Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
290,837
result(s) for
"Medical students"
Sort by:
A history of present illness
A young student doctor discovers the long hours and heartbreaking work at the hospital begin to blur the lines between her new life as a physician and the traumas she's tried to flee from her past.
BOOK
Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record
BackgroundClinician bias contributes to healthcare disparities, and the language used to describe a patient may reflect that bias. Although medical records are an integral method of communicating about patients, no studies have evaluated patient records as a means of transmitting bias from one clinician to another.ObjectiveTo assess whether stigmatizing language written in a patient medical record is associated with a subsequent physician-in-training’s attitudes towards the patient and clinical decision-making.DesignRandomized vignette study of two chart notes employing stigmatizing versus neutral language to describe the same hypothetical patient, a 28-year-old man with sickle cell disease.ParticipantsA total of 413 physicians-in-training: medical students and residents in internal and emergency medicine programs at an urban academic medical center (54% response rate).Main MeasuresAttitudes towards the hypothetical patient using the previously validated Positive Attitudes towards Sickle Cell Patients Scale (range 7–35) and pain management decisions (residents only) using two multiple-choice questions (composite range 2–7 representing intensity of pain treatment).Key ResultsExposure to the stigmatizing language note was associated with more negative attitudes towards the patient (20.6 stigmatizing vs. 25.6 neutral, p < 0.001). Furthermore, reading the stigmatizing language note was associated with less aggressive management of the patient’s pain (5.56 stigmatizing vs. 6.22 neutral, p = 0.003).ConclusionsStigmatizing language used in medical records to describe patients can influence subsequent physicians-in-training in terms of their attitudes towards the patient and their medication prescribing behavior. This is an important and overlooked pathway by which bias can be propagated from one clinician to another. Attention to the language used in medical records may help to promote patient-centered care and to reduce healthcare disparities for stigmatized populations.
Journal Article
Large language models improve clinical decision making of medical students through patient simulation and structured feedback: a randomized controlled trial
Background
Clinical decision-making (CDM) refers to physicians’ ability to gather, evaluate, and interpret relevant diagnostic information. An integral component of CDM is the medical history conversation, traditionally practiced on real or simulated patients. In this study, we explored the potential of using Large Language Models (LLM) to simulate patient-doctor interactions and provide structured feedback.
Methods
We developed AI prompts to simulate patients with different symptoms, engaging in realistic medical history conversations. In our double-blind randomized design, the control group participated in simulated medical history conversations with AI patients (control group), while the intervention group, in addition to simulated conversations, also received AI-generated feedback on their performances (feedback group). We examined the influence of feedback based on their CDM performance, which was evaluated by two raters (ICC = 0.924) using the Clinical Reasoning Indicator – History Taking Inventory (CRI-HTI). The data was analyzed using an ANOVA for repeated measures.
Results
Our final sample included 21 medical students (age
mean
= 22.10 years, semester
mean
= 4, 14 females). At baseline, the feedback group (mean = 3.28 ± 0.09 [standard deviation]) and the control group (3.21 ± 0.08) achieved similar CRI-HTI scores, indicating successful randomization. After only four training sessions, the feedback group (3.60 ± 0.13) outperformed the control group (3.02 ± 0.12), F (1,18) = 4.44,
p
= .049 with a strong effect size, partial
η
2
= 0.198. Specifically, the feedback group showed improvements in the subdomains of CDM of creating context (
p
= .046) and securing information (
p
= .018), while their ability to focus questions did not improve significantly (
p
= .265).
Conclusion
The results suggest that AI-simulated medical history conversations can support CDM training, especially when combined with structured feedback. Such training format may serve as a cost-effective supplement to existing training methods, better preparing students for real medical history conversations.
Journal Article
Emotions and reflexivity in health and social care field research
Health and social care students often undertake field research in their own area of practice using observation and interviews. This book is about emotions and reflexivity when doing field research in health and social care settings.
Book
The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis
Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.
Journal Article
The additional role of virtual to traditional dissection in teaching anatomy: a randomised controlled trial
IntroductionAnatomy has traditionally been taught via dissection and didactic lectures. The rising prevalence of informatics plays an increasingly important role in medical education. It is hypothesized that virtual dissection can express added value to the traditional one.MethodsSecond-year medical students were randomised to study anatomical structures by virtual dissection (intervention) or textbooks (controls), according to the CONSORT guidelines. Subsequently, they applied to the corresponding gross dissection, with a final test on their anatomical knowledge. Univariate analysis and multivariable binary logistic regression were performed.ResultsThe rate of completed tests was 76.7%. Better overall test performance was detected for the group that applied to the virtual dissection (OR 3.75 with 95% CI 0.91–15.49; p = 0.06). A comparable performance between groups in basic anatomical knowledge (p 0.45 to 0.92) but not muscles and 2D-3D reporting of anatomical structures was found, for which the virtual dissection was of tendential benefit (p 0.08 to 0.13). Medical students who applied to the virtual dissection were over three times more likely to report a positive outcome at the post-dissection test than those who applied to textbooks of topographical anatomy. This would be of benefit with particular reference to the understanding of 2D–3D spatial relationships between anatomical structures.ConclusionThe combination of virtual to traditional gross dissection resulted in a significant improvement of second-year medical students’ learning outcomes. It could be of help in maximizing the impact of practical dissection, overcoming the contraction of economic resources, and the shortage of available bodies.
Journal Article
Perceived stress in first year medical students - associations with personal resources and emotional distress
Background
Medical students have been found to report high levels of perceived stress, yet there is a lack of theoretical frameworks examining possible reasons. This cross-sectional study examines correlates of perceived stress in medical students on the basis of a conceptual stress model originally developed for and applied to the general population. The aim was to identify via structural equation modeling the associations between perceived stress and emotional distress (anxiety and depression), taking into account the activation of personal resources (optimism, self-efficacy and resilient coping).
Methods
Within this cross-sectional study, 321 first year medical students (age 22 ± 4 years, 39.3% men) completed the Perceived Stress Questionnaire (PSQ-20), the Self-Efficacy Optimism Scale (SWOP) and the Brief Resilient Coping Scale (BRCS) as well as the Patient Health Questionnaire (PHQ-4). The statistical analyses used
t
-tests, ANOVA, Spearman Rho correlation and multiple regression analysis as well as structural equation modeling.
Results
Medical students reported higher levels of perceived stress and higher levels of anxiety and depression than reference samples. No statistically significant differences in stress levels were found within the sample according to gender, migration background or employment status. Students reported more self-efficacy, optimism, and resilient coping and higher emotional distress compared to validation samples and results in other studies. Structural equation analysis revealed a satisfactory fit between empirical data and the proposed stress model indicating that personal resources modulated perceived stress, which in turn had an impact on emotional distress.
Conclusions
Medical students’ perceived stress and emotional distress levels are generally high, with personal resources acting as a buffer, thus supporting the population-based general stress model. Results suggest providing individual interventions for those students, who need support in dealing with the challenges of the medical curriculum as well as addressing structural determinants of student stress such as course load and timing of exams.
Journal Article