Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES) was originally developed for evaluation of nursing students' clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students' perceptions of their learning environment in primary health care.
In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument.
The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbach's alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency.
CLES, in its adapted form, appears to be a valid instrument to evaluate medical students' perceptions of their clinical learning environment in primary health care.
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The personality of medical students may have an important impact on both their academic performance and emotional adjustment during medical school. There has been little systematic study of the impact of perfectionism on medical students. The present study sought to compare the perfectionism profile of medical students with that of a general arts student group and to examine the relationship among perfectionism, distress symptoms and academic expectations and satisfaction.
Medical students (n=96) and arts students (n=289) completed a baseline assessment including two multidimensional perfectionism scales. The medical students also completed measures of distress symptoms, personality (neuroticism, conscientiousness) and questions about their perceptions of their academic performance. Of the medical students, 58 completed a second set of questionnaires 6 months later (time 2).
First-, second- and third year medical students and first-year arts students.
In comparison with arts students, the perfectionism profile of medical students showed higher personal standards, lower doubts about actions and lower maladaptive perfectionism scores. In the medical students adaptive perfectionism (achievement striving) was significantly correlated with baseline academic performance expectations and conscientiousness and was predictive of dissatisfaction with academic performance at time 2. Maladaptive perfectionism (excessive evaluative concerns) was significantly correlated with baseline distress symptoms and neuroticism and was predictive of symptoms of depression and hopelessness at time 2.
Perfectionism in medical students differs systematically from perfectionism in general arts students. Distinguishing adaptive and maladaptive aspects of perfectionism is important in understanding the cross-sectional and longitudinal implications of perfectionism for medical students.
During the spring of 1995, 734 medical students at the Karolinska Institute in Stockholm were randomly selected for inclusion in a postal questionnaire study of alcohol and drug habits. The response rate was over 80 per cent. Although both the level of alcohol consumption and the prevalence of hazardous consumption were lower than the corresponding figures for students at Stockholm and Uppsala Universities, 12 per cent of the male and four per cent of the female medical students were considered to be at risk of alcohol problems. About seven per cent of the medical students reported having used illegal drugs such as hashish, marijuana and cocaine during the past 12-month period, and about nine per cent to have used sedative and/or hypnotic drugs.
In a study to determine the site and preceptor characteristics most valued by clerks and residents in the ambulatory setting we wished to confirm whether these would support effective learning. The deep approach to learning is thought to be more effective for learning than surface approaches. In this study we determined how the approaches to learning of clerks and residents predicted the valued site and preceptor characteristics in the ambulatory setting.
Postal survey of all medical residents and clerks in training in Ontario determining the site and preceptor characteristics most valued in the ambulatory setting. Participants also completed the Workplace Learning questionnaire that includes 3 approaches to learning scales and 3 workplace climate scales. Multiple regression analysis was used to predict the preferred site and preceptor characteristics as the dependent variables by the average scores of the approaches to learning and perception of workplace climate scales as the independent variables.
There were 1642 respondents, yielding a 47.3% response rate. Factor analysis revealed 7 preceptor characteristics and 6 site characteristics valued in the ambulatory setting. The Deep approach to learning scale predicted all of the learners' preferred preceptor characteristics (beta = 0.076 to beta = 0.234, p
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BACKGROUND: American Indians and Alaska Natives (AI/ANs) remain underrepresented in the medical profession. This study sought to understand the supports and barriers that AI/AN students encountered on their path to successful medical school entry. METHOD: The research team analyzed qualitative semistructured, one-on-one, confidential interviews with 10 AI/AN medical students to identify salient support and barrier themes. RESULTS: Supports and barriers clustered in eight categories: educational experiences, competing career options and priorities, health care experiences, financial factors, cultural connections, family and friends, spirituality, and discrimination. Some of the most notable findings of this study include the following: (1) students reported financial barriers severe enough to constrain participation in the medical school application process, and (2) spirituality played an important role as students pursued a medical career. CONCLUSION: Promoting AI/AN participation in medical careers can be facilitated with strategies appropriate to the academic, financial, and cultural needs of AI/AN students.
There are different teaching styles for delivering competency-based curricula. The education literature suggests that learning is maximized when teaching is delivered in a style preferred by learners.
To determine if dermatology residents report learning style preferences aligned with adult learning.
Dermatology residents attending an introductory cutaneous biology course completed a learning styles inventory assessing self-reported success in 35 active and passive learning activities. The 35 learning activities were ranked in order of preference by learners.
Mean overall ratings for active learning activities were significantly higher than for passive learning activities (P = 0.002).
Trends in dermatology resident learning style preferences should be considered during program curriculum development. Programs should integrate a variety of curriculum delivery methods to accommodate various learning styles, with an emphasis on the active learning styles preferred by residents.
To assess stress in medical students, residents, and graduate science students at four Canadian schools of medicine.
Four schools with different curricula in three different parts of Canada participated in the study: the University of Calgary Faculty of Medicine, the University of Alberta Faculty of Medicine, the Dalhousie University Faculty of Medicine, and the McMaster University Faculty of Health Sciences. All the medical students, residents, and graduate science students at each school were surveyed in 1994-95. The three instruments used were the University of Calgary Stress Questionnaire, the Social Readjustment Rating Scale (SRRS), and the Symptom Checklist-90. Demographic data were compared across all four schools. Analysis of variance was calculated for all test-item scores, utilizing a four (school) by three (program) by two (gender) design, which were all between subject factors. Significant main effects were followed up by using planned comparisons (Newman-Keuls, with a probability level of p