Social justice in medical education: a student-led approach to addressing COVID-19 vaccine equity in the Hispanic/Latinx community.

The current healthcare system disproportionately affects vulnerable populations, leading to disparities in health outcomes. As a result, medical schools need to equip future physicians with the tools to identify and address healthcare disparities. The University of Nevada, Reno School of Medicine implemented a Scholarly Concentration in Medical Social Justice (SCiMSJ) program to address this issue. Three medical students joined the program and pioneered a project to address the equitable vaccine distribution within the local Hispanic/Latinx community. After identifying the disparity in vaccine uptake and high levels of vaccine hesitancy, they collaborated with local organizations to address vaccine misinformation and accessibility. They organized outreach events, provided vaccine education, and hosted a vaccine clinic at a Catholic church with a high Hispanic/Latinx congregation. Through their efforts, they administered 1,456 vaccines. The estimated economic and societal impacts of their work was 879 COVID-19 cases avoided, 5 deaths avoided, 45 life years saved, and $29,286 in economic value. The project's success highlights the effectiveness of a student-led approach to promote skill development in social justice training. Leadership skills and coalition building were crucial in overcoming resource limitations and connecting organizations with the necessary volunteer force. Building trust with the Hispanic/Latinx community through outreach efforts and addressing vaccine hesitancy contributed to the well-attended vaccine clinic. The project's framework and approach can be adopted by other medical students and organizations to address health disparities and improve health outcomes in their communities.

The impact of medical students' attitudes towards group ethical norms on their academic achievement and classroom deviant behaviour: An empirical study from China / El impacto de las actitudes de los estudiantes de medicina hacia las normas éticas de grupo en su rendimiento académico y el comportamiento desviado en el aula: un estudio empírico de China / O impacto de atitudes de estudantes de medicine em relação a normas éticas grupais em suas conquistas acadêmicas e comportamentos desviantes em sala de aula: um estudo empírico da China

Abstract: In recent years, medical students' absenteeism has been investigated in depth. Classroom deviant behavior is a richer concept than truancy behavior, but there are few researchers on this aspect in China. There are still many issues worth discussing about deviant classroom behavior. In this paper, questionnaires were given to 977 medical students to collect relevant data. After classifying the data, correlation analysis and multilevel linear regression analysis were used to conclude that academic performance and group ethical norms have a negative impact on medical students' deviant behaviors in class. Group ethical norms have a significant positive influence on academic performance, and descriptive ethical norms and imperative ethical norms of group ethical norms have a significant influence on academic performance. The four dimensions of academic performance: academic performance, task performance, interpersonal promotion, and social comparison have a negative influence on medical students' deviant behaviors in class. Descriptive ethical norms have an inverse effect on medical students' deviant behaviors, while imperative ethical norms have no significant effect on deviant behaviors in class. Group ethical norms as a category of ethical norms clearly have significant implications for improving academic performance and reducing their transgressions in class. Reinforcing group ethics in medical students will not only contribute to their professional ethics upon graduation, but also to their academic performance.

Resumen: En los últimos años, se ha investigado en profundidad el absentismo de los estudiantes de medicina. El comportamiento desviado en el aula es un concepto más rico que el comportamiento de absentismo escolar, pero hay pocos investigadores sobre este aspecto en China. Todavía hay muchas cuestiones que vale la pena discutir sobre el comportamiento desviado en el aula. En este trabajo, se entregaron cuestionarios a 977 estudiantes de medicina para recoger los datos pertinentes. Tras clasificar los datos, se utilizó el análisis de correlación y de regresión lineal multinivel para llegar a la conclusión de que el rendimiento académico y las normas éticas de grupo tienen un impacto negativo en los comportamientos desviados de los estudiantes de medicina en clase. Las normas éticas de grupo tienen una influencia positiva significativa en el rendimiento académico, y las normas éticas descriptivas y las normas éticas imperativas de las normas éticas de grupo tienen una influencia significativa en el rendimiento académico. Las cuatro dimensiones del rendimiento académico: rendimiento académico, rendimiento de la tarea, promoción interpersonal y comparación social tienen una influencia negativa en los comportamientos desviados de los estudiantes de medicina en clase. Las normas éticas descriptivas tienen un efecto inverso en las conductas desviadas de los estudiantes de medicina, mientras que las normas éticas imperativas no tienen un efecto significativo en las conductas desviadas en clase. Las normas éticas de grupo como categoría de normas éticas tienen claramente implicaciones significativas para mejorar el rendimiento académico y reducir sus transgresiones en clase. Reforzar la ética de grupo en los estudiantes de medicina no sólo contribuirá a su ética profesional al graduarse, sino también a su rendimiento académico.

Resumo: Nos últimos anos, o absenteísmo dos estudantes de medicina tem sido pesquisado em profundidade. O comportamento desviante na sala de aula é um conceito mais rico do que o comportamento de evasão escolar, mas há poucos pesquisadores sobre este aspecto na China. Ainda há muitas questões que vale a pena discutir sobre o comportamento desviante em sala de aula. Neste documento, foram entregues questionários a 977 estudantes de medicina para coletar dados relevantes. Após a classificação dos dados, análise de correlação e análise de regressão linear multinível foram utilizadas para concluir que o desempenho acadêmico e as normas éticas de grupo têm um impacto negativo sobre o comportamento desviante dos estudantes de medicina em sala de aula. Normas éticas de grupo têm uma influência positiva significativa no desempenho acadêmico, e normas éticas descritivas e normas éticas imperativas de normas éticas de grupo têm uma influência significativa no desempenho acadêmico. As quatro dimensões do desempenho acadêmico: desempenho acadêmico, desempenho de tarefas, promoção interpessoal e comparação social têm uma influência negativa sobre os comportamentos desviantes dos estudantes de medicina nas aulas. As normas éticas descritivas têm um efeito inverso sobre os comportamentos desviantes dos estudantes de medicina, enquanto as normas éticas imperativas não têm efeito significativo sobre os comportamentos desviantes nas aulas. Normas éticas de grupo como uma categoria de normas éticas têm claramente implicações significativas para melhorar o desempenho acadêmico e reduzir suas transgressões na classe. O reforço da ética de grupo em estudantes de medicina não só contribuirá para sua ética profissional ao se formarem, mas também para seu desempenho acadêmico.

Impact of the COVID-19 pandemic on surgical trainee education and well-being spring 2020-winter 2020: A path forward.

BACKGROUND: The time course and longitudinal impact of the COVID -19 pandemic on surgical education(SE) and learner well-being (LWB)is unknown. MATERIAL AND METHODS: Check-in surveys were distributed to Surgery Program Directors and Department Chairs, including general surgery and surgical specialties, in the summer and winter of 2020 and compared to a survey from spring 2020. Statistical associations for items with self-reported ACGME Stage and the survey period were assessed using categorical analysis. RESULTS: Stage 3 institutions were reported in spring (30%), summer (4%) [p < 0.0001] and increased in the winter (18%). Severe disruption (SD) was stage dependent (Stage 3; 45% (83/184) vs. Stages 1 and 2; 26% (206/801)[p < 0.0001]). This lessened in the winter (23%) vs. spring (32%) p = 0.02. LWB severe disruption was similar in spring 27%, summer 22%, winter 25% and was associated with Stage 3. CONCLUSIONS: Steps taken during the pandemic reduced SD but did not improve LWB. Systemic efforts are needed to protect learners and combat isolation pervasive in a pandemic.

Medical Education and the Ethics of Self-Care: A Survey of Medical Students Regarding Professional Challenges and Expectations for Living Healthy Lifestyles.

OBJECTIVES: Little is known about medical students' attitudes regarding the healthy lifestyle habits they are taught to recommend to patients and whether they believe they have a professional responsibility to live a healthy lifestyle. Understanding students' attitudes and practices regarding healthy lifestyles may provide insights into the personal and professional challenges that students face as they navigate the ethical tension between obligations to care for others (altruism) and for themselves (self-care). METHODS: The authors conducted a cross-sectional, anonymous, online survey of all medical students at the University of Iowa Carver College of Medicine in fall 2019, using descriptive statistics for analysis. RESULTS: A total of 351 students participated (response rate, 52.0%). Most agreed that physicians (85.5%) and medical students (77.8%) have a responsibility to try to live a healthy lifestyle; that physicians who practice healthy behaviors are more confident in counseling patients (94.0%), more likely to counsel patients (88.3%), and more likely to have their advice followed (86.9%); that as students they are more likely to counsel patients if they practice the healthy behavior (90.0%); and that their medical school workload resulted in exercise (69.7%), sleeping (69.4%), and eating (60.2%) practices that were less healthy than they should be. CONCLUSIONS: Most medical students support the professional responsibility to live a healthy lifestyle and believe doing so increases their effectiveness in counseling patients about healthy lifestyle habits. The medical school workload may limit some students' ability to live healthy lifestyles, however. Medical students need educational opportunities in ethics and professionalism to discuss challenges and expectations for living healthy lifestyles, with an eye toward practical approaches to living the life of a medical student that are professionally responsible and personally realistic.

Play and Learn for Surgeons: A Serious Game to Educate Medical Residents in Uterine Artery Ligation Surgery.

Objective: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality. Surgical interventions, such as uterine artery ligation and utero-ovarian arteries ligation (UAL and UOAL), are considered as effective methods to control PPH. Owing to PPH's severe outcomes, various educational tools have been developed to train surgical residents. A potential educational medium for this purpose could be serious digital games. In this pilot study, we assessed the usability and effectiveness of a serious game to promote the surgical skills of UAL/UOAL among obstetrics and gynecology (OB/GYN) residents. Methods: We designed and developed the Play and Learn for Surgeons (PLS) game to train OB/GYN residents. We assessed and compared the usability challenges of PLS before and after revising the game. To assess the effectiveness of PLS, residents were allocated randomly in control and intervention groups. Surgical skills of the residents were assessed pre- and post-test using the Objective Structured Assessment of Technical Skills checklist. Setting: This pilot study took place at the OB/GYN wards of Omolbanin Hospital (Mashhad University of Medical Sciences) and Imam Ali Hospital (Zahedan University of Medical Sciences) in Iran. Participants: Thirteen subject matter experts (nine OB/GYN experts and four senior clinical assistants) participated in the user interface design and usability assessment of PLS. Total of 46 OB/GYN residents participated in the educational effectiveness analysis of PLS. All participants were female with mean ages of 40.6, 29.9 and 28.0 years for OB/GYN experts, assistants, and residents, accordingly. Results: All participants completed the study. PLS significantly improved the skills of residents for UAL (P-value = 0.018) and UOAL (P-value <0.001) procedures. Conclusion: Serious games can be an effective and affordable approach in training OB/GYN residents for UAL and UOAL procedures. Approval number: (# IR.MUMS.fm.REC.1396.345) Trial registration number: (# IRCT2017092436366N1).

La mínima intervención en cariología en el plan de estudios D de la carrera de Estomatología en Cuba / Minimal intervention in cariology in Cuba Dentistry career study program D

Objetivo: Determinar la presencia de acercamientos a la mínima intervención en cariología en los temas sobre el proceso caries dental de los programas de asignaturas del plan de estudios D de la carrera de Estomatología. Métodos: Se realizó una investigación cualitativa, documental, analítica, a través de una lectura crítica y valorativa de los 20 programas de las asignaturas de la disciplina integradora del plan de estudios D de la carrera de Estomatología. Se realizó un análisis del contenido de cada uno de los programas de asignatura en busca de indicios de la inclusión en los mismos de temas relacionados con la caries dental y si estos se correspondían con los principios de la mínima intervención en cariología. Los datos extraídos fueron el nombre de la asignatura, año académico, total de horas del programa, inclusión de la temática del proceso caries dental, inclusión de temas relacionados con el proceso caries dental según la mínima intervención en cariología, literatura básica recomendada, especificidad de los temas tratados referentes al proceso caries dental. Resultados: De las 13 referencias básicas de los programas de estudio el 54 % se remontan a publicaciones del pasado siglo y el resto a inicios del presente. Los programas incluyen temas relacionados con la prevención y curación del proceso caries dental, factores de riesgo, etiología, conceptos, clasificaciones y características clínicas y en 3.er año la asignatura Epidemiología. Ese mismo año, y posteriores, los temas referentes se hacen redundantes y se repiten en asignaturas consiguientes. Conclusiones: Los programas de asignaturas de la disciplina integradora del plan de estudios D de la carrera de Estomatología carecen de la presencia de preceptos sobre la mínima intervención para el tratamiento de la caries dental excepto la de Odontopediatría(AU)

Objective: To determine the presence of the minimum intervention in cariology in the topics on the dental caries process of the subject programs of the Study Plan of the Stomatology career. Methods: A qualitative analytical documentary research was carried out through a critical and evaluative reading of the 20 programs of the subjects of the integrating discipline of the Study Plan D of the Stomatology career. An analysis of the content of each of the subject programs was carried out in search of indications of the inclusion in them of topics related to dental caries and if these were related to the principles of Minimum Intervention in Cariology. The data extracted were the name of the subject, academic year, total hours of the program, inclusion of the topic of dental caries process, inclusion of topics related to the dental caries process according to the minimal intervention in cariology, recommended basic literature, specificity of the topics covered referring to the dental caries process. Results: Of the 13 basic references of the study programs, 54% go back to publications of the last century and the rest to the beginning of the present. The programs include topics related to the prevention and cure of the dental caries process, risk factors, etiology, concepts, classifications and clinical characteristics and in the 3rd year the subject Epidemiology. That same year and later, the reference topics become redundant and are repeated in subsequent subjects. Conclusions: The subject programs of the integrating discipline of the Stomatology Career Curriculum lack the presence of precepts on the minimum intervention for the treatment of dental caries except that of Pediatric Dentistry(AU)

Priorities for the global advancement of care for older adults with cancer: an update of the International Society of Geriatric Oncology Priorities Initiative.

In 2011, the International Society of Geriatric Oncology (SIOG) published the SIOG 10 Priorities Initiative, which defined top priorities for the improvement of the care of older adults with cancer worldwide.1 Substantial scientific, clinical, and educational progress has been made in line with these priorities and international health policy developments have occurred, such as the shift of emphasis by WHO from communicable to non-communicable diseases and the adoption by the UN of its Sustainable Development Goals 2030. Therefore, SIOG has updated its priority list. The present document addresses four priority domains: education, clinical practice, research, and strengthening collaborations and partnerships. In this Policy Review, we reflect on how these priorities would apply in different economic settings, namely in high-income countries versus low-income and middle-income countries. SIOG hopes that it will offer guidance for international and national endeavours to provide adequate universal health coverage for older adults with cancer, who represent a major and rapidly growing group in global epidemiology.

Covid-19 and the healthcare professionals of the future.

This article discusses the impact of Covid-19 on medical and healthcare education, and the challenges that now face students, educational providers and the wider NHS.

The future of general surgery in Ireland: factors influencing career decisions of medical students.

INTRODUCTION: The decline in popularity of general surgery as a career has been well described. A number of factors have been put forward to explain this, for example, trainee burnout and perceived difficulty with work/life balance. The aim of this study was to elucidate the reasons for this among medical students in Ireland. METHOD: A questionnaire was distributed to clinical year medical students in Ireland using an online survey via SurveyMonkey™. Domains assessed included demographics, career plan and associated rationale. Anonymised responses were collated and evaluated. RESULTS: There were 307 responses (response 23%). Females accounted for 66% (202). Mean age was 24 years (SD = 2.89). One hundred twelve responses (36%) were contemplating becoming surgeons. One hundred nine-five responses were not considering surgery: however 87 had previously considered. Of the 87, 41 (47%) attributed the decision to work/life balance, 30 (35%) to impact on personal relationships and 10 (11%) blamed unclear career projection. Students interested in surgery were asked to quantify their knowledge of the application process-17 (15%) good, 39 (35%) fair and 56 (50%) poor. CONCLUSION: A small proportion of respondents plan to pursue a career in general surgery. This is concerning in view of attrition rates through junior years. Although lifestyle factors are significant, clarity regarding training pathways was also reported. Undergraduate education regarding career trajectory, quality of life and practicalities of a career in general surgery may increase applications.

"There Is a Lot of Change Afoot": A Qualitative Study of Faculty Adaptation to Elimination of Tiered Grades With Increased Emphasis on Feedback in Core Clerkships.

PURPOSE: Medical schools responding to challenges with fairness, equity, learning environments, and student wellness have reconsidered clerkship grades. This study used the Concerns-Based Adoption Model (CBAM) to explore how faculty responded to a change in the approach to assessment from focus on grades toward focus on feedback. METHOD: This qualitative study used an inductive approach to analyze data from semistructured interviews with teaching faculty and education leaders at University of California, San Francisco, School of Medicine 6 months following the elimination of traditional tiered clerkship grades. Participants were recruited in 2019 using purposive sampling. Interview questions addressed participants' perceptions of the new approach to assessment and grading that emphasizes assessment for learning, including advantages and concerns. The authors analyzed data using thematic analysis informed by sensitizing concepts from CBAM. RESULTS: Nineteen faculty participated (11 medicine, 8 surgery). Faculty expressed optimism about the impact of the change on their clinical educator roles and sought faculty development to enhance feedback and assessment skills. Perceived benefits to students addressed learning and wellness, with concern for students' motivation and professional development. Faculty shared uncertainty about their roles and larger systemic consequences involving the residency match and institutional reputation. Participants acknowledged that traditional grading is imperfect, yet felt a departure from this system represented significant culture change. CONCLUSIONS: Faculty perceptions of the assessment and grade change in 2 large departments demonstrated tensions around grading. Their descriptions of change as an ongoing process aligned with CBAM and required them to consider new approaches and perspectives. While discourse about assessment and grading frequently focuses on learners, these findings support institutional consideration of the impact of changes in assessment on teaching faculty.

Los atributos de un tutor clínico de excelencia: una revisión sistemática

Knowing what characterizes an excellent teacher is relevant to guide training, evaluation, and continuous improvement of the clinical teacher. We performed a systematic review using the PRISMA protocol, aiming to identify the attributes of an excellent clinical teacher. MEDLINE, ERIC, ScienceDirect, and Scopus databases were searched for articles published in English and Spanish, between 2007 and 2019. Two independent reviewers extracted and synthesized data from articles that met the PRISMA pre-established criteria. Twelve studies met the inclusion criteria. Of the 106 attributes reported by the studies, 49 (46,2%) were generic. The most frequently mentioned attribute was respectfulness. Forty-six attributes (43,3%) were pedagogical. Feedback and planning were those most frequently mentioned. Eleven attributes (10,3%) were disciplinary and clinical skills was the most mentioned. We conclude that generic and pedagogical dimensions had a greater representation in the literature, in comparison with the disciplinary dimension. This could be explained, considering that having adequate clinical skills is the minimal necessary requisite to become a clinical teacher, but does not make a difference in how their performance is perceived, contrary to the generic and pedagogical dimensions.