Influence of experience and training on dental students’ examination performance regarding panoramic images

Physician training has greatly benefitted from insights gained in understanding the manner in which experts search medical images for abnormalities. The aims of this study were to compare the search patterns of 30 fourth-year dental students and 15 certified oral and maxillofacial radiologists (OMRs) over panoramic images and to determine the most robust variables for future studies involving image visualization. Eye tracking was used to capture the eye movement patterns of both subject groups when examining 20 panoramic images classified as normal or abnormal. Abnormal images were further subclassified as having an obvious, intermediate, or subtle abnormality. The images were presented in random order to each participant, and data were collected on duration of the participants’ observations and total distance tracked, time to first eye fixation, and total duration and numbers of fixations on and off the area of interest (AOI). The results showed that the OMRs covered greater distances than the dental students (p<0.001) for normal images. For images of pathosis, the OMRs required less total time (p<0.001), made fewer eye fixations (p<0.01) with fewer saccades (p<0.001) than the students, and required less time before making the first fixation on the AOI (p<0.01). Furthermore, the OMRs covered less distance (p<0.001) than the dental students for obvious pathoses. For investigations of images of pathosis, time to first fixation is a robust parameter in predicting ability. For images with different levels of subtlety of pathoses, the number of fixations, total time spent, and numbers of revisits are important parameters to analyze when comparing observer groups with different levels of experience.

Influence of experience and training on dental students’ examination performance regarding panoramic images.

Physician training has greatly benefitted from insights gained in understanding the manner in which experts search medical images for abnormalities. The aims of this study were to compare the search patterns of 30 fourth-year dental students and 15 certified oral and maxillofacial radiologists (OMRs) over panoramic images and to determine the most robust variables for future studies involving image visualization. Eye tracking was used to capture the eye movement patterns of both subject groups when examining 20 panoramic images classified as normal or abnormal. Abnormal images were further subclassified as having an obvious, intermediate, or subtle abnormality. The images were presented in random order to each participant, and data were collected on duration of the participants’ observations and total distance tracked, time to first eye fixation, and total duration and numbers of fixations on and off the area of interest (AOI). The results showed that the OMRs covered greater distances than the dental students (p<0.001) for normal images. For images of pathosis, the OMRs required less total time (p<0.001), made fewer eye fixations (p<0.01) with fewer saccades (p<0.001) than the students, and required less time before making the first fixation on the AOI (p<0.01). Furthermore, the OMRs covered less distance (p<0.001) than the dental students for obvious pathoses. For investigations of images of pathosis, time to first fixation is a robust parameter in predicting ability. For images with different levels of subtlety of pathoses, the number of fixations, total time spent, and numbers of revisits are important parameters to analyze when comparing observer groups with different levels of experience.

Medical faculty and students, 1865

Standing in front of the class (from left) are Abram Sager, Alonzo Palmer, Corydon Ford, Moses Gunn, and Silas Douglas (source: Not Just Any Medical School by Horace W. Davenport). On verso: March 1865. Dr. J. Ballard, then at 20 ... Gift of Dr. Elmer Belt, Los Angeles, Calif.

Predictors of success: Medical Laboratory Associate in Science Degree Program

Hospitals and healthcare facilities in the United States are facing serious shortages of medical laboratory personnel, which, if not addressed, stand to negatively impact patient care. The problem is compounded by a reduction in the numbers of academic programs and resulting decrease in the number of graduates to keep up with the increase in industry demands. Given these challenges, the purpose of this study was to identify predictors of success for students in a selected 2-year Medical Laboratory Technology Associate in Science Degree Program. ^ This study examined five academic factors (College Placement Test Math and Reading scores, Cumulative GPA, Science GPA, and Professional [first semester laboratory courses] GPA) and, demographic data to see if any of these factors could predict program completion. The researcher examined academic records for a 10-year period (N =158). Using a retrospective model, the correlational analysis between the variables and completion revealed a significant relationship (p < .05) for CGPA, SGPA, CPT Math, and PGPA indicating that students with higher CGPA, SGPA, CPT Math, and PGPA were more likely to complete their degree in 2 years. Binary logistic regression analysis with the same academic variables revealed PGPA was the best predictor of program completion (p < .001). ^ Additionally, the findings in this study are consistent with the academic part of the Bean and Metzner Conceptual Model of Nontraditional Student Attrition which points to academic outcome variables such as GPA as affecting attrition. Thus, the findings in this study are important to students and educators in the field of Medical Laboratory Technology since PGPA is a predictor that can be used to provide early in-program intervention to the at-risk student, thus increasing the chances of successful timely completion.^

Convergence and translation: attitudes to inter-professional learning and teaching of creative problem-solving among medical and engineering students and staff

Background: Healthcare worldwide needs translation of basic ideas from engineering into the clinic. Consequently, there is increasing demand for graduates equipped with the knowledge and skills to apply interdisciplinary medicine/engineering approaches to the development of novel solutions for healthcare. The literature provides little guidance regarding barriers to, and facilitators of, effective interdisciplinary learning for engineering and medical students in a team-based project context. Methods: A quantitative survey was distributed to engineering and medical students and staff in two universities, one in Ireland and one in Belgium, to chart knowledge and practice in interdisciplinary learning and teaching, and of the teaching of innovation. Results: We report important differences for staff and students between the disciplines regarding attitudes towards, and perceptions of, the relevance of interdisciplinary learning opportunities, and the role of creativity and innovation. There was agreement across groups concerning preferred learning, instructional styles, and module content. Medical students showed greater resistance to the use of structured creativity tools and interdisciplinary teams. Conclusions: The results of this international survey will help to define the optimal learning conditions under which undergraduate engineering and medicine students can learn to consider the diverse factors which determine the success or failure of a healthcare engineering solution.

Help-seeking behaviors and mental well-being of first year undergraduate university students

University students demonstrate poor help-seeking behaviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-being, and to explore these students’ views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a university in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students’ knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group.

Knowledge, perceptions and attitudes on the sexuality of nursing students and teachers

Introduction: The personal attitudes regarding specific aspects of sexuality are of interest to practices of personal concern, as they are to practices inserted in professional roles. General attitudes towards sexuality and sexual health were evaluated. Objectives: To describe the perceptions and attitudes of students and nursing teachers about sexuality. Methods: We used a mixed methods design with a sequential strategy: QUAN→qual of descriptive and explanatory type. 646 students and teachers participated. The Sexual Attitudes Scale (EAS) of Hendrick & Hendrick (Alferes, 1999) and Attitude Scale Address Sexual and Reproductive Health (EAFSSR) of Nemčić et al (Abreu, 2008) were used. Results: There are significant differences in the level of knowledge about sexuality depending on the sample (χ2KW (2)=18.271; p=.000): students of 1st year have lower levels. The profile of the four dimensions of EAS per sample is identical in all 3 samples, having responsibility the highest average value. In subscales EAFSSR per sample and sex there are significant diferences (p<.05) for all samples and uniform pattern was noted: females have higher median values, indicating that they have more favorable attitudes towards sexual health. Conclusions: Sexual attitudes reveal a multidimensional structure based in the female identity, that shows responsibility towards family planning and sexual education, as well as towards individual self-care regarding the body and sexual and reproductive health. An attitudinal profile by gender emerges, accentuating the polarity between male and female. The importance of the training process in nursing following the personal and social development of students is corroborated.

Late Entry into HIV Care: Estimated Impact on AIDS Mortality Rates in Brazil, 2003-2006

Background: Worldwide, a high proportion of HIV-infected individuals enter into HIV care late. Here, our objective was to estimate the impact that late entry into HIV care has had on AIDS mortality rates in Brazil. Methodology/Principal Findings: We analyzed data from information systems regarding HIV-infected adults who sought treatment at public health care facilities in Brazil from 2003 to 2006. We initially estimated the prevalence of late entry into HIV care, as well as the probability of death in the first 12 months, the percentage of the risk of death attributable to late entry, and the number of avoidable deaths. We subsequently adjusted the annual AIDS mortality rate by excluding such deaths. Of the 115,369 patients evaluated, 50,358 (43.6%) had entered HIV care late, and 18,002 died in the first 12 months, representing a 16.5% probability of death in the first 12 months (95% CI: 16.3-16.7). By comparing patients who entered HIV care late with those who gained timely access, we found that the risk ratio for death was 49.5 (95% CI: 45.1-54.2). The percentage of the risk of death attributable to late entry was 95.5%, translating to 17,189 potentially avoidable deaths. Averting those deaths would have lowered the 2003-2006 AIDS mortality rate by 39.5%. Including asymptomatic patients with CD4(+) T cell counts >200 and <= 350 cells/mm(3) in the group who entered HIV care late increased this proportion by 1.8%. Conclusions/Significance: In Brazil, antiretroviral drugs reduced AIDS mortality by 43%. Timely entry would reduce that rate by a similar proportion, as well as resulting in a 45.2% increase in the effectiveness of the program for HIV care. The World Health Organization recommendation that asymptomatic patients with CD4(+) T cell counts <= 350 cells/mm(3) be treated would not have a significant impact on this scenario.

The Rural Clinical Division: a student journey to rural medicine

Background: The University of Queensland has through an Australian Government initiative, established a Rural Clinical Division (RCD) at four regional sites in the southern and central Queensland. Over the fi rst four years of the existence of the RCD, an integrated package of innovative medical education has been developed. Method: The integrated aspects of the RCD program include: The Rural Medical Rotation: Every medical student undertakes an eight week rural rotation in Year 3. Year 3 and 4 MBBS - 100 students are currently spending one to two years in the rural school and demand is increasing. Interprofessional Education - Medical and Allied Health students attend lectures, seminars and workshops together and often share the same rural clinical placement. Rural health projects - allow students to undertake a project of benefi t to the rural community. Information Technology (IT) - the Clinical Discussion Board (CDB) and Personal Digital Assistants (PDA) demonstrate the importance of IT to medical students in the 21st century. Changing the Model of Medical Education - The Leichhardt Community Attachment Placement (LCAP), is a pilot study that resulted in the addition of three interns to the rural workforce. All aspects of the RCD are evaluated with surveys using both qualitative and quantitative free response questions, completed by all students regularly throughout the academic year. Results: Measures of impact include: Student satisfaction and quality of teaching surveys – 86-91% of students improved their clinical skills and understanding across all rotations. Academic results and progress – RCD students out-perform their urban colleagues. Intent to work in rural areas – 90% of students reported a greater interest in rural medicine. Intern numbers – rural / regional intern placements are increasing. Conclusions: The RCD proves to be a site for innovations all designed to help reach our primary goal of fostering increased recruitment of a rural medical workforce.

Challenge or opportunity: can regional training hospitals capitalise on the impending influx of interns?

To the Editor: The increase in medical graduates expected over the next decade presents a huge challenge to the many stakeholders involved in providing their prevocational and vocational medical training. 1 Increased numbers will add significantly to the teaching and supervision workload for registrars and consultants, while specialist training and access to advanced training positions may be compromised. However, this predicament may also provide opportunities for innovation in the way internships are delivered. Although facing these same challenges, regional and rural hospitals could use this situation to enhance their workforce by creating opportunities for interns and junior doctors to acquire valuable experience in non-metropolitan settings. We surveyed a representative sample (n = 147; 52% of total cohort) of Year 3 Bachelor of Medicine and Bachelor of Surgery students at the University of Queensland about their perceptions and expectations of their impending internship and the importance of its location (ie, urban/metropolitan versus regional/rural teaching hospitals) to their future training and career plans. Most students (n = 127; 86%) reported a high degree of contemplation about their internship choice. Issues relating to career progression and support ranked highest in their expectations. Most perceived internships in urban/metropolitan hospitals as more beneficial to their future career prospects compared with regional/rural hospitals, but, interestingly, felt that they would have more patient responsibility and greater contact with and supervision by senior staff in a regional setting (Box). Regional and rural hospitals should try to harness these positive perceptions and act to address any real or perceived shortcomings in order to enhance their future workforce.2 They could look to establish partnerships with rural clinical schools3 to enhance recruitment of interns as early as Year 3. To maximise competitiveness with their urban counterparts, regional and rural hospitals need to offer innovative training and career progression pathways to junior doctors, to combat the perception that internships in urban hospitals are more beneficial to future career prospects. Partnerships between hospitals, medical schools and vocational colleges, with input from postgraduate medical councils, should provide vertical integration4 in the important period between student and doctor. Work is underway to more closely evaluate and compare the intern experience across regional/rural and urban/metropolitan hospitals, and track student experiences and career choices longitudinally. This information may benefit teaching hospitals and help identify the optimal combination of resources necessary to provide quality teaching and a clear career pathway for the expected influx of new interns.

The prevalence of Helicobacter pylori in practising dental staff and dental students

Recent studies suggest Helicobacter pylori is spread by faecal-oral or oral-oral transmission. Gastroenterologists who are exposed to gastric secretions and saliva have a high prevalence of H. pylori infection. Venous blood was obtained from 92 dentists, 40 dental nurses, 33 fifth year and 30 first year dental students. An ELISA assay was used to detect H. pylori IgG antibodies. Results were compared with an age and sex matched normal population. The prevalence of H. pylori infection in dentists, dental nurses, fifth year dental students and first year dental students were 23 per cent, 18 per cent, 18 per cent and 16 per cent, respectively. There were no significant differences when compared with the normal population controls. The prevalence of H. pylori antibody was not significantly increased with years of practice or patient contact time in dentists and dental nurses. Helicobacter pylori infection is uncommon in dental professionals working in the oral cavity.

An Ethics Core Curriculum for Australasian Medical Schools

Teaching ethics incorporates teaching of knowledge as well as skills and attitudes. Each of these requires different teaching and assessment methods. A core curriculum of ethics knowledge must address both the foundations of ethics and specific ethical topics. Ethical skills teaching focuses on the development of ethical awareness, moral reasoning, communication and collaborative action skills. Attitudes that are important for medical students to develop include honesty, integrity and trustworthiness, empathy and compassion, respect, and responsibility, as well as critical self-appraisal and commitment to lifelong education.

Crescer com saúde. Perspectiva dos professores do 1.º ciclo acerca da postura dos alunos e análise postural de crianças com 6 a 7 anos inseridas na comunidade escolar

O presente estudo teve como objectivos conhecer a percepção dos professores do ensino básico acerca da postura corporal dos alunos na sala de aula e analisar a postura de alunos do 1º ano do ensino básico. Este estudo foi realizado numa escola do 1º Ciclo, com 6 professores voluntários e 40 alunos do 1º ano. Na I parte referente ao estudo qualitativo, realizou-se uma discussão por grupo focal, com um roteiro de perguntas que os professores foram discutindo livremente expondo as suas opiniões. Concluiu-se que há por parte dos professores noção de como é a postura corporal dos alunos na sala de aula, como essa postura corporal, pode influenciar de forma, positiva ou negativa o estado de saúde do aluno na sala de aula e comprometer a qualidade de vida dos alunos. Na II parte quantitativa os alunos foram avaliados através do registo fotográfico, num programa de avaliação postural, demonstrando os resultados que na amostra em estudo não foi encontrado desvio vertical significativo entre a cintura escapular e a cintura pélvica. No entanto, foi encontrado desvio horizontal significativo do alinhamento das omoplatas entre si e das espinhas ilíacas postero-superiores entre si, já indicando um início de desvio postural com carácter escoliótico. Conclui-se pois que os alunos avaliados apresentavam problemas posturais com necessidade de serem acompanhados por Fisioterapeutas.

Avaliação da postura corporal em estudantes do ensino superior

A Era moderna trouxe ao Homem meios que facilitam muitas das suas tarefas diárias, diminuindo a actividade física e condicionando a postura corporal. Actualmente a população jovem, e sobretudo os estudantes, encontra-se exposta a uma grande quantidade de riscos de alterações posturais. Todavia, a postura assumida por parte desta classe não tem sido muito investigada. Sendo assim, este estudo tem como objectivo geral a avaliação bi-dimensional da postura corporal, na posição de pé e de sentado, de estudantes do 1º ano do Curso de Terapia Ocupacional, do Instituto Politécnico de Leiria. Os objectivos específicos centram-se na verificação das relações entre as alterações posturais desse grupo de estudantes e os sintomas de lesões músculo-esqueléticas nos últimos 12 meses, os factores sócio-demográficos e os factores considerados de risco de alterações posturais em estudantes. Para tal, utilizaram-se o Software para Avaliação Postural e a Versão adaptada do Questionário Nórdico Músculoesquelético. Constataram-se elevadas percentagens de posturas inadequadas. Na posição de pé todos os indivíduos apresentam alterações posturais num ou mais segmentos analisados, sendo que a flexão do tronco é a mais frequente. Já na posição sentada a alteração postural mais frequente é a inclinação da cabeça para o lado direito. Verificou-se ainda que algumas das alterações posturais apresentam uma relação positiva e significativa com os sintomas de lesões músculo-esqueléticas, com alguns factores de risco e sócio-demográficos. A partir dos resultados obtidos, torna-se evidente a necessidade de estabelecer programas de consciencialização para esta problemática, assim como programas de prevenção de desvios posturais.

A influência do modelo pedagógico em variáveis psicológicas de estudantes do 1º ano da ESTSP-IPP

Introdução – A adaptação ao ensino superior reveste-se de experiências académicas que podem constituir fonte de stress para os estudantes. A implementação de novos modelos pedagógicos, no âmbito do processo de Bolonha, introduz novas variáveis cujo impacto, designadamente em termos de saúde, importa conhecer. Este estudo tem como objetivo analisar as associações entre modelo pedagógico (Problem Based Learning – PBL vs. modelos próximos do tradicional) e variáveis psicológicas (coping, desregulação emocional, sintomas psicossomáticos, perceção de stress e afeto). Metodologia – O estudo tem um design transversal. Foram usados os seguintes questionários online: Brief-COPE, Escala de Dificuldades de Regulação Emocional, Questionário de Manifestações Físicas de Mal-Estar, Escala de Stress Percebido e Escala de Afeto Positivo e Negativo. A amostra é constituída por 183 estudantes do primeiro ano (84% do género feminino) de cursos da Escola Superior de Tecnologia da Saúde do Porto – Instituto Politécnico do Porto (ESTSP-IPP). Resultados – Foram encontradas correlações significativas entre as variáveis demográficas e psicológicas. Considerando diferentes modelos pedagógicos, foram encontradas diferenças significativas nas variáveis psicológicas. Os principais preditores de stress na amostra foram: ser mulher, frequentar uma licenciatura no modelo PBL, ter maiores índices de desregulação emocional, apresentar mais sintomas psicossomáticos, menos afeto positivo e mais afeto negativo. Conclusão – As diferenças encontradas entre modelos pedagógicos são discutidas, possibilitando a reflexão sobre as implicações práticas e sugestões para futuras investigações.