One Hundred Years of the Pathology Medical Student Fellowship

Context.— The Pathology Medical Student Fellowship (PSF) is a unique, year-long immersive educational experience. Review of institutional archives describes a medical student “Fellowship in Pathology” founded in 1919. Objective.— To characterize the impacts of this 100-year-old program. Design.— We determined subsequent medical specialty of each PSF graduate in our department and surveyed those with available contact information. Results.— Of 145 pathology student fellows graduating between 1924 and 2020, a total of 50 (34.4%) matched into pathology; medical, surgical, and radiology subspecialties were also well-represented career choices. Between 2001 and 2020, of 36 students who matched into pathology from our institution, 19 (52.8%) had completed the fellowship. Survey respondents (n = 42) indicated that before the PSF, 11 of 42 students (26.2 %) were undecided in specialty, with only 6 (14.3%) identifying pathology as their primary field of interest. Of survey respondents who had completed training, 26 (61.9%) practice in academic settings. Nonpathology physicians reported frequent utilization of skills gained during the PSF year, with 5 of 23 (21.7%) responding “daily,” and 9 (39.1%) responding “weekly.” The most useful skills included knowledge of pathophysiology of disease and anatomy, improved communication with multidisciplinary teams, and/or interpretation of pathology results (each selected by 17 to 20 students, 73.9%–87.0%). Free-text responses on impacts of the PSF described enhanced knowledge of disease pathobiology and diagnostic complexity and increased confidence and autonomy. Conclusions.— We describe the program structure, educational benefits, graduate specialty choices, and career impacts of 100 years of the PSF at our institution. Although undecided before pathology exposure, many PSF graduates subsequently enter pathology careers. Regardless of specialty choice, PSF graduates have a high rate of subsequently pursuing academic medical careers.

Energizing scholarly activity in a regional medical campus

Implication Statement Medical education is increasingly delivered at distributed sites away from Academic Health Sciences Centres. The Council of Ontario Faculties of Medicine recommends schools develop resources and metrics to foster regional campus scholarly activity. Opportunities for distributed program trainees must support learning core skills in research and critical appraisal to comply with medical school accreditation standards and to develop their interests and skills in scholarly work for their future medical careers. We describe a scholarly activity program that is a template for distributed campuses or regional teaching sites seeking to increase learner and faculty engagement and research productivity.

Investigation of Human Errors in Emergency Department of Imam Khomeini Hospital Emergency Department of Jiroft Using Systematic Human Error Reduction and Prediction Approach

Introduction: In examining the unfortunate events that have taken place in the industrial and health sectors, human error is considered as the main cause of these events. Given the sensitivity and importance of medical careers, the occurrence of errors can lead to irreparable consequences. The purpose of this study was to investigate the human error in the emergency department of Imam Khomeini Hospital in Jiroft. Methods: This study was a cross-sectional and descriptive one. Emergency nurses' job duties have been analyzed by interviewing emergency nurses and studying nursing job guidelines and procedures using hierarchical task analysis. Finally, using the Systematic Human Error Reduction and Prediction Approach, human errors in nursing care were analyzed. Results: Generally, 4 tasks, 18 sub-tasks and 91 types of errors related to nursing activities were identified. Number of errors found, 27 (30%) Action errors, 18 (20%) Checking errors, 19 (21%) Retrieval errors, 12 (13%) communication errors, and 15 (16%) selection errors Were. As can be seen, the largest number of errors was related to the type of Action errors. Conclusion: Considering the results of the present study, the highest numbers of errors were related to Action and Checking errors respectively, which due to the sensitivity of nursing jobs and especially in the emergency department, require the use of highly skilled people to perform tasks that require high concentration and accuracy.

Impact of an All-Female Surgical Team on Moroccan Patient Perspectives of Female Healthcare Providers

Introduction Increasing numbers of women in medicine could address Morocco’s 5.5-fold deficit in surgical providers. Cultural perceptions towards women limit female advancement in healthcare. This study evaluates the impact of an all-female surgical team on Moroccan attitudes. Objective This study aimed to evaluate how attitudes towards female healthcare professionals changed for Moroccan patients after exposure to a unique, all-female medical environment. Methods Cleft patients were surveyed after a surgery mission with all-female volunteers in Oujda, Morocco. Analysis included quantitative, qualitative, and mixed-methods approaches. Results Of 121 respondents (94%), 85% and 77% had prior exposure to a female nurse or doctor, respectively. 94% of respondents strongly agreed to receiving high-quality care. 75% developed increased confidence in female providers. 68% and 69% of respondents, regardless of gender (p = 0.950), felt that having a female nurse or doctor did not impact care. Female patients were more likely than male patients to strongly encourage female relatives to pursue medical careers (p = 0.027). Respondents without prior exposure to female nurses were more likely to: pursue medical careers (p = 0.034), believe female relatives could pursue medical careers (p = 0.006), and encourage them to do so (p = 0.011). Conclusions Increased visibility of women improved patient attitudes towards female providers, especially in patients without prior exposure. Initiatives that increase female representation in healthcare may have greater effects in cultures with more gender inequity.

Training and Assessment of Communicative Skills of Medical Students: Foreign Experience and Objectives of Medical Education in the Russian Federation

Analyzed is the problem of communication skills that are essential for an optimal doctor-patient relationship to improve treatment outcomes and health outcomes. The need for teaching the communication skills of medical students is recognized by all foreign medical schools and declared as a requirement for the results of training in the Federal State Educational Standard 3++ in the direction of preparation of General Medicine in the form of a universal “Communicative Competence” (UK-4). Teaching and assessing communication skills requires different approaches to teaching in other clinical disciplines. The challenge is to transform formal training in these skills, which still remains fragmented and heterogeneous in most curricula of Russian universities, into a systematic and purposefully organized, organically integrate communication skills training with clinical training. In addition, it is important that students not only know the nuances of communication and interpersonal skills with the patient, but also adhere to them throughout their medical careers. The article describes the communication models adopted by the international medical educational community, training scenarios, various methods of teaching and assessment of communication skills based on the best foreign practices. The article discusses the barriers to teaching communication skills in Russian medical universities and ways to overcome them. Possible ways of standardization of teaching and assessment of communication skills and their integration into the existing curricula of medical universities in Russia are shown.

Navigating the Labyrinth of Integrated Clinical Training in Neurology: a guide for the uninitiated

The National Institute for Health Research (NIHR) Integrated Academic Training (IAT) programme was introduced following recommendations within a 2005 report made by the Academic Careers Sub-Committee of Modernising Medical Careers and the UK Clinical Research Collaboration.1 This report highlighted the need for a more transparent academic career trajectory for trainees, with clear entry and exit points, and need for flexibility to be built into medical training to allow for research time. Now, more than fifteen years later, the NIHR IAT programme is well established, and arguably the best-recognised route for combining clinical and academic training in a given specialty. The protected research time provided by these posts is invaluable for pursuing scientific projects, acquiring any relevant technical or statistical skills, and for planning next steps, including applications for research funding. In this article, our aim is to demystify the application and interview process for NIHR Academic Clinical Fellowships (ACFs) and Clinical Lectureships (CLs); we will also discuss how these positions fit within the clinical academic pathway. This article is an amalgamation of theoretical facts and our practical experience, written in the context of neurology training, but might also be of relevance and interest for other medical specialties. Whilst we have chosen to focus on NIHR posts in this article, as these are most commonly encountered and advertised, some academic centres also offer locally funded ACF and CL posts; details can often be found on the relevant university website.

“I’d Like to Let People Know What We Did:” Values of Fukushima Medical Students Following the Great East Japan Earthquake

Background: The Great East Japan Earthquake and the resulting tsunami and nuclear disaster on March 11, 2011 have had a profound and lasting effect on residents of Japan’s Fukushima Prefecture, particularly among evacuees. While there continues to be extensive news coverage and academic study of Fukushima Prefecture’s recovery, there has been little exploration of individual narratives. This study aims to illuminate some individual stories of medical students at Fukushima Medical University (FMU) who lived in the Prefecture at the time of the Earthquake.Methods: 10 open-ended ethnographic interviews were conducted with medical students at FMU in years 1-5 who lived in Fukushima Prefecture at the time of the Great East Japan Earthquake. All interviews were recorded and transcribed; the transcriptions served as the basis for thematic analysis under the lens of ethnographic anthropology.Results: Three major topics emerged from these interviews: first, that the events following the Earthquake influenced not only these students’ decisions to become doctors, but the ways in which they hope to practice medicine in the future. Second, that these students were motivated to share their experiences by a want to change Fukushima Prefecture’s public image. And lastly, that the students viewed the opportunity to discuss their experiences through these interviews as healing, both for themselves and for the future.Conclusions: While multiple factors undoubtably contributed these students’ medical education, they cite the Earthquake as essential to their approach to their medical careers. Additionally, opportunities for the participants to discuss their experiences following the Earthquake appear to be rare but valued, as the students view their stories as their “legacies.” The enduring, burdening effects of the Earthquake appear to have galvanized the participating students to act on behalf of their communities and their Prefecture.

Recruiting medical students from underrepresented backgrounds to a project to identify support challenges amongst their peers whilst encouraging early career engagement in psychiatry

AimsTo engage lived experience individuals to run a project identifying the mental health challenges unique to medical students who self identify as belonging to marginalised groups;To use the project findings to inform mental health support and education during medical training and beyond;To encourage the individuals to engaged mental health policy and education whilst also using the process to inform their future medical careers, including in the field of psychiatry.MethodLived experience individuals were recruited to the project following open applications from medical students. The role was to design a project to create an evidence base for tailored support methods needed to reduce marginalised medical students’ increased risk of poor mental health. This formed the basis of guidance on how medical schools and healthcare systems can improve wellbeing support for their students and staff. With support from a trained staff and student member, the recruited officers were encouraged to follow their preferred method for fulfilling the project aims, using their own and peers’ experiences to inform what was most useful.ResultRepresentatives were selected from BAME, LGBT+, international, disabled and widening participation backgrounds. The students decided to conduct a survey open to all medical student colleagues across the United Kingdom. The survey questions were split into four sections based on the challenges faced by their own lived experience: General Information; University and Community Experiences; Medical School Experiences and Teaching and Clinical Experiences. There were 58 questions in total including 26 multiple choice; 24 open answers; and 8 Likert scale.Following data collection, the information taken from the survey and focus groups, supported by background reading, was thematically analysed to identify the key challenges. This will then be used to create a report to share with the medical school containing areas for improvement in mental health support, education and engagement. The officers themselves would also reflect on their experiences throughout the process, including their ability to engage in mental health policy, education and further career options such as psychiatry.ConclusionFrom creating an appropriate and supportive structure, it can be possible to encourage students with lived experience to share their challenges whilst becoming engaged in mental health policy and support. Furthermore, from creating a culture of reflection in the area of mental health, they are helping raise awareness of the subject early on in medical careers and promote engagement into specialties such as psychiatry.

36 A Randomised Trial to Compare How Undergraduates Diagnose Common Ear Pathology Using A Smartphone Otoscope and Standard Otoscope in A Simulated Setting

Introduction Competent otoscopy is a key otolaryngology skill for a broad range of medical careers, yet undergraduate’s confidence to perform otoscopy is reported as low. This study aimed to evaluate whether a smartphone-otoscope could enhance medical undergraduates recognition of common ear pathology. Method 52 medical students were randomised into a standard group (traditional otoscope) and an intervention group (smartphone-otoscope). Following a short didactic presentation, participants were asked to diagnose four simulated pathologies. Force response items and 5-point Likert scales loaded on an electronic platform recorded their diagnosis and their perceptions towards the otoscope. Results The smartphone-group (n = 20) had higher overall rates of correct diagnosis compared to control (n = 22) (84% vs 39%, p = <0.001). Only the grommet station did not show a significant improvement between the two groups (100% vs 91%, p = 0.49). 90% (n = 20) of participants felt the smartphone-otoscope was preferential for their learning. The same number expressed they want to use it in future learning. The remainder were indifferent. Conclusions The smart-phone otoscope enabled learners to better observe and recognise middle ear pathology. This popular learning tool has the potential to accelerate the learning curve of otoscopy and therefore improve the proficiency of future doctors at recognising middle ear diseases.