BackgroundExperiencing the death of a patient can be one of the most challenging aspects of clinical medicine for medical students. Exploring what students' learn from this difficult experience may contribute to our understanding of how medical students become doctors, and provide insights into the role a medical school may play in this development. This research examined medical students' responses of being involved personally in the death of a patient.MethodTen undergraduate medical students were followed through their three years of clinical medical education. A total of 53 individual semi-structured interviews were conducted. Grounded theory analysis was used to analyze the data.ResultsStudents illustrated a variety of experiences from the death of a patient. Three main themes from the analysis were derived: (i) Students’ reactions to death and their means of coping. Experiencing the death of a patient led to students feeling emotionally diminished, a decrease in empathy to cope with the emotional pain and seeking encouragement through the comfort of colleagues; (ii) Changing perceptions about the role of the doctor, the practice of medicine, and personal identity. This involved a change in students’ perceptions from an heroic curing view of the doctor’s role to a role of caring, shaped their view of death as a part of life rather than something traumatic, and resulted in them perceiving a change in identity including dampening their emotions; (iii) Professional environment, roles and responsibilities. Students began to experience the professional environment of the hospital by witnessing the ordinariness of death, understanding their role in formalizing the death of a patient, and beginning to feel responsible for patients.ConclusionsAlong with an integrative approach to facilitate students learning about death, we propose staff development targeting a working knowledge of the hidden curriculum. Knowledge of the hidden curriculum, along with the role staff play in exercising this influence, is vital in order to facilitate translating the distressing experiences students face into worthwhile learning experiences. Finally, we argue that student learning about death needs to include learning about the social organization and working life of clinical settings, an area currently omitted from many medical education curricula.
Purpose To describe the research capacity and culture, and research activity (publications and new projects) of medical doctors across a health service and determine if the research activity of specialty groups correlated with their self-reported “team” level research capacity and culture. Methods Cross-sectional, observational survey and audit of medical doctors at a tertiary health service in Queensland. The Research Capacity and Culture (RCC) validated survey was used to measure self-reported research capacity/culture at organisation, team and individual levels, and presence of barriers and facilitators to research. An audit of publications and ethically approved research projects was used to determine research activity. Results Approximately, 10% of medical doctors completed the survey (n= 124). Overall, median scores on the RCC were 5 out of 10 for organisational level, 5.5 for specialty level, and 6 for individual level capacity and culture; however, specialty-level scores varied significantly between specialty groups (range 3.1–7.8). Over 80% of participants reported lack of time and other work roles taking priority as barriers to research. One project was commenced per year for every 12.5 doctors employed in the health service, and one article was published for every 7.5. There was a positive association between a team’s number of publications and projects and their self-reported research capacity and culture on the RCC. This association was stronger for publications. Conclusion Health service research capacity building interventions may need a tailored approach for different specialty teams to accommodate for varying baselines of capacity and activity. When evaluating these initiatives, a combination of research activity and subjective self-report measures may be complementary.
The search for the soul has been documented since the fifth Century BCE when philosophers and physicians began to explore the role of human consciousness and emotion. Traditionally in western civilization, there have been two distinct followings with some believing that the brain was the seat of the soul and others believing that this role belonged to the heart. The aim of this study was to assess the attitudes of medical students towards the heart and brain during their anatomy laboratory dissections to evaluate if any extra meaning is given to these organs and where they perceived the origin of the soul. Medical students (n = 16) at the University of Otago were interviewed in regards to their thoughts about body dissection and particularly their views towards the brain and the heart. Semi-structured interviews were conducted following the dissection of these two organs, and then transcribed and analyzed. There were mixed opinions among students with some experiencing difficulty dissecting the brain because this organ had special meaning to them; they perceived it as the organ that "made a person who they were." Others commented on their emotional reactions when removing the heart, which they viewed as the "seat of emotion." Some students experienced emotional and physical reactions to these two dissections and Anatomy faculty need to be aware that students may struggle because they viewed these organs as special. A dialogue emerged amongst some medical students on the seat of the soul which gave extra meaning to the dissection.
The aim of this research was to explore whether medical students believe in a soul and how this may affect their dissecting experience. Three questionnaires were delivered electronically to the 2011 cohort of secondyear medical students over a 2-year period. At the University of Otago, students enter medicine via three categories: Health Sciences First Year (following 1 year of university); postgraduate (following a Bachelors or higher degree); and 'other' category entry (Allied Health Professional or 3 years after a Bachelors degree). The entry category, age, ethnicity and gender of the students were collected; 51.6% of the students believed in the concept of a soul. On a scale of 1-5, students ranked the importance of religion/spirituality as 2.69. Those who believed in a soul were more likely to have a religious/spiritual component to their life and be males or 'other' category entrants. However, there were many students who believed in the soul who did not have a religious/ spiritual association, suggesting that this belief extends beyond religion. Those who believed in a soul had significantly higher anticipatory stress and experienced higher levels of stress during dissection. A higher proportion of students in the 'other' category entrants believed in the concept of the soul and also had significantly higher levels of stress during dissection. Our data suggest that a belief in a soul may affect students' experiences in dissecting. Incorporating the teaching of humanities with anatomy may help medical students as they assimilate both the biomedical and philosophical aspects of dissection.
This project examined the effects of two team selection methods (self-selected and instructor-formed based on matched academic performance) on team and individual student performance and on self-reported attitudes and team behaviors in a freshman-level core-required introductory engineering course. The inclusion of both mid and end-of-semester self-reports provided some insights on the development of team dynamics, and because self-report data were not anonymous, correlations could be performed between the self-report and performance data. Matched-performance groups had significantly higher grades on several performance measures, with a larger effect on the team grades than on the individual grades; however, overall the effect sizes were small. There were no group differences for most self-reported items, although a key finding was that self-selected teams were significantly more likely to already have friends on their team, and a significant correlation showed that already having friends on a team was negatively correlated with many of the performance measures. In contrast, members of both types of teams reported equally high likelihood to make new friends, which was positively correlated with performance. For both groups there were small but significant decreases from mid to end of semester in satisfaction with team formation method, general enjoyment, and task-orientation over time. All of these time-related factors also showed significant correlations with the performance measures. Therefore, these factors seem like natural points for instructor attention when using teams. Understanding the impact of different approaches to team formation may guide instructors and lead to more well-functioning teams, higher student learning, and greater student satisfaction.
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