Medical Student’s Use of Time During Clinical Clerkships and the Credits Based System

Introduction: Comprehensive undergraduate education in clinical sciences is grounded on activities developed during clerkships. To implement the credits system we must know how these experiences take place. Objectives: to describe how students spend time in clerkships, how they assess the educative value of activities and the enjoyment it provides. Method: We distributed a form to a random clustered sample of a 100 students coursing clinical sciences, designed to record the time spent, and to assess the educative value and the grade of enjoyment of the activities in clerkship during a week. Data were registered and analyzed on Excel® 98 and SPSS. Results: mean time spent by students in clerkship activities on a day were 10.8 hours. Of those, 7.3 hours (69%) were spent in formal education activities. Patient care activities with teachers occupied the major proportion of time (15.4%). Of the teaching and learning activities in a week, 28 hours (56%) were spent in patient care activities and 22.4 hours (44.5%) were used in independent academic work. The time spent in teaching and learning activities correspond to 19 credits of a semester of 18 weeks. The activities assessed as having the major educational value were homework activities (4.6) and formal education activities (4.5). The graded as most enjoyable were extracurricular activities, formal educational activities and independent academic work. Conclusion: our students spend more time in activities with patients than the reported in literature. The attending workload of our students is greater than the one reported in similar studies.

Orde Wingate in the Sudan, 1928-1933: Formative Experiences of the Chindit Commander

This short paper looks at Orde Wingate's role in armed policing and counter-bandit operations in Sudan during his time with the Sudan Defence Force.

Operatives’ experiences of cultural diversity on Australian construction sites

Construction sites are among Australia's most culturally diverse workplaces. A survey of 1155 construction operatives on Australian construction sites investigated, for the first time, the extent of this diversity and how it is experienced by workers. Results show that while cultural diversity presents organizational challenges by segregating the workforce, operatives' cultural groups also perform positive functions such as maintaining positive bonds among group members and providing group support and safe havens. While there broadly appears to be equality of opportunity for all cultural groups, there is significant evidence of differential treatment for some groups, particularly in relation to accessing higher paying jobs, offensive graffiti and racist joke telling. Language barriers are one of the major challenges affecting work and social relations between different cultural groups and there is evidence that this has a detrimental impact upon safety.

Challenging climate change and migration discourse: different understandings of time-scale and temporality in the Maldives

This article draws on ongoing research in the Maldives to explore differences between elite and non-elite perceptions of climate change and migration. It argues that, in addition to variations in perceptions based on diverse knowledge, priorities and agendas, there exists a more fundamental divergence based upon different understandings of the time-scale of climate change and related ideas of urgency and crisis. Specifically, elites tend to focus on a distant future which is generally abstracted from people’s everyday lived realities, as well as utilise the language of a climate change-induced migration ‘crisis’ in their discussions about impacts in a manner not envisaged by non-elites. The article concludes that, rather than unproblematically mapping global, external facing narratives wholesale onto ordinary people’s lives and experiences, there needs to be more dialogue between elites and non-elites on climate change and migration issues. These perspectives should be integrated more effectively in the development of policy interventions designed to help people adapt to the impacts of global environmental change.

Parents' experiences of their children's presence in discussions with physicians about leukemia

OBJECTIVE: We aimed to examine parents' views regarding their preadolescent child's presence during discussions about serious illnesses. METHODS: In-depth qualitative interviews with parents of children receiving treatment for acute lymphoblastic leukemia were conducted. Parents were sampled from 6 UK treatment centers. Analysis was informed by the constant comparative method and content analysis. RESULTS: We report on interviews with 53 parents (33 mothers, 20 fathers). Parents acknowledged the benefits of communicating openly with children, but few thought that their child's presence in discussions was straightforwardly desirable. They described how their child's presence restricted their own communication with physicians, made concentrating difficult, and interfered with their efforts to care for their child emotionally. Children's presence was particularly difficult when significant issues were being discussed, including prognoses, adverse results, and certain medical procedures. Parents felt that such discussions posed a potential threat to their child, particularly when they had not first had an opportunity to discuss information with the physician separately from the child. In contrast, separate meetings enabled parents to absorb information and to convey it to their child at an appropriate time and in a reassuring way. Some parents experienced difficulties in accessing separate meetings with physicians. CONCLUSIONS: The difficulties parents described could potentially be addressed by extending, beyond the diagnosis period, the practice of sequencing significant information so that it is communicated to parents in separate meetings before being communicated to the child and by periodically exploring with parents what information would be in each child's interests.

Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment

Background: Attention deficit hyperactivity disorder (ADHD) can be treated with stimulant medication such as methylphenidate. Although effective, methylphenidate can cause serious side-effects, including suppressed appetite, growth retardation and sleep problems. A drug holiday is a deliberate interruption of pharmacotherapy for a defined period of time and for a specific clinical purpose, for example for appeasing side-effects. Whilst some international guidelines recommend introducing drug holidays in ADHD treatment, this is not practised routinely. Our aim was to examine the views and experiences of planned drug holidays from methylphenidate with adults who have responsibility for treatment decisions in children and adolescents with ADHD. Method: In-depth interviews were carried out. Child and Adolescent Mental Health Services (CAMHS) practitioners (n=8), General Practitioners (n=8), teachers (n=5), and mothers of children with ADHD (n=4) were interviewed in a UK setting. Interview transcripts were analysed using grounded theory. Results: Methylphenidate eases the experience of the child amid problems at home and at school and once started is mostly continued long-term. Some families do practise short-term drug holidays at weekends and longer-term ones during school holidays. The decision to introduce drug holidays is influenced by the child’s academic progress, the parents’ ability to cope with the child, as well as medication beliefs. Trialling a drug holiday is thought to allow older children to self-assess their ability to manage without medication when they show signs of wanting to discontinue treatment prematurely. Conclusions: Planned drug holidays could address premature treatment cessation by enabling adolescents to assess repercussions under medical supervision.

E-learning opens the door to the global community. Novice users experiences of e-learning in a Somali University

E-learning has become one of the primary ways of delivering education around the globe. In Somalia, which is a country torn within and from the global community by a prolonged civil war, University of Hargeisa has in collaboration with Dalarna University in Sweden adopted, for the first time, e-learning. This study explores barriers and facilitators to e-learning usage, experienced by students in Somalia’s higher education, using the University of Hargeisa as case study. Interviews were conducted with students to explore how University of Hargeisa’s novice users perceived elearning, and what factors positively and negatively affected their e-learning experiences. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was used as a framework for interpreting the results. The findings show that, in general, the students have a very positive attitude towards e-learning, and they perceived that e-learning enhanced their educational experience. The communication aspect was found to be especially important for Somali students, as it facilitated a feeling of belonging to the global community of students and scholars and alleviated the war-torn country’s isolation. However, some socio-cultural aspects of students’ communities negatively affected their e-learning experience. This study ends with recommendations based on the empirical findings to promote the use and enhance the experience of e-learning in post conflict Somali educational institutions

The phenomenological experiences of Autobiographical Memory: A cross-sectional and a longitudinal study

Phenomenology is a critical component of autobiographical memory retrieval. Some memories are vivid and rich in sensory details whereas others are faded; some memories are experienced as emotionally intense whereas others are not. Sutin and Robins (2007) identified 10 dimensions in which a memory may vary—i.e., Vividness, Coherence, Accessibility, Sensory Details, Emotional Intensity, Visual Perspective, Time Perspective, Sharing, Distancing, and Valence—and developed a comprehensive psychometrically sound measure of memory phenomenology, the Memory Experiences Questionnaire (MEQ). Phenomenology has been linked to underlining stable dispositions—i.e. personality, as well as to a variety of positive/negative psychological outcomes—well-being and life satisfaction, depression and anxiety, among others. Using the MEQ, a cross-sectional and a longitudinal study were conducted on a large sample of American and Italian adults. In both studies, participants retrieved two ‘key’ personal memories, a Turning Point and a Childhood Memory, and rated the affect and phenomenology of each memory. Participants also completed self-reported measures of personality (i.e. Neuroticism and Conscientiousness), and measures of depression, well-being and life satisfaction. The present research showed that phenomenological ratings tend (a) to cross-sectionally increase across adulthood (Study 1), and (b) to be moderately stable over time, regardless the contents of the memories (Study 2). Interrelations among memory phenomenology, personality and psychological outcome variables were also examined (Study 1 and Study 2). In particular, autobiographical memory phenomenology was proposed as a dynamic expression of personality functioning that partially explains adaptive/maladaptive psychological outcomes. In fact, the findings partially supported the hypothesized mediating effect of phenomenology on the personality association with psychological outcomes. Implications of the findings are discussed proposing future lines of research. In particular, the need for more longitudinal studies is highlighted, along with the combined application of both self-report questionnaires and narrative measures.

[Experiences of patients and family members during the stay on a nursing unit]

In 2004, the university hospital of Berne ran a pilot project with a Nursing Unit (NU). In this unit patients who no longer needed a close surveillance by physicians were cared for. They needed primarily complex professional nursing care which could not be provided by other hospitals, nursing homes, home care or family members. The nurses were responsible for the coordination of care. This qualitative study investigated experiences of patients and family members with the care concept of the NU. Thematically focused interviews were conducted with nine patients and five family members. Qualitative content analysis was used for data analysis. Results show that patients and family members mostly accepted the new care concept. They positively experienced the quiet and restful atmosphere, the patient-centred and continuous care by competent nurses, the education and the discharge planning. Some study participants reported missing information at the time of their transfer to the NU, insufficient assessments or unsuitable educational scripts. The study provides evidence to positive effects of a patient-centred care approach.

Capitalisation of Experiences of the Swiss Support to Sustainable Management of Natural Resources (SMNR) in Bulgaria

Following the collapse of the communist regime in 1989, Bulgaria has undergone dramatic political, economic and social transformations. The transition process of the past two decades was characterized by several reforms to support democratisation of the political system and the functioning of a free-market economy. Since 1992, Switzerland has been active in Bulgaria providing assistance to the transition process, with support to Sustainable Management of Natural Resources (SMNR) starting in 1995. The SMNR Capitalisation of Experiences (CapEx) took place between March and September 2007, in the context of SDC phasing out its programmes in Bulgaria by the end of 2007 due to the country’s accession to the European Union. The CapEx exercise has culminated in the identification of 17 lessons learned. In the view of the CapEx team, many of these lessons are relevant for countries that are in the process of joining the EU, facing similar democratisation challenges as Bulgaria. Overall, the Swiss SMNR projects have been effective entry points to support areas that are crucial to democratic transitions, namely participation in public goods management, decentralisation, human capacity development in research and management, and preparation for EU membership. The specificity of the Swiss support stems from an approach that combines a long-term commitment with a clear thematic focus (forestry, biodiversity conservation and organic agriculture). The multistakeholder approach and diversification of support between local, regional and national levels are also important elements that contributed to make a difference in relation to other donors supporting the Bulgarian transition. At the institutional level, there are a number of challenges where the contribution of SMNR activities was only modest, namely improving the legal framework and creating more transparency and accountability, both of which are time and resource-consuming processes. In addition, the emergence of competent and sustainable non-government organisations (NGOs) is a complex process that requires support to membership based organisations, a challenge that was hardly met in the case of SMNR. Finally, reform of government institutions involved in management of natural resources is difficult to achieve via project support only, as it requires leverage and commitment at the level of policy dialogue. At the programme management level, the CapEx team notes that corruption was not systematically addressed in SMNR projects, indicating that more attention should be given to this issue at the outset of any new project.

Exploring the Experiences of International Student-Athletes

According to the latest National Collegiate Athletic Association (NCAA) Student Athlete Ethnicity Report, there are 17,653 non-US citizen student-athletes competing in various sports in universities across the country, yet there is very little research to understand their experiences (NCAA, 2010). Previous research has focused on recruitment practices (Bale, 1991; Pierce, Popp, & Meadows, 2011), satisfaction (Trendafilova, Kim, & Hardin, 2010), and adjustment and transitional factors (Pierce, Popp, & Meadows, 2011; Popp, Love, Kim, & Hums, 2010; Ridinger & Pastore, 2000), with a void in examining their overall experiences. Therefore, purpose of this qualitative study was to explore the experiences of international student-athletes in the United States within their athletic department and universities, as well as in the country. Participants were solicited by email, and ultimately six (n = 6) international student-athletes from a Division-I university chose to participate in the study and represented two different countries of origin, Canada and Norway. Participants completed a semi-structured interview, consisting of one broad open-ended question followed by a series of specific follow-up questions. Content analysis revealed that most participants did not consider their experiences different than domestic student-athletes. Challenges shared by most athletes included language barriers, balancing their time, and homesickness. Results also revealed the importance of interpersonal connections, especially with coaches and athletes from the international student-athlete's home country, in ensuring a positive overall experience. Implications of this study are that individuals and professionals working in campus offices associated with international student-athletes should be mindful of their unique roles within the university in order to foster positive experiences and retention.

A quantitative assessment of students’ experiences of studying music: a Spanish perspective on the European credit transfer system (ECTS)

The purpose of this investigation is to evaluate whether or not the allocation of time proposed in the Music Study Guide, adapted from the European Higher Education Area (EHEA) guidelines, is consistent and adequate for students with minimal musical knowledge. The report takes into account the importance of students’ previous knowledge and the relation this has to the time and effort expended by students in acquiring appropriate knowledge and skills. This is related also to the adequacy of the course specification to meet the demands of university study and the labour market. Results show that those students who enrolled at university without any previous musical knowledge are likely to experience significant difficulty in the acquisition of certain musical and professional competences. This highlights a need to reinforce the music curriculum, or establish zero-level courses, in order to enable such students to succeed in the subject.

The Developmental Experiences of Adolescent Females in Structured Basketball Programs

The purpose of the present study was to determine whether adolescent females had unique developmental experiences in different types of basketball programs. The Youth Experiences Survey 2.0 [YES] (Hansen & Larson, 2005) was used to measure the learning experiences of 14 and 15 year old females (n = 212) who were enrolled in a school, recreational, or competitive basketball program. Interviews with organization representatives were conducted to determine the structure of each basketball program (n= 16) from which participants were drawn. One-way ANOVAs and Bonferroni comparisons were used to compare YES 2.0 positive experience scale scores of participants in school, recreational and competitive basketball programs. Results revealed that females in recreational programs had significantly lower scores than those in competitive and school programs on numerous positive experiences scales. Mann-Whitney U tests found that those in school and competitive programs reported higher stress levels. Interview results indicate that four characteristics of competitive and school programs may contribute to participants in these programs reporting more growth experiences: 1) time commitment, 2) coaches’ training and background, 3) competition, and 4) volunteer opportunities.

Cultivating Care: Understanding Intimate Partner Violence Experiences of Undocumented Latinas in Washington State

Thesis (Ph.D.)--University of Washington, 2016-06

'Urine testing is a waste of time': newly diagnosed Type 2 diabetes patients' perceptions of self-monitoring

Aims To date, there is no convincing evidence that non-insulin treated patients who undertake self-blood glucose monitoring (SBGM) have better glycaemic control than those who test their urine. This has led to a recommendation that non-insulin dependent patients undertake urine testing, which is the cheaper option. This recommendation does not take account of patients' experiences and views. This study explores the respective merits of urine testing and SBGM from the perspectives of newly diagnosed patients with Type 2 diabetes. Methods Qualitative study using repeat in-depth interviews with 40 patients. Patients were interviewed three times at 6-monthly intervals over 1 year. Patients were recruited from hospital clinics and general practices in Lothian, Scotland. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results Patients reported strongly negative views of urine testing, particularly when they compared it with SBGM. Patients perceived urine testing as less convenient, less hygienic and less accurate than SBGM. Most patients assumed that blood glucose meters were given to those with a more advanced or serious form of diabetes. This could have implications for how they thought about their own disease. Patients often interpreted negative urine results as indicating that they could not have diabetes. Conclusions Professionals should be aware of the meanings and understandings patients attach to the receipt and use of different types of self-monitoring equipment. Guidelines that promote the use of consistent criteria for equipment allocation are required. The manner in which negative urine results are conveyed needs to be reconsidered.