Attributes Affecting the Medical School Primary Care Experience
Favorable primary care (PC) experiences might encourage more medical students to pursue generalist careers, yet academicians know little about which attributes influence the medical school PC experience. The authors sought to identify such attributes and weight their importance.
Semistructured interviews with 16 academic generalist leaders of family medicine, general internal medicine, and general pediatrics led to the development of a Web-based survey, administered to a national sample of 126 generalist faculty. Survey respondents rated (on a nine-point Likert-like scale) the importance of each interview-generated PC medical school attribute and indicated (yes/no) whether outside experts' assessment of the attributes would be valid. The authors assessed interrater agreement.
Interview thematic analysis generated 58 institutional attributes in four categories: informal curriculum (23), institutional infrastructure (6), educational/curricular infrastructure (6), and specific educational experiences (23). Of these 58, 31 (53%) had median importance ratings of >7 (highly important). For 14 of these (45%), more than two-thirds of respondents indicated external expert surveys would provide a valid assessment. Of the 23 informal curriculum attributes, 20 (87%) received highly important ratings; however, more than two-thirds of respondents believed that external expert survey ratings would be valid for only 4 (20%) of them. Strong agreement occurred among respondents across the generalist fields.
Academic generalist educators identified several attributes as highly important in shaping the quality of the medical school PC experience. Informal curriculum attributes appeared particularly influential, but these attributes may not be validly assessed via expert surveys, suggesting the need for other measures.
Available from: Katherine J Gold
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ABSTRACT: Student perceptions of day-to-day physician work life, and relationships between these perceptions and specialty choices, have not been quantitatively explored. The study's purposes were to measure student perceptions of primary care and specialist physician work life, including administrative burden, time pressures, autonomy, and relationships with patients, to determine whether senior students' perceptions vary from junior students' perceptions and to determine whether students with primary care career plans view primary care work life differently than their peers.
A cross-sectional anonymous survey was offered to all students at three allopathic US medical schools between 2006 and 2008.
Of 1,533 eligible students, 983 submitted usable surveys (response rate 64.1%). Students viewed the day-to-day work life of all physicians negatively but viewed primary care physician work life more negatively. Senior students viewed specialist work life more positively and primary care work life more negatively than junior students. Students planning primary care and specialist careers had similar views of primary care and specialist work life.
Students have negative views of the work life of all physicians, especially primary care physicians. Students planning careers in primary care share this negative view of their future work life, suggesting that their career choices are not based on different work life perceptions.
Available from: Ian Geoffrey Wilson
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ABSTRACT: Medical education in Australia is increasingly delivered through longitudinal placements in general practice and other community settings. Early meaningful exposure to patients has been shown to improve the transition from medical student to junior doctor. This study examines the experience of the first year cohort of the University of Western Sydney (UWS) Medical School long-term rural placement students. Results have been placed in the context of other published results for rural training schemes, comparing and contrasting the present results to those of others.
Students undertaking a rural placement in their final year of the UWS medical program (n=21) participated in a mixed methods evaluation. Students filled out a quantitative survey, modified from a validated instrument, and also participated in a focus group. Class ranking of students, and changes over the time of their placement, were also examined.
Overall, students were very pleased with their rural experience, both clinically and socially. Students found the rural experience more comprehensive than they had expected. They considered that they had a stronger learning experience in most aspects than they expect they would have received in a metropolitan area. The smaller realm of the medical world in a rural area was considered an advantage in providing more hands-on experience and more interprofessional team approaches to healthcare provision. It was also considered a drawback by some that more advanced cases of all kinds were sent out of the area to metropolitan hospitals. Between their ranking in the end of Year 3 examination and the examination in the middle of Year 5, during which period students undertook their year-long placement, 14 of 22 students increased their class rank while two experienced no change and six decreased their class rank. Overall, the rural cohort advanced 4.2 places compared to their urban-placed peers.
The present results confirm that rural placements have come into their own in Australia. Curriculum content regarding Aboriginal health issues should emphasise the complexity of culture and range of living conditions that makes up Aboriginal Australia and avoid a 'deficit-based perspective' that emphasises extreme cases over routine presentations. Taken together, the results reported by Australian medical schools now offering long-term rural placements suggest that rural long-term placements are at least as effective, and may even be more effective, than metropolitan hospital placements as an effective means of providing clinical education to medical students in their senior years.
Available from: europepmc.org
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ABSTRACT: BackgroundThe students’ perception of working conditions in hospitals
hasn’t been subject of research in Germany so far. However the
perception plays an important role talking about the sustainability of
working conditions. The iCept Study wants to examine the perception of
medical students compared to the perception of practicing physicians.Methods/designThe perception will be investigated with a redesigned questionnaire based
upon two established and validated questionnaires. The two samples built for
this study (students and physician) will be chosen from members of the labor
union Marburger Bund. The iCept-Study is designed as an anonymized
online-survey.DiscussionThe iCept-Study is thought to be the basis of ongoing further investigations
regarding the perception of working conditions in hospitals. The results
shall serve the facilitation of improving working conditions.
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