ON THE FORMATION OF ETHNOMEDICINE OF THE NORTH CAUCASUS PEOPLES

Статья посвящена истории формирования этномедицины народов Северного Кавказа. Ставится задача уточнения динамики исторического процесса относительно формирования этномедицины народов Северного Кавказа. Материалы исследований многих авторов по истории медицины подтверждают высокую эффективность лекарского искусства в оказании хирургической помощи, которую отмечали многие наблюдатели в период Кавказской войны. Несомненно, опыт лекарского искусства на Кавказе имеет весьма древнюю историю. Он накапливался эмпирическим путем и, передаваясь от отца к сыну, формировал династии лекарей, имевшие свой опыт и свои секреты врачевания. Не исключается взаимовлияние культур народов, в частности арабской медицины, которая способствовала формированию врачей традиционной арабской школы медицины. Таким образом, народных целителей можно разделить на два типа: чье лечение содержало доисламские и исламские методы. Отмечается, что именно народные лекари с доисламским опытом сопровождали войска в походах и показали высокую эффективность своих методов, получив заслуженную оценку многих врачей в годы Кавказской войны. The paper is devoted to the history of formation of ethnomedicine of the peoples of the North Caucasus. The task is to clarify the dynamics of the historical process regarding the formation of ethnomedicine of the peoples of the North Caucasus. The research materials of many authors on the history of medicine confirm the high effectiveness of medicinal art in the provision of surgical care, which was noted by many observers during the Caucasian War. Undoubtedly, the experience of medicinal art in the Caucasus has a very ancient history. It accumulated empirically and, passing from father to son, formed dynasties of doctors who had their own experience and their secrets of healing. The mutual influence of the cultures of peoples, in particular Arab medicine, which contributed to the formation of doctors of the traditional Arab school of medicine, is not excluded. Thus, folk healers can be divided into two types: whose treatment contained pre-Islamic and Islamic methods. It is noted that it was people's doctors with pre-Islamic experience who accompanied the troops on campaigns and showed the high effectiveness of their methods, having received a well-deserved assessment of many doctors during the Caucasian war.

Adaptive challenges of curriculum implementation for enhancing medical student resilience at Showa University in Japan

It has been consistently reported that medical students experience a high rate of psychological morbidity, depersonalization, and low personal accomplishment around the world. Under the circumstances, resilience-enhancing programs have been gathering attention and partially implemented even in Japan. However, most of the programs just imitate resiliency programs in North America even though studies have indicated that there are cultural differences between East Asia and North America in the capacity to cope with a stressful situation. The presenters investigated what factors might affect the similarities or differences in the perception of resilience among experienced palliative care physicians in Canada and Japan in 2017-2018. This study showed that Japanese physicians are more likely to rely on “Relationships” with other persons such as family members, friends, mentors or colleagues; in contrast, Canadian physicians tended to be more focused on individual factors such as “Autonomy” and “Confidence”. As a result, the presenters at Showa University School of Medicine in Japan have implemented a progressively advancing resiliency program in a passed manner for the 1st through 6th year medical students as part of a new curriculum. This represents one of the most drastic revisions of curriculum in the school’s history. This presentation will introduce a course for resiliency programs as part of a new curriculum, including course description, course content, educational objectives, instructional strategies and the tips for the classroom teaching and learning.

Climate Surveys of Biomedical PhD Students and Training Faculty Members in the Time of Covid

In July 2020, four months into the disruption of normal life caused by the Covid-19 pandemic, we assessed the institutional climate within the School of Medicine. Voluntary surveys were completed by 135 graduate students in 11 PhD-granting programs and by 83 members of the graduate training faculty. Several themes emerged. PhD students work hard, but the number of hours spent on research-related activities has declined during the pandemic. The students are worried about the pandemic's impact on their research productivity, consequent delays in their graduation, and diminished future job prospects. Many late stage PhD students feel they do not have adequate time or resources to plan for their future careers. Symptoms of anxiety and/or depression are prevalent in 51% of the students, based on answers to standardized questions. Most students report they have strong mentoring relationships with their faculty advisors and like their programs, but they identify to a lesser extent with the medical school as a whole. Faculty think highly of their graduate students and are also worried about the pandemic's impact upon productivity and the welfare of students. Students are interested in access to an Ombuds office, which is currently being organized by the medical school. Moving forward, the school needs to address issues of bias, faculty diversity, support for mentor training, professional development, and the imposter syndrome. We must also work to create a climate in which many more graduate students feel that they are valued members of the academic medicine community.

Challenges and experiences to develop a Japanese language course for international medical students in Japan: Maximising acquisition of Japanese language by applying adult learning theories

Introduction: The International University of Health and Welfare (IUHW) School of Medicine was founded in 2017 with the intention of providing medical content in English a historical first in Japan. Twenty international medical students have been accepted annually, with the majority possessing less than beginner level Japanese language proficiency at the time of enrolment. However, proficiency in Japanese, especially in the context of medicine is required for academic success and program completion. To address this, the IUHW School of Medicine has developed a course in medical Japanese with the objective of facilitating international students’ acquisition of medical Japanese and reinforcing such acquisition through various listening, speaking, reading, and writing activities. This study aims to describe the Japanese language education program for international students at the IUHW School of Medicine, with particular focus on the development of the curriculum and course content. Methods: The course is designed based on the following educational strategies and their applications: (a) Synchronisation of both medical and Japanese contents; (b) Collaborative learning; (c) Japanese output of medical content learned in English; (d) Practical output through making/giving a presentation and discussion with medical experts; (e) Detailed language feedback from language experts; (f) Reinforcing the vocabulary knowledge by writing; and (g) Building up vocabulary and expressions with relevant contents. Results: Our observations suggest that our international students have been able to continue their medical education in Japanese smoothly. Conclusion: The content-based instructional design that includes second language acquisition strategies may also be applicable to other Asian languages such as Korean and Chinese.

“More than just a medical student”: a mixed methods exploration of a structured volunteering programme for undergraduate medical students

Background As a result of the COVID-19 pandemic Imperial College School of Medicine developed a structured volunteering programme involving 398 medical students, across eight teaching hospitals. This case study aims to explore the relationship between the processes, context, participant experiences and impacts of the programme so that lessons can be learned for future emergencies and service-learning programmes. Methods Using an illuminative approach to evaluation we invited all volunteers and supervisors to complete a mixed-methods survey. This explored differences in experience across demographics and contextual factors, correlations between aspects of induction, supervision and overall experience, and reviewed the impacts of the programme. Quantitative responses were statistically analysed and qualitative reflections were thematically coded to triangulate and explain quantitative findings. Follow up interviews were carried out to check back findings and co-create conclusions. Results We received responses from 61 students and 17 supervisors. Student participants described predominantly altruistic motivations and transformational changes to their professional identity driven by feeling included, having responsibility, and engaging in authentic workplace-based learning afforded by freedom from the assessed curriculum. They reported new perspectives on their future professional role within the multidisciplinary team and the value of workplace-based learning. They reported increases in wellbeing and self-esteem related to feeling included and valued, and positively contributing to service provision at a time of need. Significantly higher overall satisfaction was associated with a personalised induction, active supervision, earlier stage of training, and male gender. Gender-related differences were not explained through our data but have been reported elsewhere and warrant further study. The duration, intensity and type of role that volunteers performed was similar across demographics and did not appear to modulate their overall experience. Conclusions Whilst acknowledging the uniqueness of emergency volunteering and the survey response rate of 15% of volunteers, we suggest the features of a successful service-learning programme include: a learner-centred induction, regular contact with engaged and appreciative supervisors, and roles where students feel valued. Programmes in similar settings may find that service learning is most impactful earlier in medical students’ training and that students with altruistic motivations and meaningful work may flourish without formal outcomes and assessments.

Undergraduate Medical Training in Communication Skills

Communication skills are important for physicians, as they are continuously in contact with human beings—patients, families, or members of healthcare teams—in various circumstances. At Universidad de los Andes' School of Medicine, these skills are a fundamental part of the curriculum and the subject of two undergraduate concentration courses. The purpose of this chapter is to present the experience of transitioning one of these courses, Communication Skills II, from face-to-face to a virtual learning environment as a response to the COVID-19 pandemic. It describes the rationale behind teaching communication skills, illustrates how the course was developed and taught face-to-face, presents the challenges posed the COVID-19 pandemic, explains the transition of the course to a virtual learning environment, and concludes by offering an overview of the evaluations and perceptions of the course, as taught in the virtual environment, by those involved in it.

Physiological Stimulation of the Synthesis of Preelastic Fibers in the Dermis of a Patient with Fibrosis

Objective. The aim of the present study was to report the physiological stimulation of the synthesis of preelastic fibers in the dermis of a patient with fibrosis. Design. A clinical study was conducted involving the analysis of histological changes in preelastic fibers following treatment for stage II primary lymphedema for the clinical reversal of lymphedema and fibrosis. Setting. University Hospital of the São Jose do Rio Preto of School of Medicine in 2020. Participant was a 67-year-old male patient with late-onset primary lymphedema diagnosed 12 years earlier. Intervention is the lymphatic stimulation using the Godoy method adapted to the treatment of fibrosis. Main outcomes and measures are biopsies before and after treatment. Ten randomly selected histological fields were evaluated using the multipoint morphometric method. The values with this method are relative and expressed as percentages. Statistical analysis was performed with the t-test, considering a 95% significance level. Results. A visible, significant difference in the percentage of preelastic fibers was found between the preintervention and postintervention slides, which were confirmed by the microscopic evaluation and quantification (4.95 ± 0.64% and 14.70 ± 1.06%, respectively). Conclusion. The physiological stimulation of the lymphatic system using a specific method resulted in the clinical reduction of fibrosis, the return of the elasticity of the skin, and the stimulation of the synthesis of preelastic fibers.

Spirituality/Religiosity as a Therapeutic Resource in Clinical Practice: Conception of Undergraduate Medical Students of the Paulista School of Medicine (Escola Paulista de Medicina) - Federal University of São Paulo (Universidade Federal de São Paulo)

Introduction: The high degree of religious/spiritual involvement that brings meaning and purpose to a patients’ life, especially when they are weakened by pain, is among the various reasons to consider the spiritual dimension in clinical practice. This involvement may influence medical decisions and, therefore, should be identified in the medical history of a patient (anamnesis).Objective: To verify the opinion of undergraduate medical students of the Paulista School of Medicine – Federal University of São Paulo regarding the use of a patient’s Spirituality/Religiosity as a therapeutic resource in clinical practice.Method: Quantitative approach of the transversal analytical observational type. The sample was composed of academics’ medical program, from the first to the sixth year, regularly enrolled in 2017. Data collection was performed with a standardized questionnaire divided into three sections: sociodemographic profile; Duke University Religious Index; Spirituality/Religiosity in the clinical and academic context.Results: Participated in the survey 72% of the enrolled students, of which 61.4% had religious affiliation, 26.2% declared themselves agnostic and 12.4% atheists. All of them proposed to answer questions about the insertion of Spirituality/Religiosity in the patient care process. Through the Duke Religiosity Index, we evaluated the importance of religiosity in the student’s personal life and the pertinence of religiosity as a therapeutic insertion for medical treatment. Regarding the clinical and academic context, most participants considered relevant the proposition of didactic-pedagogical actions in medical education related to the spiritual dimension of the patient.Conclusion: We conclude, through our research, that the insertion of the Spirituality/Religiosity of the patient as a therapeutic resource in clinical practice is feasible for most undergraduate students in Medicine of the Escola Paulista de Medicina – Universidade Federal de São Paulo (Paulista School of Medicine - Federal University of São Paulo). The result of the research, although it shows only the opinion of medical students at a Brazilian university, indicates that Spirituality/Religiosity is already part of the contemporary medical universe.