Knowledge, attitude, perceived effectiveness and self-practice of complementary and alternative medicine: a cross-sectional comparison between medical and non-medical students of Bangladesh.

BACKGROUND: Bangladesh's population commonly utilizes Complementary and alternative medicine (CAM) to treat their health issues. Despite the increasing interest in CAM, it has been excluded from conventional medical training in Bangladesh for many years. Therefore, this study assessed and compared the knowledge level, attitude, perceived effectiveness, and self-practice of CAM among undergraduate students of Bangladesh. METHODS: This cross-sectional group comparison study was conducted among undergraduate (both medical and non-medical) students of Bangladesh between November and December 2021. Data was collected using a self-reported pretested semi-structured online questionnaire. The questionnaire contained questions regarding background information, knowledge regarding CAM, source of CAM knowledge, attitude towards CAM, interest in attaining CAM knowledge, perceived effectiveness of CAM, perceived adverse effects of CAM, self-practice of CAM, and whether would they refer CAM to others. A total of 576 students responded and the data gathered allowed for the following: (1) an overview of the study groups, (2) respondents' general perception and knowledge regarding CAM, and (3) a comparison of respondents' CAM knowledge, general perception, and usage by area of study. Data were analyzed using STATA (v.16) and descriptive statistics, Pearson's chi-square test, and Mann-Whitney U test were performed. RESULTS: A total of 329 medical students and 247 non-medical students participated in the study. The mean age of the participants was 21.57 ± 1.8 years and 56.2% of them were male. The most known CAM among medical (M) students was homeopathy (44.6%) and among non-medical (NM) students were herbal medicine (45.7%). Non-medical students had significantly better knowledge about nine out of twelve CAM modalities included in the study, and no significant differences were present for the rest of the modalities. Medical (81.1%) and non-medical students (86.2%) perceived traditional Chinese medicine and homeopathy to be the most effective respectively. "Incorporating CAM with conventional medicine would result in increased patient satisfaction" showed the most statistically significant (p = 0.0002) difference among both groups. Yoga was the most often practiced modality among medical students and homeopathy among non-medical students. CONCLUSION: Medical students have a lacking of knowledge and a positive attitude towards CAM, despite its very common practice among the people of Bangladesh. Therefore, emphasis should be put on the inclusion of CAM modules in medical training.

Selecting Instruments for Measuring the Clinical Learning Environment of Medical Education: A 4-Domain Framework.

Learning environments shape the experiences of learners and practitioners, making them an important component of program evaluation. However, educators find it challenging to decide whether to measure clinical learning environments with existing instruments or to design their own new instrument and, if using an existing instrument, which to choose. To assist educators with these decisions, the authors compared clinical learning environment instruments based on their characteristics, underlying constructs, and degree to which items reflect 4 domains (personal, social, organizational, material) from a recently developed model for conceptualizing learning environments in the health professions. Building on 3 prior literature reviews as well as a literature search, the authors identified 6 clinically oriented learning environment instruments designed for medical education. They collected key information about each instrument (e.g., number of items and subscales, conceptual frameworks, operational definitions of the learning environment) and coded items from each instrument according to the 4 domains. The 6 instruments varied in number of items, underlying constructs, subscales, definitions of clinical learning environment, and domain coverage. Most instruments focused heavily on the organizational and social domains and less on the personal and material domains (half omitted the material domain entirely). The variations in these instruments suggest that educators might consider several guiding questions. How will they define the learning environment and which theoretical lens is most applicable (e.g., personal vitality, sociocultural learning theory)? What aspects or domains of the learning environment do they most wish to capture (e.g., personal support, social interactions, organizational culture, access to resources)? How comprehensive do they want the instrument to be (and correspondingly how much time do they expect people to devote to completing the instrument and how frequently)? Whose perspective do they wish to evaluate (e.g., student, resident, fellow, attending, team, patient)? Each of these considerations is addressed.

Perceptions and practices of self-medication in healthcare and nonhealthcare university students in South India.

BACKGROUND: The aim was to study and compare knowledge, attitude and practices regarding self-medication in healthcare and nonhealthcare university students. METHODS: Suitably constructed, structured and pretested questionnaires were distributed to 350 students in each group; data were documented in SPSS software version 20.0 and analyzed using χ2-test and multivariate logistic regression analysis. RESULTS: Completed questionnaires only were analyzed, which were 314 and 310 in healthcare and nonhealthcare groups, respectively. The majority of students practiced self-medication (84.4% vs. 68.1%; p<0.001) with the most common indications being fever (46.4% vs. 37.9%; p<0.001) and cough and common cold (30.9% vs. 37%; p=0.004). Most commonly self-medicated drugs were antipyretics (67.9% vs. 52.6%; p=0.03) and multivitamins (28.7% vs. 16.8%; p<0.001). A few of them experienced adverse drug reactions due to self-medication (6.8% vs. 1.9%; p<0.001). Independent risk factors for self-medication were younger age group (OR=2.93, CI 95% 1.09-7.85), storage of medicines at home (OR=2.49, CI 95% 1.21-5.12), healthcare students (OR=2.54, CI 95% 1.72-3.74), higher knowledge scores (OR=1.65, CI 95% 1.08-2.52), those consuming homeopathic preparations (OR=9.19, CI 95% 1.24-68.11), multivitamins (OR=6.7, CI 95% 2.88-15.6) or health supplements (OR=6, CI 95% 2.15-16.74), participants who strongly agreed that self-medication is a part of self-care (OR=3.97, CI 95% 1.56-10.09), and those self-medicating with an old prescription for same illness (OR=0.04, CI 95% 0.01-0.15) or over advice from home (OR=0.11, CI 95% 0.04-0.3). CONCLUSIONS: Though self-medication is common in university students, there is a dearth in their knowledge regarding the same. This highlights the need for increasing awareness among students regarding hazards of self-medication.

Medicine prescription practices of homeopathic undergraduate students in West Bengal, India.

OBJECTIVE: To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students. METHODS: A cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences. RESULTS: A total of 328 forms were completed. Of these, 264 (80.5%) homeopathic undergraduate students admitted of prescribing medicines independently and most (40.5%) said that they did this 2-3 times a year. The most common reasons for this were 'urgency of the problem' (35.2%), 'previous experience with same kind of illness' (31.8%), and 'the problem too trivial to go to a doctor' (25.8%). About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital (odds ratio = 5.8; 95% confidence interval 2.247-14.972). Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses. CONCLUSION: Prescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.

Substance abuse among Iranian high school students.

PURPOSE OF REVIEW: In this study, we reviewed data on drug use among high school students in Iran. RECENT FINDINGS: Published epidemiological studies in international and domestic journals show that drug use/abuse is a serious mental health problem in Iran. There is cultural support for opium in Iran and also there is cultural tolerance for tobacco smoking, especially as water pipe smoking in Iranian families. Alcohol, opium and cannabis are the most frequently used illicit drugs, but there are new emerging problems with anabolic steroids, ecstasy and stimulant substances, such as crystal methamphetamine. SUMMARY: There is a serious drug abuse problem among Iranian high school students. It could be due to role modeling by parents - mainly fathers - and also cultural tolerance of some substances. Early onset of tobacco smoking, with a daily use rate between 4.4 and 12.8% in high school students, is an important risk factor for other drug abuse problems. Use of all types of drugs, except prescription drugs, is more prevalent among boys. Alcohol is the most frequently abused substance, with a lifetime rate of at least 9.9%. Lifetime rates of opiate use - mostly opium - was between 1.2 and 8.6% in different parts of the country. As drug abuse is a frequent problem among Iranian high school students, it is necessary to design and implement drug prevention programs to protect them. Such programs, including life skills training and drug education, have been operating in recent years for Iranian students from kindergarten to the university level.

Alternatives to animal experimentation in biomedical education.

In education, it is important that students are not put in a position in which they are forced to participate in animal experiments or to use dead animals, killed especially for such purposes. Continued use of animal experiments to demonstrate known facts or teach skills which can be taught using non-animal methods evidences only a lack of sensitivity towards students who still maintain respect for life. In countries where animal testing in education is reduced to close to zero, there is no evidence that the students who are being trained are less capable or qualified. There are sufficient alternatives available at relatively low-cost and with proven educational efficacy to allow the vast majority of students who study biomedical science courses to qualify without using animal experiments. However, in many universities across Europe, there is still a resistance to adoption of such methods amongst faculty. The global situation is probably worse with animals still being used in high school teaching in some countries such as the USA.