Assessing professional behaviors: a self-administered scale for medical students during clerkships
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SUBMITTER: Xin C
PROVIDER: S-EPMC11200818 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:ObjectivesMany medical students experience career decision-making stress in the final phase of training. Yet, the factors that induce or reduce career decision-making stress and how progression in their clerkships relates to these factors are unknown. This knowledge gap limits the possibilities for medical schools to develop and implement interventions targeting students' career decision-making stress. This study explores content, process, and context factors that may affect career decision-making stress.MethodsUsing cross-sectional survey data from medical master students (n = 507), we assessed content (future work self), process (choice irreversibility, time pressure, career decision-making self-efficacy), and context (supervisory support, medical school support, study load, competition) factors and their relationships with career decision-making stress. The hypothesized relationships were tested with structural equation modelling.ResultsA clearer future work self and higher career decision self-efficacy were associated with lower career decision-making stress, while experienced time pressure, competition, and study load were associated with higher career decision-making stress. Choice-irreversibility beliefs, supervisory support, and medical school support were unrelated to career decision-making stress. As students' clerkships progressed, they gained a clearer future work self, but also experienced more time pressure.DiscussionClinical clerkships help students to form a clearer future work self, which can diminish career decision-making stress. Yet, students also experience more time pressure as the period of clerkships lengthens, which can increase career decision-making stress. A school climate of high competition and study load seems to foster career decision-making stress, while school support hardly seems effective in diminishing this stress.
| S-EPMC9734734 | biostudies-literature
Project description:BackgroundThe increased use of social media, cloud computing, and mobile devices has led to the emergence of guidelines and novel teaching efforts to guide students toward the appropriate use of technology. Despite this, violations of professional conduct are common.ObjectiveWe sought to explore professional behaviors specific to appropriate use of technology by looking at changes in third-year medical students' attitudes and behaviors at the beginning and conclusion of their clinical clerkships.MethodsAfter formal teaching about digital professionalism, we administered a survey to medical students that described 35 technology-related behaviors and queried students about professionalism of the behavior (on a 5-point Likert scale), observation of others engaging in the behavior (yes or no), as well as personal participation in the behavior (yes or no). Students were resurveyed at the end of the academic year.ResultsOver the year, perceptions of what is considered acceptable behavior regarding privacy, data security, communications, and social media boundaries changed, despite formal teaching sessions to reinforce professional behavior. Furthermore, medical students who observed unprofessional behaviors were more likely to participate in such behaviors.ConclusionsAlthough technology is a useful tool to enhance teaching and learning, our results reflect an erosion of professionalism related to information security that occurred despite medical school and hospital-based teaching sessions to promote digital professionalism. True alteration of trainee behavior will require a cultural shift that includes continual education, better role models, and frequent reminders for faculty, house staff, students, and staff.
| S-EPMC5438450 | biostudies-literature
Project description:IntroductionProfessionalism in physician assistant (PA) students is an essential behavior to assess during formative medical education. Objective structured clinical examinations (OSCEs) provide an opportunity to evaluate PA students performing professional behaviors within simulated clinical settings. This scoping review aims to explore insights the existing literature offers regarding evaluating the professional behaviors of PA students using an OSCE. A secondary objective is to identify gaps in the literature to clarify future research.MethodsThis scoping review was conducted in March 2024. From January 2018 until March 2024, CINAHL, MEDLINE Ultimate, Health Source-Nursing/Education, and PubMed online databases were searched for publications in English. Records included research studying PA or medical students evaluated on professional behaviors using an OSCE or performance-based assessment instrument. Allied health profession students were excluded from the primary search because of their heterogeneous curriculum models outside the population of interest.ResultsThis review includes 5 papers. All papers reported communication as a professional behavior measured in an OSCE or performance-based assessment. A consensus or formal definition of professional behavior is a notable absence in this scoping review.DiscussionMore definitive homogenous evidence is needed to assess the professional behaviors of PA students using an OSCE. This limits the guidance and educational standards for future health profession educators. Comprehensive research into professional behaviors among PA students is essential. Scholars must publish their findings on professionalism curriculum design and outcomes to facilitate a broader understanding and improvement in educating future PA professionals.
| S-EPMC11841713 | biostudies-literature
Project description:PurposeStudies show that measures of physician and medical students' empathy decline with clinical training. Presently, there are limited data relating self-reported measures to observed behavior. This study explores a self-reported measure and observed empathy in medical students.MethodStudents in the Class of 2009, at a university-based medical school, were surveyed at the end of their 2nd and 3rd year. Students completed the Jefferson Scale of Physician Empathy-Student Version (JSPE-S), a self-administered scale, and were evaluated for demonstrated empathic behavior during Objective Structured Clinical Examinations (OSCEs).Results97.6% and 98.1% of eligible students participated in their 2nd and 3rd year, respectively. The overall correlation between the JSPE-S and OSCE empathy scores was 0.22, p < 0.0001. Students had higher self-reported JSPE-S scores in their 2nd year compared to their 3rd year (118.63 vs. 116.08, p < 0.0001), but had lower observed empathy scores (3.96 vs. 4.15, p < 0.0001).ConclusionsEmpathy measured by a self-administered scale decreased, whereas observed empathy increased among medical students with more medical training.
| S-EPMC2839329 | biostudies-literature
Project description:BackgroundWhile conspiracy theories cover many different themes, medical conspiracy theories (MCTs) have become particularly prevalent in modern societies. As beliefs in MCTs can become a source of "infodemics", influence individual health behaviors and cause distrust in medical institutions and personnel, healthcare workers must find ways to overturn patients' conspiracy thinking. However, as the medical world is not free of these beliefs, in this study, we investigated beliefs in MCTs among medical and health science students and their association with reported health behaviors.MethodsOur sample was derived from a self-administered, anonymized, computer-assisted web survey conducted among 1,175 medical and health science students enrolled at the Poznan University of Medical Sciences, Poland.ResultsFrom a set of twenty different MCTs, one-third of students rejected all of them, 18% believed in one, 15% in two, 10% in three, and 24% supported four or more conspiracy theories. In addition, many students were hesitant or unsure about MCTs. We also found that nursing and midwifery students were the most likely to believe in MCTs, while medical and dental students were the least supportive. Support for MCTs was higher among students in the early years of their studies and who declared themselves religious and conservative. This study also highlights the association between students' support for MCTs and their reported health behaviors, including avoiding vaccinations, using alternative medicine, taking vitamin C, or using social media as an essential source of health information.ConclusionsAs medical and health science students are prone to conspiratorial thinking, they should be trained to act as a trusted and reliable source of medical information, to mitigate conspiratorial beliefs, and to act as role models for their patients and society, effectively shaping health behaviors in the population.
| S-EPMC11439324 | biostudies-literature
Project description:Background: During clinical clerkships students experience complex and challenging clinical situations related to problems beyond the domain of the "Medical Expert". Workplace routine may leave little opportunity to reflect on these situations. The University of Zurich introduced a mandatory course directly after the clinical clerkship year (CCY) to work up these situations. Prior to the course each student submitted a vignette on a case he or she had perceived challenging during the CCY and which was not related to the domain of the "Medical Expert" role. In this paper we want to characterize these cases in respect to most prominent themes and related CanMEDS roles. The goal was to inform clinical supervisors about potential teaching demands during the CCY. Methods: All case vignettes submitted by a years' cohort were analysed by three researchers in two ways: for the clinical characteristics and the main theme of the underlying problem and the most prominent CanMEDS roles involved. Themes of the underlying problem were aggregated to overarching topics and subsequently to main categories by pragmatic thematic analysis. Results: 254 case vignettes covered the whole spectrum of clinical disciplines. A wide range of underlying themes could be assigned to five main categories: "communication within team" (23.2%), "communication with patients and relatives" (24.8%), "patient behavior and attitudes" (18.5%), "clinical decision making" (24.0%), and "social and legal issues" (9.4%). Most frequent CanMEDS roles were "Communicator" (26.9%) and "Professional" (23.5%). Conclusions: Cases students perceived as challenging beyond the "Medical Expert" were reported from all clinical disciplines. These were mainly related to communicational and professional issues, mirrored by the CanMEDS roles "Communicator" and "Professional". Therefore, supervisors in clinical clerkships should put an additional teaching focus on communication and professionalism.
| S-EPMC6545608 | biostudies-literature
Project description:For medical students first entering the clinical space in July 2020, the unique challenges related to the coronavirus pandemic threatened to amplify the psychological distress associated with clerkship rotations. This study aimed to characterize the mental health of third-year medical students starting clinical clerkships in the midst of a pandemic by assessing symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) as well as risk, coping, and protective factors associated with psychological outcomes. Of 147 third-year medical students at the Icahn School of Medicine at Mount Sinai in New York City, 110 (75%) participated in this prospective survey-based study with 108 included in the final analysis. 43 (39.8%) respondents screened positive for symptoms of either MDD, GAD, or PTSD. Multiple regression analyses revealed that greater overall symptom severity was associated with more avoidant coping, more traumatic events witnessed, poorer student and leisure functioning, lower trait emotional stability, and lower social support. Worries related to COVID-19 did not significantly influence outcome variables. To better understand the role of the pandemic on psychological outcomes in third-year medical students, additional research should focus on the trajectory of these outcomes over the year during the coronavirus pandemic.
| S-EPMC8495188 | biostudies-literature
Project description:BackgroundThis study aims to qualitatively examine the readiness of medical students to change to virtual clerkship (VC) during the pandemic, from both the faculty and students' perspectives.MethodsA qualitative study was conducted based on the framework of readiness to change. Focus group discussions with students, and semi-structured interviews with clinical faculty members were done using appropriate online platforms. Transcripts were then analyzed using inductive-deductive approach.ResultsTwelve themes emerged which are (1) Perceptions about the university's decision and its communication to students, (2) A Perceived lack of clinical experience, (3) Students' role as members of the medical team facing the pandemic, (4) Student safety, (5) Quality and design of VC and the skills it offered, (6) Belief in own ability to succeed in the VC, (7) Confidence that VC would reach its goals, (8) New enhanced learning approaches, (9) Preparing students for new types of practice in the future (10) Acquired skills, 11) Academic support and communication with faculty and college, and 12) Psychological support. Medical students showed limited readiness to undertake a virtual clerkship and not play their role as healthcare professionals during the pandemic. They perceived a huge gap in gaining clinical skills virtually and asked for a quick return to training sites.ConclusionMedical students were not ready for virtual clerkships. There will be a need to integrate novel learning modalities such as patient simulations and case-based learning in order to meet future demands of the medical profession and enhance the efficiency of virtual clerkships.
| S-EPMC10042106 | biostudies-literature
Project description:BACKGROUND:The clinical reasoning process, which requires biomedical knowledge, knowledge about problem-solving strategies, and knowledge about reasons for diagnostic procedures, is a key element of physicians' daily practice but difficult to assess. The aim of this study was to empirically develop a Clinical Reasoning Indicators-History Taking-Scale (CRI-HT-S) and to assess the clinical reasoning ability of advanced medical students during a simulation involving history taking. METHODS:The Clinical Reasoning Indictors-History Taking-Scale (CRI-HT-S) including a 5-point Likert scale for assessment was designed from clinical reasoning indicators identified in a qualitative study in 2017. To assess indicators of clinical reasoning ability, 65 advanced medical students (semester 10, n =?25 versus final year, n =?40) from three medical schools participated in a 360-degree competence assessment in the role of beginning residents during a simulated first workday in hospital. This assessment included a consultation hour with five simulated patients which was videotaped. Videos of 325 patient consultations were assessed using the CRI-HT-S. A factor analysis was conducted and the students' results were compared according to their advancement in undergraduate medical training. RESULTS:The clinical reasoning indicators of the CRI-HT-S loaded on three factors relevant for clinical reasoning: 1) focusing questions, 2) creating context, and 3) securing information. Students reached significantly different scores (p <?.001) for the three factors (factor 1: 4.07?±?.47, factor 2: 3.72?±?.43, factor 3: 2.79?±?.83). Students in semester 10 reached significantly lower scores for factor 3 than students in their final year (p <?.05). CONCLUSIONS:The newly developed CRI-HT-S worked well for quantitative assessment of clinical reasoning indicators during history taking. Its three-factored structure helped to explore different aspects of clinical reasoning. Whether the CRI-HT-S has the potential to be used as a scale in objective structured clinical examinations (OCSEs) or in workplace-based assessments of clinical reasoning has to be investigated in further studies with larger student cohorts.
| S-EPMC7574202 | biostudies-literature
Project description:BackgroundSelf-regulated learning is a key competence to engage in lifelong learning. Research increasingly acknowledges that medical students in clerkships need others to regulate their learning. The concept of "co-regulated learning" captures this act of regulating one's learning by interacting with others. To effectively cultivate such skills in students, we need to increase our understanding of co-regulated learning. This study aimed to identify the purposes for which students in different phases of clinical training engage others in their networks to regulate their learning.MethodsIn this social network study, we administered a questionnaire to 403 medical students during clinical clerkships (65.5% response rate). The questionnaire probed into the composition of students' co-regulatory networks and the purpose for which they engaged others in specified self-regulated learning activities. We calculated the proportion of students that engaged others in their networks for each regulatory activity. Additionally, we conducted ANOVAs to examine whether first-, second-, and third-year students differed in how they used their networks to support self-regulation.ResultsStudents used others within their co-regulatory networks to support a range of self-regulated learning activities. Whom students engaged, and the purpose of engagement, seemed to shift as students progressed through clinical training. Over time, the proportion of students engaging workplace supervisors to discuss learning goals, learning strategies, self-reflections and self-evaluations increased, whereas the proportion of students engaging peers to discuss learning strategies and how to work on learning goals in the workplace decreased. Of all purposes for which students engaged others measured, discussing self-reflections and self-evaluations were consistently among the ones most frequently mentioned.ConclusionsResults reinforce the notion that medical students' regulation of learning is grounded in social interactions within co-regulatory networks students construct during clerkships. Findings elucidate the extent to which students enact self-regulatory learning within their co-regulatory networks and how their co-regulatory learning behaviors develop over time. Explicating the relevance of interactions within co-regulatory networks might help students and supervisors to purposefully engage in meaningful co-regulatory interactions. Additionally, co-regulatory interactions may assist students in regulating their learning in clinical workplaces as well as in honing their self-regulated learning skills.
| S-EPMC8939067 | biostudies-literature