Автор неизвестен - Mededworld and amee 2013 conference connect - страница 63

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times), #4. Job/Work (471 times) and #5.

Interest/Curiosity (296 times). When the texts were analyzed contextually, the five most frequently appeared phrases were #1. People and Help/Save/Secure (230 times), #2. Living/Income and Stable/Good (142 times), #3. People and Many (134 times), #4. People and Encounter/Relate (133 times), and #5. People and Suffering/Difficulty (103 times). Most of the students evaluated this program affirmatively in the post-exercise questionnaire. Conclusions: 1st-year medical students most commonly perceive "Becoming a doctor" in the context of relationship with people. Stable life and income may be behind their choice for this profession. Take-home messages: The NLPT allowed analysis of a vast amount of document information in both quantitative and qualitative ways. Our new program worked effectively to facilitate medical students' awareness of being a doctor.

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An investigation of the relationship between laparoscopic box trainer score and interest in surgery as a future career

William Malins (Durham University, School of Medicine, Pharmacy and Health, Stockton-on-Tees, United Kingdom)

David Williams (Durham University, School of Medicine, Pharmacy and Health, Stockton-on-Tees, United Kingdom)

Gabrielle Finn (Durham University, School of Medicine, Pharmacy and Health, Stockton-on-Tees, United Kingdom)

Background: Medical students are often uncertain of their general career choice of either medicine or surgery. Moreover, students have little idea of whether they hold the skills necessary to enter a surgical career before hands-on exposure. This study explores whether a relationship exists between performance on a laparoscopic box trainer, which reflects visuospatial and dexterity skills, as a pre-clinical medical student and a student's prior interest in a surgical career. Summary of work: 1st and 2nd Year medical students at Durham University will be quantitatively assessed during a timed exercise on the laparoscopic box trainer. Students will also fill in a questionnaire before and after the exercise, aimed at gauging their interest in a surgical career.

Summary of results: Data has been collected and in the process of being analyzed. Results will show whether medical students with an interest in a surgical career demonstrate signs of visuospatial or dexterity skills. Moreover, they will show whether the box trainer exercise changes student views on future career choices. Conclusions: Demonstration of visuospatial and dexterity skill as measured by performance on a laparoscopic box trainer may or may not serve as a predictor of a medical students' propensity to choose a career in surgery over medicine. Take-home messages: Junior doctors often find themselves having to make a major career choice between medicine and surgery despite uncertainty over their interest and competence in each respective field. A surgically-related predictor of early interest in a career in surgery could therefore be beneficial in helping such decisions.

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The Hidden Curriculum of Career Choice: its nature and influence on who chooses a surgical career

K A Bowman (University of Manchester, School of Medicine, Stopford Building, Oxford Road, Manchester

M13 9PT, United Kingdom)

E J R Hill (Maastricht University, School of Health

Professions Education, Maastricht, Netherlands)

R E Stalmeijer (Maastricht University, School of Health

Professions Education, Maastricht, Netherlands)

J Hart (University of Manchester, Manchester Medical

School, Manchester, United Kingdom)

Background: We hypothesise that students become socialised into the culture of different specialties whilst at medical school, suggesting specialty-specific hidden curricula exist. We aimed to establish, through examining the specialty of surgery, whether a specialty-specific curriculum exists, and the mechanism by which students encounter and negotiate career options in medicine.

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

Summary of work: Data were collected from medical students in Years 1-5 using a questionnaire and twelve in-depth semi-structured interviews. The research was conducted in accordance with constructivist grounded theory methodology and emergent memos captured during analysis were used to construct a theoretical model.

Summary of results: Students accumulated information regarding the hidden curriculum via relationships and network building. Students enacted the hidden curriculum of surgery in two ways; accumulating practical achievements, and displaying personal characteristics expected from surgeons. This allowed them to identify themselves, and be identified by others, as future surgeons. Students were thus able to fit in and gain access to participation in theatre; a way to further expand their network and acquire more careers information. Whilst research shows role models are important, our findings suggest a more complex web of interrelationships best facilitate the flow of careers information and access to the hidden curriculum. Conclusions: Relationships and network building allow students to gather surgical careers information, enabling them to adopt the persona of a future surgeon and accumulate relevant achievements allowing participation and success in surgery. Take-home messages: Surgery has a distinct hidden curriculum associated with becoming successful, which students uncover via relationships and network building, and subsequently embody to gain participation in the surgical world.

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Tracking our graduates: where are they going and why?

Suzanne Edwards (Swansea University, Medicine, Grove Building (213), Singleton Park, Swansea SA2 8PP, United Kingdom)

Ana Da Silva (Swansea University, Medicine, Swansea, United Kingdom)

Judy McKimm (Swansea University, Medicine, Swansea, United Kingdom)

Frances Rapport (Swansea University, Medicine, Swansea, United Kingdom)

Rhys Williams (Swansea University, Medicine, Swansea, United Kingdom)

Background: Medical schools need to understand the factors affecting the career choices of its graduates so as to improve the quality of career advice and support given to students for such life-determining choices (Watmough, 2009). This is especially relevant for medical schools in rural and other under-served areas (such as Wales) dealing with problems with retaining and recruiting doctors (Barnighausen & Bloom, 2009; Henry, Edwards, & Crotty, 2009; Stagg, Greenhill, & Worley, 2009; Tolhurst et al., 2008). Summary of work: A mixed-methods exploratory study using an online survey and 16 follow-up semi-structured, audio-recorded telephone interviews with graduates from the 2010 and 2012 cohorts of a graduate entry

programme. Thematic analysis of data was conducted using QSRNvivo10 software.

Summary of results: Response rate to the online survey was approximately 33% for both cohorts (24/73 and 22/65 respectively). The main themes identified were consistent across cohorts and across different training locations.

Conclusions: Themes identified reveal a strategic approach to selection of postgraduate training location based on a combination of multiple factors. Attaining a balance between career aspirations, perceived training/job opportunities and personal factors/circumstances is a key determinant for career decision-making.

Take-home messages: Personal relationships and circumstances such as family proximity and connections to a region are very influential for early career decision-making, especially in Graduate Entry Medical programmes. Early engagement of students via social media, alumni web pages and other networks, allied to good collaboration across institutions is fundamental for the success of tracking projects.

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Impact of the psychiatric internship on seventh-year medical students with regard to attitudes to mental illness and psychiatry and the impact on development of clinical skills

Sergio Valdivieso (Escuela de Medicina, Pontificia Universidad Catolica de Chile, Psychiatry, Santiago,

Chile)

MarisolSirhan (Escuela de Medicina, Pontificia Universidad Catolica de Chile, Center of Medical Education, Blasie Cendrars 6580, Lira 44, Santiago 56-2,

Chile)

Background: There is increasing evidence of the importance of mental health in medical education, not only because of the prevalence of psychiatric illness among the population, and their impact on the quality of life, but also because mental health training increases psychosocial competencies and improves the quality of medical performance

Summary of work: Objective: To assess the impact of the psychiatric internship on seventh-year medical students with regard to attitudes to mental illness and psychiatry and the impact on clinical skills. Method: A questionnaire with 32 items regarding attitudes toward psychiatry and a written test with nine MCQ about clinical situations were applied at the beginning and the end of the internship.

Summary of results: One hundred and ten seventh-year students participated in the study, providing responses anonymously. A low level of negative prejudice against psychiatry was found at the beginning of the internship, and no significant differences were observed in comparison to mean scores at the end of it. The analysis by item showed significant differences in five items, with significant differences and improvement in negative prejudice in four. There was a significant difference in

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the percentage of correct answers of the written test between the applications at the beginning and the end. Conclusions: Undergraduate students of a Chilean medical school showed more favorable attitudes toward psychiatry and low levels of negative prejudice, which were not significantly modified by the internship, in contrast to the improvement in clinical skills. Take-home messages: These findings suggest and could determine a greater disposition to develop psychosocial competencies and to choose psychiatry as specialty.

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Personal Values, Vocational Motivations, And Career Perceptions Of Medical Students Of A New, Private University In Santiago, Chile

Ernesto Guiraldes (Universidad Mayor, School of Medicine, Santiago, Chile)

M.Elisa Giaconi (Facultad de Medicina-Universidad Mayor, Oficina de Educacion en Ciencias de la Salud, Santiago, Chile)

M.Elisa Bazan-Orjikh (Facultad de Medicina-Universidad Mayor, Oficina de Educacion en Ciencias de la Salud, Santiago, Chile)

Claudia Morales (Universidad Mayor, School of Medicine, Santiago, Chile)

Amelia Hurtado (Facultad de Medicina-Universidad Mayor, Oficina de Educacion en Ciencias de la Salud, Camino La Piramide 5750, Huechuraba, Santiago

8580745, Chile)

Background: Insight into medical students' particular values and vocational interests can help schools modulate their educational practices. Summary of work: We evaluated the nature of vocational preferences, career perceptions and values of 260 medical students, from first to seventh year, of a Chilean university by means of a specially devised survey.

Summary of results: Younger students, and females in general, regarded medicine as primarily socially-oriented, while interns and males, were largely inclined to consider it a predominantly scientific-technologic discipline. The notions "studying medicine reflects a personal moral/ethical choice", and "altruism is a key component of a physician work" were more favored by younger students, irrespective of their gender, than were by interns. The latter agreed more with: "medical students lose their ideals as career evolves". A majority of responders expressed interest in pursuing a postgraduate specialty; working in the public sector, and in high-complexity, tertiary care hospitals, despite their predominant perception that there is a country-wide shortage of generalists and primary-care physicians. Students' degree of interest for a future career in primary care or general medicine decreased steadily from 1st to 7th year. A majority of responders declared that Medicine had been their preferred vocational choice but that a private "nontraditional" university had not been their number one option. Interestingly, a sizeable proportion of students had entered medical school motivated by a future career in Sports Medicine.

Conclusions: This study constitutes the first characterization of our students' profiles. Take-home messages: Defining their students' values, preferences and vocational motivations should help medical schools redefine their institutional practices and graduates' profile.

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Influences on Career Choice: What factors influence the career choice of medical students?

Sandra Banner (CaRMS, CEO, 171 Nepean Street, Suite

300, Ottawa K2P 0B4, Canada)

Stephen Rimac (CaRMS, Ottawa, Canada)

Background: The purpose of this study is to uncover what factors influenced graduate's career choice in family medicine, surgery, and internal medicine. Summary of work: This longitudinal study aggregates data from CaRMS' Post-Match Survey of Canadian Medical Graduates. The goal of the survey is to address issues concerning medical graduates. Summary of results: From 2003 - 2013, interest in family medicine increased (8.9% increase) while interest in surgery decreased (3.9% decrease), and little change was found in interest for internal medicine (0.2% decrease). Differences in factors that influence career decisions have also been found between specialties. Conclusions: Graduate discipline choice is an important determinant of the distribution of specialties and associated training locations across the country. Take-home messages: Understanding the characteristics associated with career choice can assist residency institutions in determining the characteristics, motivations, and needs of residency applicants.

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Who wishes to work in Family Medicine?

Lucija Murguc (University of Zagreb, School of Medicine, Department for Educational Technology, Zagreb, Croatia)

Gordana Pavlekovic (University of Zagreb, School of Medicine, Department for Educational Technology, Rockefeller str, 4, Zagreb 10000, Croatia)

Background: Although a large number of the students will have to work in primary health care, Family Medicine does not seem to be an attractive area. Students generally believe that primary health care is not a prosperous field for personal development. Summary of work: Aim of the study: to analyse students' perception of reasons which make a specialty more prestigious. Participants were first and 6th (final) year students of Zagreb School of Medicine (N=462) in the academic year 2012/13. Since, this study was a part of a larger study a pre-validated anonymous questionnaire was administered containing also one open question on their reasons for difference in specialty prestige. Qualitative analysis of obtained data was performed.

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

Summary of results: Reflecting the reasons for certain specialty's prestige most often were mentioned factors such as labour characteristics (hospital environment, vital decision making, stressful, responsible, often manual and invasive work, at the edge of life and death, which demands sacrifice, long working hours, night shifts, broad knowledge and sophisticated technology), treatment/therapy results (rapid, evident improvement or life rescue), specialisation characteristics (duration, severity, difficulty to obtain, subspecialisation needed) and dealt with illness characteristics (type, acuteness, vital vulnerability, complexity, drug/therapy dependency and importance of the body part). Other factors included political and pharmaceutical industry influence, health system organisation, health care accessibility, society needs, income, media, fashion, possibility for private praxis, and stereotypes. However some students indicated there was no difference in various specialties' prestige.

Take-home messages: differences in prestige influence medical student choice of their future specialisation and it should be taken into consideration when planning medical career development.

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Factors associated with preference for primary care specialties in undergraduate medical students: a national cross-sectional study in Portugal

Jose Pedro Agueda (University of Minho, School of Health Sciences, Gualtar Campus, Braga 4710-057, Portugal)Patricio Costa (University of Minho, School of Health Sciences, Braga, Portugal) Manuel Joao Costa (University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal)

Background: In Portugal, medical graduates tend not to prefer careers in primary care. In the last decade, undergraduate medical curricula have put more emphasis on primary care.

Summary of work: This was a cross-sectional study on the specialty preference of undergraduate students attending medical schools in Portugal. A sample of 924 students of every year in all medical schools (8,89% of the population) replied to an online questionnaire that collected the following variables: sociodemography, year of study in medical school, current specialty of preference, motivations and perceptions about specialties and the practice of medicine. Multiple logistic regression was used with specialty categories - medical, surgical and primary care - as dependent variables. Summary of results: Few students preferred primary care specialties (n=58; 6,3%). Preference for primary care was associated with attending the clinical years (OR = 2.7, OR = 2.5), intend to practice medicine in non-urban areas (OR = 2.7, OR = 3.3) and to pursue primary care regardless of the location (OR = 5.4, OR = 4.1) , compared with surgical and medical specialties respectively. However, the regression model accounted for 21.9% of the preferences, suggesting that other

factors should be considered to understand specialty preference.

Conclusions: Undergraduate students in Portugal demonstrate little preference for primary care specialties and the main factors associated with that preference were: attending the clinical years of the degree, intention to work in non-urban areas and preference for primary care, regardless of geographic location.

Take-home messages: Despite the changes in Portuguese undergraduate medical curricula, students continue not to favor primary care specialties.

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Studying and graduating with a disability in a health sciences education program

Anselme GM Derese (Ghent University, Faculty of Medicine and Health Sciences, UZ5K3, De Pintelaan 185, Ghent 9000, Belgium)

Stephanie Claus (Ghent University, Department of

Special Education, Ghent, Belgium)

Karen Leyman (Ghent University, Department of Special

Education, Ghent, Belgium)

Elisabeth Tijtgat (Ghent University, Department of

Special Education, Ghent, Belgium)

Meggie Verstichele (Ghent University, Department of

Special Education, Ghent, Belgium)

Background: As part of a more global study about "graduating with a disability" at Ghent University, special attention was paid to students in medicine and other health sciences.

Summary of work: Graduates from various health sciences education programs functioning successfully as professionals with a disability were sought and interviewed. Students considering themselves as having a disability were invited to participate in a written survey and an oral interview. Afterwards the results of those interviews were discussed with the education committee chairpersons of the different health sciences education programs.

Summary of results: Sixteen students were interviewed, with disabilities ranging from ADHD, ASD, hearing or vision disorders, diabetes, cancer, CVS to bipolar disorders. For many students their disability motivated them to choose for a career in health care or health science. Despite reasonable adjustments, students with psychological disturbances experienced the most difficulties to overcome the challenges of their curriculum.

Conclusions: Although the researchers of this study concluded that program managers should give information but no advice to candidates for health sciences education programs, education committee chairs considered themselves entitled, even obliged to advise students with disabilities negatively when they considered them unfit to complete the educational program or function successfully in a health professions' environment.

Take-home messages: Although the researchers of this study concluded that program managers should give

ABSTRACT BOOK: SESSION 5 MONDAY 26 AUGUST: 1600-1730

information but no advice to candidates for health sciences education programs, education committee chairs considered themselves entitled, even obliged to advise students with disabilities negatively when they considered them unfit to complete the educational program or function successfully in a health professions' environment. Conflicts seem irresolvable between students' remaining abilities and perceived limitations in a (often stressful) professional health care or research environment.

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Change in career choice and motivation over time at medical school

Georgia Tunnicliffe (St George's Hospital, Respiratory Medicine, London, United Kingdom) Yee Ean Ong (St George's Hospital, Respiratory Medicine, Chest Clinic, Perimeter Road, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom) Andrew Singleton (St George's Medical School, London, United Kingdom)

Background: A number of factors are known to influence the career choices of medical students including both intrinsic factors such gender, parental occupation and personality attributes and extrinsic influences relating to individual medical schools such as educational system curriculum and size of programme and also career factors such as pay and prestige. Little has been studied about how the career preferences of medical students changes over their studentship. Summary of work: Medical students in their 1st year, each clinical year and a group of doctors, who had qualified 2 years prior, from the same institution, were invited to take part in an on-line survey. Data gathered included demographics, career choice and motivators for these preferences.

Summary of results: 449 people participated with a response rate was 27.2 % (qualified doctors) to 45.7% (students in 2nd clinical year). The most popular "first choice" careers in 1st years were Surgery (25.6%) and Paediatrics (21.2%) changing to General Practice (12.7­19.1%) and Medicine (20.4-27%) in clinical years. Anaesthetics only became popular in the final year (14.5%). General practice was favoured by 30.8% of qualified doctors. When examining motivators for this preference, the most popular factors were consistently "job satisfaction" and "intellectual stimulation" with "flexible hours" and "salary" deemed important/ very important for 50-60% of respondents. "Shorter time in training" became marginally more important and "social status" less important over time. Conclusions: Career preference and its motivating factors, changes over time in training. Take-home messages: Career preference and motivation of choice are dynamic, and both are subject to change throughout undergraduate and postgraduate training.

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How do students, foundation doctors and specialty trainees perceive a career in O&G? Mixed methods analysis of a national survey

Jane L D Currie (Homerton University Hospital, Obstetrics and Gynaecology, Homerton Row, London E9 6SR, United Kingdom)

S Melissa Whitten (University College London Hospitals NHS Trust, Obstetrics and Gynaecology, London, United Kingdom)

Matthew Huggins (Royal College of Obstetrics and Gynaecology,, London, United Kingdom)

Background: A survey into attitudes of students and junior doctors towards a career in Obstetrics and Gynaecology (O&G) was carried out by the RCOG in 20051. Since then, UK training has changed considerably. This survey sought to answer how O&G as a career is perceived by current medical students, Foundation doctors and O&G Specialty Trainees (Years1-

3).

Summary of work: An anonymous, piloted survey was distributed electronically to the three groups nationally during May 2012. Free-text responses were analysed thematically.

Summary of results: There were 2073 responses: 1114 medical students, 666 Foundation doctors and 293 ST1-3 trainees. 38.4% of students and 30.1% of Foundation doctors were likely to consider O&G as a career. Overall, the most positive features of a career in O&G related to interest in the specialty itself. The most negative features were litigation and work-life balance. These results were comparable with the previous survey. Following analysis by career intentions the negative factors varied. The greatest negative factor for medical students and Foundation doctors not considering O&G was bad undergraduate experience. Foundation doctors considering O&G highlighted getting a training post as a negative factor. Qualitative analysis of open-ended free-text responses provided richer assessment of the impact of undergraduate and foundation posts on career choices.

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