Enhancing student perspectives of humanism in medicine: reflections from the Kalaupapa service learning project.

BACKGROUND: Service learning is endorsed by the Liaison Committee on Medical Education (LCME) as an integral part of U.S. medical school curricula for future physicians. Service learning has been shown to help physicians in training rediscover the altruistic reasons for pursuing medicine and has the potential to enhance students' perspectives of humanism in medicine. The Kalaupapa service learning project is a unique collaboration between disadvantaged post-baccalaureate students with an underserved rural community. This study was conducted to determine whether the Kalaupapa service learning curricula enhanced student perspectives of humanism in medicine at an early stage of their medical training. METHOD: Program participants between 2008 and 2014 (n = 41) completed written reflections following the conclusion of the service learning project. Four prompts guided student responses. Reflections were thematically analyzed. Once all essays were read, team members compared their findings to condense or expand themes and assess levels of agreement. RESULTS: Emerging themes of resilience and unity were prominent throughout the student reflections. Students expressed respect and empathy for the patients' struggles and strengths, as well as those of their peers. The experience also reinforced students' commitment to service, particularly to populations in rural and underserved communities. Students also gained a deeper understanding of the patient experience and also of themselves as future physicians. CONCLUSION: To identify and address underserved and rural patients' health care needs, training programs must prepare an altruistic health care workforce that embraces the humanistic element of medicine. The Kalaupapa service learning project is a potential curricular model that can be used to enhance students' awareness and perspectives of humanism in medicine.

Imi Ho'ola program: producing primary care physicians for Hawai'i and the Pacific.

BACKGROUND: The impact on health care delivery due to the impending shortage of primary care physicians is of national concern. To meet the growing health care needs of Hawai'i and the Pacific, the Imi Ho'ala Post-Baccalaureate Program (IHP) provides educational opportunities for students from disadvantaged backgrounds to pursue careers in medicine. Students selected to participate in the IHP have demonstrated a commitment to serve in areas of need of Hawai'i and the Pacific. IHP alumni enter the John A. Burns School of Medicine (JABSOM) as first year medical students. Following graduation, these students enter a variety of residency training programs. PURPOSE: The purpose of this study was to determine whether IHP alumni who successfully graduate from JABSOM choose primary care as their specialty of choice. METHODS: A retrospective review of IHP alumni from 1973 - 2010 was conducted. All IHP alumni who graduated from JABSOM and are currently in practice were included in the study. RESULTS: Of the 213 IHP graduates, 71.6% (n=152) are primary care physicians currently in practice. CONCLUSIONS: The majority of IHP alumni are currently serving as primary care physicians. Selection criteria, educational curriculum, and experiential nature of the program may contribute to Imi Ho'ala's success in producing primary care physicians.

[Effects of acute loading of alcohol on platelet aggregation in normal subjects]. / Effetto del carico acuto di alcool sull'aggregazione piastrinica in soggetti normali.

Ten healthy subjects were submitted to alcohol loading (0.8 g/kg body weight; average alcohol blood level 0.97 g 0/00). The number of platelets, hematocrit and ADP-induced platelet aggregation curves did not show any variation from baseline. Significant changes (p less than 0.05) were observed as regards latent period (increased) and maximum amplitude (reduced) for collagen-induced platelet aggregation. In agreement with others, the authors conclude that alcohol definitely inhibits platelet aggregation.