Prevalence of Anxiety and Depression among Medical Students

ABSTRACT Background Medical students are a vulnerable population to develop depression and anxiety disorders. Objective To estimate the prevalence and associated factors of anxiety and depression among medical students. Methods A cross-sectional study with a random sample (n = 346) of medical students at a Brazilian university was performed. The Beck Depression Anxiety Inventory was used to measure anxiety and depression levels. Crude and adjusted analyses were performed using Poisson regression. Results The prevalence of anxiety was 35.5% and depression was 32.8%. The prevalence of anxiety and depression was 14% higher and 16% higher among women (p = 0.025 and p = 0.006, respectively). Students whose parents were not physicians reported 23% higher prevalence of anxiety (p = 0.006), and those who had physician parents reported 29% higher prevalence of depression (p = 0.034). Those who always or often felt pushed by their parents showed 22% higher prevalence of anxiety (p =.006) and 19% higher depression (p = 0.016). Students who had concerns over the future had 15% higher prevalence of depression (p = 0.017). Conclusion The prevalence of anxiety and depressive symptoms was higher than the average found in the general population.

Knowledge of Guidelines for Cardiopulmonary Resuscitation among Brazilian Medical Students

ABSTRACT Introduction Sudden death is a substantial public health problem, representing a major cause of mortality worldwide. Suitable initial care is essential for a good prognosis of these patients. Objectives To assess the knowledge of the 2010 guidelines for cardiopulmonary resuscitation (CPR) among medical students in their final year of undergraduate training. Methods This was a cross-sectional study with a sample of 217 medical students enrolled in the sixth year of accredited medical schools in Brazil. A structured questionnaire with 27 items was used to record the sociodemographic characteristics of the participants and to assess their knowledge base of the 2010 ILCOR guidelines for CPR. Results Only fifty (23.04%) out of 217 students achieved results considered as satisfactory in the written evaluation. The average score obtained was 56.74% correct answers. Seventeen percent of the students had never performed CPR maneuvers and 83.80% had never performed cardioversion or defibrillation. Conclusions The knowledge base of medical students regarding cardiopulmonary resuscitation is low. Considering these medical students are in their final year of medical school, this study reveals a worrisome scenario.

Karneval i klassrum – kunskap på hjul : en studie av elevers möten med clown analyserade med narrativ metod och poetisk etnografi

The aim of this study is to contribute to the knowledge about learning in and through art related to pupils’ study processes developing clown characters in secondary school. The pre understanding of this qualitative piece of micro ethnographic research is that the elaboration of clown has openness to play, creative activity and imagination. The art form clown inspires and motivates. The clown character creates a kind and friendly atmosphere, calls upon smile, which promotes learning. It is an art form promoting deep and personal reflection and evoking questions regarding identity formation. The pre understanding finally is that existential themes are brought to articulation in the art form clown. The problem formulation for the hermeneutic phenomenological study is an exploration of the meaning potential of an arts educational work with clown from the pupils’ as well as the teacher’s perspective. The study elaborates the following research questions: 1.) How are the pupils staging themselves in the work with clown? a) How are they constructing the clown character? b) How do they reflect upon their construction? c) What are the characteristics of the working process in the elaboration of clown? 2.) What is characteristic of the teacher’s contribution to the arts educational work? 3.) What is characteristic of the meaning making in the elaboration of clown? One group of 21 pupils and their drama teacher in a Swedish secondary school in six workshops (each one 90 minutes) elaborating the clown theme is the group under study through video observation, interviews, students’ logs and drawings, teacher log and researcher’s field notes. The theoretical framework comprises three perspectives on clown: a perspective on the culture of carnival, a drama education perspective and a performance perspective. Through a content analysis of texts about clown a set of characteristics for the clown is used as analytical concepts in the subsequent analysis of the pupils’ working process when they create three clown characters: August, the white clown and the bag lady. The results are presented as fictive narratives built on the video observations and the interviews. The presentation is brought to even more condensation through poetic ethnographic writing of haiku poems by the researcher. This ethnographic writing is idiomatic to the art form under study, and can be seen as a metaphorical meta commentary to the narratives. As a main result the researcher has developed a model describing the different aspects of the clown characters and the meaning potential of the clown as learning regarding exploration of identity and elaboration of existential questions regarding life, loneliness, love, religion and death.

Hvordan øve hellige handlinger? : en profesjonsdidaktisk studie av øving av muntlige ferdigheter innenfor en norsk presteutdanning

How can the holy craft of liturgy be trained? A study of approaches to instruction in training oral skills within education of the Norwegian clergy The theme of this study is the competence of expression of clerics performing liturgies as part of their duties in the Norwegian Lutheran Church. The aim of the study is to find a teaching practice which can raise the competence in oral expression characteristic of the clergy profession. The teaching practice is explored and discussed within the context of the basic education of the clergy. The main thesis is formulated as a question: How can the holy craft of liturgy be trained? An underpinning of the study is that liturgical acts are holy, which gives these performances an aspect of otherness. This otherness constitutes a clear agreement between the students and the teacher, and between the professional and the employer. The pre-understanding of the researcher is that these liturgical oral acts are trainable, and that there is a need and a necessity to train in these skills. Three research questions are elaborated on in the explorative section of the study: • What is characteristic of a competence of expression connected to the profession? • How can this competence of expression connected to liturgical performance be developed? • What is the importance of this competence in the holy craft of liturgy for the development of a cohesive professional self-understanding? The study is based on a research and development project where the researcher as the teacher and students from one specific clergy education in Norway (MF) were the source of the empirical material. The empirical data came from practice with two external observers› logs on the coaching, video observations, of the teacher and the students› texts on the practice under study, which is liturgical performance. The researcher›s log and field notes also provide material for the analysis. This is a qualitative project and an arts education project carried out within an interpretative framework. The theoretical framework has three perspectives: a structural approach based on the system theory of Niklas Luhmann, an epistemological approach discussing forms of knowledge in practice or informing practice and an arts education approach. The results indicate that the competence in oral liturgical performance can be considered a trainable skill, and that this training can be understood as an arts education method of instruction based on meaningful communication, dramaturgical thinking and the development of authenticity. The main result from this study can be considered as articulating and sketching the contours of the field of knowledge where the students embody the meaning of the clergy profession ‒ and this articulation has an innovative potential as knowledge combining experience and theoretical understanding.

Mild developmental dyslexia in university students: diagnosis and performance features in L1, L2, and L3

Avhandling visar att lindrig dyslexi påverkar läs- och skrivprestationer hos högpresterare. Särdrag träder tydligast fram i främmande språk och vid hantering av språkljud i krävande testuppgifter. Även om dyslexirelaterade problem vanligtvis är lindriga hos universitetsstudenter, är det centralt att dessa identifieras, eftersom de ses påverka akademiska prestationer. Avhandlingen lägger fram det första finlandssvenska dyslexitestet normerat för universitetsnivå (FS-DUVAN) och ger verktyg för utredning av läs- och skrivsvårigheter hos unga vuxna i Svenskfinland. Avhandlingen utforskar också språkspecifika särdrag av dyslexi hos högpresterande finlandssvenska universitetsstudenter i läs- och skrivuppgifter i svenska, finska och engelska. Detaljerade felanalyser visar att studenter med dyslexi speciellt har problem med kopplingar mellan språkljud och bokstav i det främmande språket engelska, som också i detta avseende är komplext. Resultat i komplexa kognitiva testuppgifter som förutsätter hantering av språkljud pekar på svikt i fonologisk processering, som betecknas som den huvudsakliga underliggande kognitiva nedsättningen vid utvecklingsbetingad dyslexi.

Competence in intensive and critical care nursing - development of a basic assessment scale for graduating nursing students

Intensive and critical care nursing is a speciality in its own right and with its own nature within the nursing profession. This speciality poses its own demands for nursing competencies. Intensive and critical care nursing is focused on severely ill patients and their significant others. The patients are comprehensively cared for, constantly monitored and their vital functions are sustained artificially. The main goal is to win time to cure the cause of the patient’s situation or illness. The purpose of this empirical study was i) to describe and define competence and competence requirements in intensive and critical care nursing, ii) to develop a basic measurement scale for competence assessment in intensive and critical care nursing for graduating nursing students, and iii) to describe and evaluate graduating nursing students’ basic competence in intensive and critical care nursing by seeking the reference basis of self-evaluated basic competence in intensive and critical care nursing from ICU nurses. However, the main focus of this study was on the outcomes of nursing education in this nursing speciality. The study was carried out in different phases: basic exploration of competence (phase 1 and 2), instrumentation of competence (phase 3) and evaluation of competence (phase 4). Phase 1 (n=130) evaluated graduating nursing students’ basic biological and physiological knowledge and skills for working in intensive and critical care with Basic Knowledge Assessment Tool version 5 (BKAT-5, Toth 2012). Phase 2 focused on defining competence in intensive and critical care nursing with the help of literature review (n=45 empirical studies) as well as competence requirements in intensive and critical care nursing with the help of experts (n=45 experts) in a Delphi study. In phase 3 the scale Intensive and Critical Care Nursing Competence Scale (ICCN-CS) was developed and tested twice (pilot test 1: n=18 students and n=12 nurses; pilot test 2: n=56 students and n=54 nurses). Finally, in phase 4, graduating nursing students’ competence was evaluated with ICCN-CS and BKAT version 7 (Toth 2012). In order to develop a valid assessment scale of competence for graduating nursing students and to evaluate and establish the competence of graduating nursing students, empirical data were retrieved at the same time from both graduating nursing students (n=139) and ICU nurses (n=431). Competence can be divided into clinical and general professional competence. It can be defined as a specific knowledge base, skill base, attitude and value base and experience base of nursing and the personal base of an intensive and critical care nurse. Personal base was excluded in this self-evaluation based scale. The ICCN-CS-1 consists of 144 items (6 sum variables). Finally, it became evident that the experience base of competence is not a suitable sum variable in holistic intensive and critical care competence scale for graduating nursing students because of their minor experience in this special nursing area. ICCN-CS-1 is a reliable and tolerably valid scale for use among graduating nursing students and ICU nurses Among students, basic competence of intensive and critical care nursing was self-rated as good by 69%, as excellent by 25% and as moderate by 6%. However, graduating nursing students’ basic biological and physiological knowledge and skills for working in intensive and critical care were poor. The students rated their clinical and professional competence as good, and their knowledge base and skill base as moderate. They gave slightly higher ratings for their knowledge base than skill base. Differences in basic competence emerged between graduating nursing students and ICU nurses. The students’ self-ratings of both their basic competence and clinical and professional competence were significantly lower than the nurses’ ratings. The students’ self-ratings of their knowledge and skill base were also statistically significantly lower than nurses’ ratings. However, both groups reported the same attitude and value base, which was excellent. The strongest factor explaining students’ conception of their competence was their experience of autonomy in nursing. Conclusions: Competence in intensive and critical care nursing is a multidimensional concept. Basic competence in intensive and critical care nursing can be measured with self-evaluation based scale but alongside should be used an objective evaluation method. Graduating nursing students’ basic competence in intensive and critical care nursing is good but their knowledge and skill base are moderate. Especially the biological and physiological knowledge base is poor. Therefore in future in intensive and critical care nursing education should be focused on both strengthening students’ biological and physiological knowledge base and on strengthening their overall skill base. Practical implications are presented for nursing education, practice and administration. In future, research should focus on education methods and contents, mentoring of clinical practice and orientation programmes as well as further development of the scale.

Trauma leagues: an alternative way to teach trauma surgery to medical students

OBJECTIVE: to compare the knowledge of medical students between those who are members of the Trauma League (TL) and those from a non-Trauma League (NTL) group of the Federal University of Espírito Santo (UFES).METHODS: cross-sectional, analytical and descriptive study. Two knowledge tests, with 30 questions each, were applied to students from 3rd to 12th period, randomly selecting five students per period, with 50 students in the TL group and 50 in NTL. The questionnaire topics were: pre-hospital care, the mnemonic ABCDE trauma sequence, advanced trauma and imaging. The students' performances were evaluated by graduation-period group: basic (3rd-5th period), intermediary/clinical (6th-8th) and internship (9th-12th).RESULTS: in the first test the average accuracy of the TL group was 20.64 ± 3.17, while for the NTL group, it was 14.76 ± 5.28 (p<0.005). In the second test the average accuracy for the TL group was 21.52 ± 3.64, while for the NTL group, the average was 15.36 ± 29.5 (p<0.005). When divided into graduation periods, it was observed that the TL group showed a higher average across all three groups (p<0.05) in both tests.CONCLUSION: the students who attended the academic league activities have greater knowledge of the issues that are considered relevant to patient trauma care. In all periods of undergraduate academic training, the TL group had greater knowledge of the subject than the NTL group.