Undergraduate occupational medicine education in European Medical Schools: better training to meet today's challenges.

BACKGROUND: Occupational medicine (OM) faces considerable challenges today, one of them related to the university training of future physicians considered suboptimal at a global level as it has been pointed out in many studies. The aim of this study is to update the state of OM medical education in European universities. METHODS: Between March and August 2022, an e-mail survey regarding OM training to undergraduate medical students was conducted among OM professors at European universities in 28 countries (n = 347). RESULTS: Of the 347 universities, 53 medical schools from 19 countries responded (response rate = 15.3%). In 89% of cases, OM was taught. The average number of hours per academic year was 24.3, with significant variation within the same country. Lectures were the most popular teaching technique (98%), with a considerable use of modern approaches such as problem-based learning (61%), and e-learning (57%). While occupational diseases and principles of prevention were covered, other subjects such as the environmental impact or collaboration with an OM physician were poorly represented in the educational program. CONCLUSION: According to data, several European medical schools may provide insufficient OM education and training to their students. The education of undergraduate occupational medicine students in European medical schools should be designed to equip them with the knowledge and skills required to meet today's challenges. It is critical that undergraduate OM education in European medical schools be enhanced, harmonized, and standardized.

A Heart Rate Step Function Response Method for the Evaluation of Pulse Wave Velocity as a Predictor of Major Adverse Cardio-Vascular Events.

Background and Objectives: Cardiovascular diseases are the main cause of death worldwide, and pulse wave velocity (PWV) is considered a predictor of major adverse cardiovascular events. The study intended to be helpful in finding methods for the preliminary assessment of PWV in primary care units. Materials and Methods: The study group consisted of 36 subjects (considered healthy by their own statement) from the medical field (medicine students and residents) aged between 20 and 30 years: 33.3% males and 66.7% females. Two types of measurements were carried out successively: (a) measurements with the arteriograph and (b) measurements on a treadmill effort testing system, where heart rate (HR) was measured over time as a response to step function physical effort (PE). Results: The study allowed for the highlighting of some limits which, if exceeded, can be associated with high PWV values: (i) if after a moderate PE and a resting time of at least 6 min, the HR is larger than 80 b/min; (ii) if the relaxation time in a PE test of moderate intensity is larger than 1 min; (iii) if the HR measured after the subject is raised from the supine to orthostatic position is larger than 100 b/min, and (iv) if the resting HR is larger than 80 b/min. Conclusions: Steady-state HR correlates with PWV and may be used for the preliminary assessment of PWV.

Acute Effects of Sedentary Behavior on Ankle Torque Assessed with a Custom-Made Electronic Dynamometer.

Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-to-moderate level of activity on ankle torque in one group of eight healthy participants. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Three consecutive maximal voluntary isometric contractions for bilateral plantar flexor and dorsiflexor muscles were captured at different moments in time. The average peak torque significant statistically decreased at 6 h (p = 0.019) in both static and active behaviours, with a higher average peak torque in the active behaviour (p < 0.001). Age, gender, body mass index and average steps did not have any significant influence on the average value of maximal voluntary isometric contraction. The more time participants maintained either static or active behaviour, the less force was observed during ankle torque testation. The static behaviour represented by the sitting position was associated with a higher reduction in the average peak ankle torque during a maximal voluntary isometric contraction when compared to the active behaviour.

Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer.

Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician's role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.

Development and evaluation of a new occupational medicine teaching module to advance self-efficacy and knowledge among medical students.

OBJECTIVES: Self-efficacy is defined as a person's beliefs in his or her abilities to successfully complete a task, and has been shown to influence student motivation and academic achievement. The purpose of this study was to evaluate the impact of a new European teaching module in occupational medicine on undergraduate students' self-efficacy and knowledge in the subject matter. METHODS: Pre-, in-between, and posttraining tests were used to assess self-efficacy and knowledge building of 261 third-year medical students on occupational health issues. Determinants of self-efficacy and knowledge were also identified. Repeated measurement data were analyzed with multilevel statistical procedures. RESULTS: The level of self-efficacy and knowledge in occupational medicine increased after the training. Students who frequently attended the lectures scored significantly higher than sporadic attendees. There was no relation between the level of self-efficacy and the final knowledge score. CONCLUSIONS: Teaching with the new occupational medicine module was effective. Lecture attendance is an important determinant of self-efficacy and performance. Self-efficacy was not associated with knowledge score. Encouraging classroom participation may enhance student achievement.

Case based e-learning in occupational medicine--a European approach.

OBJECTIVE: The main aim of the European Union project NetWoRM (Net-based training for Work-Related Medicine) is an international case-based e-learning curriculum for occupational medicine (OM). METHODS: To improve teaching in OM, web-based cases have been created and implemented at the University of Munich since 1999. In the last 5 years, the project has been further developed with a view to implement the methods internationally. RESULTS: Overall, 26 cases were developed in a standard English version and 10 cases each were made available for several national European curricula. The evaluation of cases showed easiness in accepting the cases and high level of interest in working with them. CONCLUSIONS: Case-based e-learning on an international platform is a unique tool, which supports the quality improvement of education and training in OM throughout Europe in the longer term.