Reflecting on 12 years of training medical students in rural longitudinal integrated clerkships.

Longitudinal integrated clerkships (LICs) are effective in promoting careers in rural primary health care environments. This model of training medical professionals involves longer clinical placements of medical students and a different approach to learning which better prepares them for primary health care practice. Stellenbosch University created a LIC in 2011 for this purpose and has trained almost 100 doctors in their yearlong LIC since then. The past 12 years have brought about a lot of learning as this model of training was implemented, developed, and refined to suit the needs of students and the clinical environments.Contribution: Countries across the globe face challenges in recruiting and retaining doctors in rural primary health care environments. Longitudinal integrated clerkships have several educational benefits in addition to increase recruitment and retention of rural doctors, and 12 years of experience have led to a greater understanding regarding implementation and outcomes of an LIC in the South African context.

Why move abroad? Factors influencing migration intentions of final year students of health-related disciplines in Nigeria.

BACKGROUND: Limited human resource for health may impede the attainment of health-related sustainable development goals in low-income countries. This study aims to identify migration factors among final-year students of health-related disciplines at a Nigerian university, reflecting trends in Nigeria and sub-Saharan African countries. METHODS: A cross-sectional study was conducted using a semi-structured, self-administered questionnaire to collect data from 402 final-year students of Medicine/Dentistry, Nursing, Pharmacy and Occupational therapy Physiotherapy at Obafemi Awolowo University, Ile Ife. Univariate, bivariate and multivariate data analysis were conducted and a p-value < 0.05 was taken as statistically significant. RESULTS: The mean age of the respondents was 24.3 ± 2.3 years. Most (326; 81.1%) respondents had intentions to migrate and majority (216; 53.7%) of respondents had an unfavourable attitude towards practising in Nigeria. Students of Nursing constitute the highest proportion (68; 91.9%) of those willing to migrate (p = 0.009). The common preferred destinations for those who intend to migrate were the United Kingdom (84; 25.8%), Canada (81; 24.8%), and the United States of America (68; 20.9%). Respondents who had favourable attitude towards practicing abroad (AO.R: 2.9; 95% C.I 1.6-5.2; p = 0.001) were three times more likely to have migration intentions compared with those who had an unfavourable attitude towards practicing abroad, while the odds for those who had favourable attitude towards practicing in Nigeria (AO.R: 0.4; 95% C.I 0.2-0.7; p = 0.002) was two times less than those who had an unfavourable attitude towards practice in Nigeria. Respondents who desire specialist training (AO.R: 3.0; 95% C.I 1.7-5.4; p < 0.001) were three times more likely to have intention to migrate abroad when compared to those who were undecided or had no desire to pursue specialist training. CONCLUSION: Most respondents had the intention to migrate abroad after graduation and this could be attributed to the desire for specialist training and their attitude towards practising in Nigeria. Interventions aimed at improving specialist training in Nigeria and incentivizing health care practice may reduce migration trends among Nigeria's health professionals in training.

Assessment of the Adequacy of Neurosurgery Teaching Methods among Medical Students in Enugu State, Nigeria.

Background: Various educational neurosurgery teaching methods are employed across few Nigerian universities, especially Enugu state. Aims: To determine the adequacy of current neurosurgery teaching methods, factors influencing eventual choice of neurosurgery amongst final year medical students in Enugu state, Nigeria and suggest improvement methods towards best global standards. Materials and Methods: This was an online cross-sectional study conducted among final year medical students currently on Neurosurgery rotation in Enugu state, Nigeria using a validated questionnaire. Data was analyzed (inferential and deferential) using SPSS; chi-squares values were calculated. Significance was set at p value <0.05 and measures were put in place to limit bias. Results: 106 students filled and submitted the form with a response rate of 72.60%. Most respondents revealed that their universities had mandatory neurosurgery rotations. Majority affirmed that a general poor learning environment (75%) was the major obstacle to standard teaching. About 49% had interest in specializing in surgery but only 18% have interest in neurosurgery as a future sub-specialty choice. Positively, majority (90.6%) alluded to having qualified teachers, with 43.4% of them advocating for improved training of the teachers. There was a significant correlation between choice of specialty and the students' monthly income (less than N10, 000 had a p: 0.003). Other factors that were positively correlated in eventual choice as their future desired subspecialty include poor exposure to clinical neurosurgery cases (p: 0.020) and little or no exposure of students to neurosurgery research opportunities (p: 0.024). Conclusion/Recommendations: The current neurosurgical teaching methods in Enugu state are not fully optimal yet. There is a need for some improvement in current learning environment and teaching methods to improve the students' understanding of neurosurgery and eventual increased interest in final choice of neurosurgery as their desired subspecialty.

Perceptions of and Preparedness for the Application of Pharmacoeconomics in Practice, among Final Year Bachelor of Pharmacy Students in South Africa: A National Cross-Sectional Study.

For the improvement of access to health, many countries including South Africa, have adopted universal healthcare. However, this requires skills to apply health technology assessments for the facilitation of investment decisions. This study aimed to ascertain final year Bachelor of Pharmacy (BPharm) students' perceptions of the relevance of pharmacoeconomics in pharmacy practice, and their level of preparedness to apply pharmacoeconomic principles, using a quantitative, cross-sectional, and descriptive design. Data were collected using a self-administered questionnaire over 12 months, and included student demographics, knowledge about pharmacoeconomics and its applicability in practice, as well as students' satisfaction with the appropriateness of the curriculum content. Five of nine universities offering pharmacy education took part. The overallstudent response rate was 38.1% (189/496), with 26.2% (45/172) of students signifying a good understanding of basic pharmacoeconomic concepts. Pharmacoeconomics application in South Africa was perceived to be relevant by 87.5% (140/160); however, 47.0% (79/168) felt they were not prepared to apply pharmacoeconomic principles in medicine management, and 86.7% (137/158) wanted to acquire additional pharmacoeconomic knowledge. Whilst students' perceptions of the relevance of pharmacoeconomics were positive, results indicated a gap in knowledge, understanding, and application. Addressing this gap may increase students' preparedness to apply pharmacoeconomic principles and better equip them for the practical application of pharmacoeconomics post qualification. Consequently, we have started this process.

Understanding of Final Year Medical, Pharmacy and Nursing Students in Pakistan towards Antibiotic Use, Antimicrobial Resistance and Stewardship: Findings and Implications.

Antimicrobial resistance (AMR) is a leading public health threat, which is exacerbated by the high and inappropriate use of antibiotics. Consequently, there is a need to evaluate knowledge regarding antibiotic use, AMR and the readiness to implement antimicrobial stewardship programs (ASPs) among final year medical, pharmacy and nursing students in Pakistan. This reflects the high and increasing rates of AMR in the country, and students as future healthcare professionals (HCPs). A cross-sectional study was conducted among 1251 final year students from 23 public and private educational institutions in Punjab. The majority of the surveyed participants possessed good knowledge of antibiotic use, AMR and the potential causes of AMR. The most common sources of the information on antibiotics were smartphones (69.9%), peers (35.9%) and medical textbooks (30.6%). However, most surveyed participants were not fully prepared to participate in ASPs. They knew, though, how to reduce AMR by educating HCPs about appropriate prescribing, implementing ASPs and improving laboratory facilities. There was a significant association between antibiotic knowledge and causes of AMR with sex, family income and student type (p < 0.05). Being a student at a public sector university (OR = 4.809; CI = 3.261−7.094; p < 0.001) and age (OR = 0.524, CI = 0.327−0.842; p < 0.008) were among the key factors impacting students' training on ASPs. Educational curricula must be improved to include more information about appropriate antibiotic use and ASPs, along with sufficient training, workshops and clinical rotations in the final year, to fully equip students by graduation.

Knowledge, Attitude and Practice on Leptospirosis among Undergraduate Students in University Putra Malaysia

@#Introduction: Leptospirosis is an infectious and zoonotic disease caused by pathogenic bacteria called leptospires which can be transmitted through the exposure to the urine or excretion of infected animals, and also water or soil that being contaminated with secretion of the infected animals. Leptospirosis remains a concern in Malaysia, as the number of cases had steadily increased. This study aims to determine the knowledge, attitude and practice (KAP) among final year students of selected programmes in Universiti Putra Malaysia (UPM). Methods: A cross sectional study was conducted among students of Environmental and Occupational Health (ENVOCH) (57 students), Nursing (22 students) and Veterinary Medicine (97 students). Thus, the total sample sizes were 170, however the response rate were 81.76%. Questionnaire was used as the study instrumentation. Results: There was a significant association between race and knowledge, also gender and attitude with p<0.05, (p=0.008) and (p=0.001) respectively. Furthermore, there was also an association between attitude and practice (p<0.05). Meanwhile, there was a significant difference on the knowledge between students of ENVOCH with Veterinary Medicine and Nursing with Veterinary Medicine (p<0.05). Conclusion: Most of the final year students in this study had moderate level of KAP towards Leptospirosis disease. Thus, improvement in education and training must be done to face this issue.

Does the training of mentors increase the contact frequency and the quality of support in a portfolio-based teaching module?

INTRODUCTION: All over the world, mentors are employed more and more for portfolio-based training modules in order to support the learner's learning- and reflection process.Within the final year of medical education, tertial internal medicine, the University Hospital of Erlangen, Department of Medicine 1 offered trainings for mentors.In the framework of the student's evaluation of this training period it was asked whether and what kind of effect the mentor training has had on the contact frequency between mentor and student and whether it affects how students experience the mentor's support. METHODS: Since spring 2005, the Medizinische Klinik 1 held one-day-long mentor trainings, and in the following two years, about half of the medical staff attended. During the following four years, both trained and untrained mentors participated.At the end of the training section the students evaluated the contact to their mentor with a structured question form. The questions on the contact frequency and how the students experienced the support through the mentor were evaluated for the present study.186 question forms were evaluated; 67 of them related to trained mentors. RESULT: One year after the first training, the students rated the trained mentor's support significantly higher than the support by untrained mentors. There was a tendency noted, though not significant, for a higher contact frequency with the trained mentors.During the following three years, the measurable difference between the trained and untrained mentors regarding both items was not significant. In those years, a tendency towards a more intensive support of the students through all mentors was shown. DISCUSSION: The evaluation results one year after the intervention imply that trained mentors can intensify their support for the students without requiring more time. The positive development of the evaluation results for both mentor groups during the following three years can be interpreted as a result of the process of exchange between trained and untrained mentors and readjustment among staff.