that those who had no religious affiliation were more likely to report the intention to become a psychiatrist [OR: 2.92 (95%CI: 2.14-4.00)]. There is a strong positive association between not having a religious affiliation and the intention to become a psychiatrist. The possible factors that influence this phenomenon must be evaluated in greater depth, ideally through longitudinal research. / Revisión por pares

La presente investigación tiene como objetivo analizar la relación entre el engagement y las estrategias de afrontamiento en estudiantes de medicina de una universidad privada de Lima, de modo que se pueda descubrir la relación entre estas dos variables, y qué estrategias de afrontamiento se encuentran positivamente relacionadas con el engagement. La muestra está conformada por 137 participantes, y se hizo de modo no probabilístico e intencional. El 59.9% de la muestra son mujeres y el 39.4% hombres, cuyas edades oscilan entre 15 y 34 años, siendo la media 19.53 años y el 20.4% de 19 años. En cuanto al ciclo de estudios oscilan entre 1 y séptimo ciclo, siendo el 48.9% del tercer ciclo. Luego del análisis estadístico de los datos se encontró que existe una correlación positiva y significativa entre las estrategias de afrontamiento Búsqueda de apoyo social, Actitud positiva y proactiva, y evitación con el engagement. / This research purpose is to analyze the relationship between engagement and coping strategies as well as to discover if there exist coping strategies that are positively related to this concept, in medical students from a private university of Lima-Perú. The sample of the research was made up of 137 participants and was done in a non-probabilistic and intentional way, 59.9% of the sample was women and 39.4% were men, all of them between 34 and 15 years old. The average age was 19.53 years old and 20.4% was 19 years old. All of the participants were between first and seventh semester, being the 48.9% of them on the third. All data was analyzed with the SPSS program. After the statistical analysis it was found that there is a positive and significant correlation between the coping strategies search for social support, positive and proactive attitude, and the avoidance with engagement. / Tesis

There is ample evidence that clinical communication skills deteriorate in medical students without specific training, but are improved by training. However, little is known about how well-equipped students are to communicate with patients on entering medical school, and there is limited evidence about whether all students improve with tuition in communication skills. This thesis describes a longitudinal study into these issues at the University of Otago�s Medical School. It was hypothesised that the majority of participants would demonstrate significant improvement in communication skills over their first two phases of specific tuition in communication. However, a small minority of participants were expected to fail to develop adequate skills in communication over this time, and the researcher wished to investigate whether any of the variables measured at baseline (demographic characteristics, personal qualities, academic abilities, and demonstrated interaction and interview observation skills) would predict those participants who developed superior communication skills, or who failed to demonstrate sufficient improvement by the end of eighteen months of medical education. Participants were 232 new entrants to the Otago Medical School programme, who were evaluated at three time points over the first eighteen months of their medical training. After completing a range of baseline measures (including a pre-training videotaped interview with a simulated patient role-played by an actor), participants completed two phases of communication skills training and, at the end of each phase, undertook a further videotaped interview. Interviews were marked by trained raters, using a novel assessment tool, the Brown-Peace Interview Marking Schedule, developed specifically for this purpose. Actors and participants themselves also evaluated each interview. Results showed that there was considerable variation in participants� abilities to perform the pre-training interview, indicating that the communication skills required in a clinical setting were not present in the majority of participants before training. Analysis of participant performance over time indicated that, while certain skills improved with training (e.g., receptive listening skills, non-verbal expression, and degree of structure in the interview) others did not improve significantly (e.g., responsiveness to the patient�s needs). As a group, participants benefited from the training, but a small sub-group of participants exhibited significant deficits in communication, even after two phases of communication skills training. It was easier to predict those participants who would develop superior communication skills than those who would continue to experience difficulties with simulated interviews. However, a small number of qualities (such as lack of familiarity with the English language, and high levels of personal qualities such as aloofness) were useful predictors of poor performance in the videotaped interviews. Further research could clarify whether the same personal qualities influence student performance in later interviews, once students have had more experiential training and opportunities to practise interviewing in a range of settings. In terms of the practical implications of the research findings, a number of issues are highlighted, such as the range of skills required of those who teach and evaluate communication skills. Recommendations are made regarding the timing, content and implementation of communication skills training for medical students.

This thesis explores whether a carefully designed educational program can impact unfavourably on a proportion of students, what the magnitude of this proportion may be, whether previously identified ???deep enhancing??? features could stimulate surface approaches in some students, and the possible reasons for such paradoxical impact. These questions are set within a context of continuing efforts to find the ???ideal??? medical curriculum, and where evaluation studies of these curricular methods have failed to demonstrate the expected degree of positive impact. This leads to the final question of the thesis, which is whether the phenomenon of different responses by different students, could help explain the less-than-expected positive impact of curricular innovations reported in the literature. The questions were explored through a series of three studies. The First study consisted of individual student interviews and surveys (using the R-SPQ-2F, Biggs et al 2001) during a traditional program in medicine and upon conclusion of an educational program designed along currently accepted principles associated with higher quality learning outcomes. The two follow up studies included surveying students in two other settings in medical education. These studies were useful to overcome some of the limitations of the First study, and to explore the possible wider prevalence of the findings of the First study. The findings of the First study indicated that one-third of the student group did respond unfavourable to a carefully designed educational program. The interview findings highlighted this phenomenon, and illustrated how these students responded to ???deep enhancing curricular features??? by changing to more surface approaches. The survey findings supported these findings, and helped cluster and categorise students into subgroups who responded to the Pilot program in distinct ways. The two follow up studies indicated similar patterns of response in the other settings of medical education, and suggested that this phenomenon may be more widely prevalent. The findings suggest an area of research that requires further exploration. If confirmed and extended by further work, the findings could have significant theoretical and practical implications for medical education. From a theoretical perspective, the findings enrich the current theory of student approaches to learning by beginning to unravel the complex interaction between student and context factors that lead to approaches. The thesis further contributes to the literature by its finding that some previously identified ???deep enhancing??? context factors could stimulate change to more surface approaches in some students, and by the finding that different students??? approaches could change in different directions, when measured before and after the same ???deep enhancing??? educational context. From a practical perspective, the findings could be relevant to designers and evaluators of medical curricula, and to facilitators of small group learning. An understanding of the different patterns of response that may be expected, and an understanding of different strategies that may better support these different subgroups, may help optimise the benefits of curricular design.

No description available.

Little uniquely identifiable information about Hispanic women who gain entrance into medical school is known. A few studies that focus just on stress in Hispanic women in medical school have found “unique” stressors. This research examines stress in Hispanic women students (all four years) at Texas A&M University System – Health Science Center – College of Medicine (TAMUS-HSC) at College Station and at the University of Texas Medical Branch (UTMB) at Galveston, Texas. Twenty- four women took part in this project. Data was gathered using a packet of questionnaires, incorporating Sheridan and Radmacher’s Comprehensive Scale of Stress Assessment and the Personal Style Inventory (1987 and 1991) and The Community Oriented Primary Care (COPC) Student Project: Stress in First-Year Medical Students (Lensky, Noori, Matsukuma, Melamud & Chen, 1999). Each woman was personally interviewed. The results suggest increased stress and “unique” stressors found by others who have researched Hispanic women in medical school. The intensity of medical school coupled with the stress that engulfs them from fear and sometimes anger (two stress emotions) stemming from worry about failure in school and worry about student loans that they are fearful they may not be able to repay causes high stress. Social, ethnic, and cultural bias and norms barriers to which they struggle to overcome anger them. Results from investigation of coping strategies suggest the women are coping as well as can be expected and are joyous over what they are doing. They rely on social groups to give them support. The knowledge they have obtained that there is prejudice toward their academic qualifications seems to make them more determined. They appear to be non-traditional and strong women who feel they are destined to become medical doctors This research should add valuable information to future research in this area. It is suggested by this author that there is a need for substantial, active, immediate and constant support for all minority students in Texas medicine. It is of necessity that minority mentors be trained and efforts made to put in place a program that works to support the women who are struggling and in fear of failing out.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 249-259). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 249-259). Also available on the Internet.

Project Thesis (D. Min.)--Denver Seminary, 1988. / Includes bibliographical references (leaves 313-329).