When the wheels fall off - Medical students' experiences of interrupted academic progression.

INTRODUCTION: There is limited published research on medical students' perspectives of a significant interruption to their academic progression. This study sought to identify the factors that contribute to difficulties with academic progression and to understand how medical students successfully respond. METHODS: This interpretive phenomenological study reports on the findings from in-depth interviews of 38 final year medical students who had experienced a significant academic interruption. RESULTS: The two superordinate themes were: the factors contributing to the interruption and their experience of the interruption. Factors identified as contributing to the interruption were: workload, learning in medicine, motivation for medicine, isolation, adapting to local culture, health and external factors. Their experience of the interruption focused on stages of working through the process: 'what happened,' 'how it felt,' 'managing the failure,' 'accepting the failure' and 'making some changes.' DISCUSSION: Each factor affected how the participants reacted and responded to the interruption. Regardless of the origins of the interruption, most reacted and responded in a comparable process, albeit with varying timespans. These reactions and responses were in a state of fluctuation. In order to succeed many stated they shifted their motivation from external to internal, in direct response to the interruption, resulting in changed learning behaviours. CONCLUSIONS: The process of working through an interruption to academic progression for students may benefit from a model of interval debriefing, restorative academic and personal development support. Facilitation of this process could enable students to face an interruption constructively rather than as an insurmountable emotionally burdensome barrier. Medical schools could utilise these findings to implement further support strategies to reduce the number of significant academic disruptions.

Twelve tips for medical students experiencing an interruption in their academic progress.

For every commencing cohort of medical students, a small but significant number will experience an interruption to their academic progression because of academic difficulties, health concerns or external influences outside of the students' control. During the process of researching the factors surrounding difficulties with academic progression, students told us many ways that they have learned from that experience, which then allowed most of them to graduate. This paper combines the shared experiences of students who have had an interruption, and those of the authors as medical educators.

Preventing Online Victimization: College Students' Views on Intervention and Prevention.

Facebook, Twitter, and other social networking sites have changed the way we interact online. Technological advances have also facilitated the emergence of cyberstalking and online harassment, a growing issue on college campuses. This study utilizes focus group data to examine college students' experiences with online harassment and cyberstalking. Students voiced concerns with online tracking, falsifying identities, and harassment. They also noted that incoming first-year students and those negotiating some of their first romantic relationships are especially vulnerable. In addition, students were asked to propose appropriate prevention, education, and intervention strategies at the college level. Surprisingly, many students recommended offline programs to battle this online problem.

There are no "innocent victims": the influence of just world beliefs and prior victimization on rape myth acceptance.

Utilizing data from an online survey of 979 university students, this study explores the relationship between prior sexual assault victimization experiences, belief in a just world, and acceptance of rape myths. Results indicated that men, younger respondents, and those with less education were more likely to support rape myths. Support for just world beliefs and rape myths were also positively associated, while rape victims exhibited less support for rape myths than non-victims. Implications for future studies are discussed.

Patient perceptions of medical students' involvement in their obstetrics and gynaecology health care.

OBJECTIVE: To determine perceptions held by patients of the involvement of medical students in their obstetrics and gynaecology health care. STUDY DESIGN: This study evaluated patients' perceptions of medical students involved in their care at a tertiary women's hospital. A questionnaire was used to collect patients' perceptions of the student's professional skills, their attitude to and level of comfort in the patient and student interaction. RESULTS: Ninety-five percent of patients approached participated in this study. Results demonstrated a high level of patient satisfaction with student involvement in care. Most patients believed students should be part of the hospital team and were prepared to have a student involved in the future. Satisfaction levels were higher for patients for whom English was their first language, women under 40 years of age and those receiving care in assessment and in-patient settings. Patient comfort in student participation was greater for those seen by a female student and those who had previously had a student involved in their care or previously attended the hospital. CONCLUSION: Patient perceptions of students' involvement in their obstetrics and gynaecology care are mainly positive. Satisfaction levels differ with the gender of the student, the age of the patient, the location of care and for those for whom English is their first language. Attention must be paid to informing patients of the presence and possible level of interaction of students in their care.

Perceptions by medical students of their educational environment for obstetrics and gynaecology in metropolitan and rural teaching sites.

BACKGROUND: Medical student education in Western Australia is expanding to secondary level metropolitan hospitals and rural sites to accommodate workforce demands and increasing medical student numbers. AIMS: To determine if students' perceptions of the teaching environment for obstetrics and gynaecology differ between tertiary, secondary level metropolitan hospitals and rural sites, and to determine if students' perceptions of their learning environment are associated with improved academic performance. METHOD: An evaluation was conducted of medical students' perceptions of their learning environment during an obstetrics and gynaecology program at a variety of sites across metropolitan and rural Western Australia. The evaluation was based on the Dundee Ready Education Environmental Measure (DREEM) questionnaire. RESULTS: There were no significant differences in students' perceptions of their learning environment between the tertiary hospital, combined programs involving a tertiary and secondary metropolitan hospital, rural sites with a population of more than 25,000 and rural sites with a population less than 25,000 people. Perceptions were similar in male and female students. The overall mean score for all perceptions of the learning environment in obstetrics and gynaecology were in the range considered to be favorable. Higher scores of perceptions of the learning environment were associated positively with the measures of academic achievement in the clinical, but not written, examination. CONCLUSION: Medical students' perceptions of their learning environment in obstetrics and gynaecology were not influenced by the geographical site of delivery or their gender but were positively related to higher academic achievement. Providing appropriate academic and clinical support systems have been put in place the education of medical students can be extended outside major hospitals and into outer metropolitan and rural communities without any apparent reduction in perceptions of the quality of their learning environment.

Experiential learning in women's health: medical student reflections.

CONTEXT: Reflection on clinical experience is used by medical students to enhance the development of clinical practice skills and professional behaviours in the area of obstetrics and gynaecology. It is applied through small-group reflective tutorials, writing reflective summaries and one-to-one discussion of reflections with staff. OBJECTIVE: To identify the levels of critical reflection achieved and explore the emergent themes in students' written reflections. METHODS: Thematic analysis was undertaken to document the recurring emergent themes on which students chose to reflect and the depth of reflection students achieved. RESULTS: Most students reflected on clinical, communication and reasoning skills, lack of medical knowledge, and the development of their own and others' professional practice. The 4 levels of reflection students demonstrated were: listing, where students only state the clinical experience; describing, where students describe the clinical experience, including what they did well and what they did not; applying, where students discuss what they need to change and how to develop, and integrating, where students apply reflection to future clinical practice. Few respondents demonstrated the ability to reflect to the level of integration except with facilitated discussion. DISCUSSION: The range of experiences on which students reflected was appropriate. The information obtained from the emergent themes has been useful for programme development. At the end of the process students were still not reflecting at the level of integration. This affirms that reflectivity is a skill that develops throughout life. Evaluating the level of reflection achieved and discussing this explicitly with the student may be instrumental in helping the student develop his or her reflective capacity further.

Sexual assault victim advocates in Virginia: challenges faced in the field.

In 2004, Virginia State Senate Joint Resolution 131 led to a study of services for sexual assault victims in Virginia. (Barbosa, Carmody, Gainey, Payne,Plichta, Sajko, Vandecar-Burdin, 2005) Utilizing a variety of research methodologies, the study examined the response by law enforcement, criminal justice, medical and social service agencies. It also included interviews with sexual assault victim advocates and focus group interviews with various professionals. This article summarizes major findings from the focus groups as well as the in-depth interviews with twenty- three sexual assault victim advocates in Virginia. It highlights the challenges they face and recommendations for change.

Outcomes of teaching medical students core skills for women's health: the pelvic examination educational program.

OBJECTIVE: The purpose of this study was to evaluate the outcomes of introducing an educational program that teaches medical students how to approach taking relevant and sensitive gynecologic histories and to perform pelvic examinations with the use of role-play with well women from the general community. STUDY DESIGN: Medical students and the women recorded their perceptions of the program over a 2-year period. The outcomes of the program were evaluated by a comparison of medical student perceptions of confidence, competence, and anxiety; the mean number of pelvic examinations that were performed during their course both before and after the introduction of the program and results of students' continuous and summative assessment are given. RESULTS: In the year before the introduction of the program, students performed a mean of 2.6 pelvic examinations (95% CI, 2.1, 3.0) compared with 4.1 pelvic examination (95% CI, 3.8, 4.4) in the first year of implementation and 4.0 (95% CI, 3.7, 4.3) in the second year of implementation (P <.05). Students reported improved competence and reduced anxiety to perform a pelvic examination without supervision (P <.05). All students passed their continuous assessment. Between 92% and 100% of students and women agreed that the program had clear learning objectives, was well organized, and was a useful and appropriate method of teaching that helped prepare them for the clinical setting. CONCLUSION: This pelvic examination educational program has been evaluated positively by students and participant women and has resulted in a significant improvement in the amount of pelvic examination experience that medical undergraduates obtain.