Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study.

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.

Asthma-Themed Chest Diseases Elective Internship Program Experience at Dokuz Eylül University School of Medicine.

OBJECTIVES: The purpose of this article is to introduce asthma-themed chest diseases elective program applied within the scope of the Dokuz Eylül University School of Medicine. undergraduate medical program. MATERIALS AND METHODS: Asthma-themed chest diseases elective internship program in Year 4 was developed to increase student gains from the elective internship program. During the two-week program, lectures and bedside and outpatient clinics practices were implemented. RESULTS: Students' pre-education and post-education knowledge scores and OSCE scores were investigated. A minimal increase was observed in post-education score, and no significant difference was determined in the statistical analysis. The students' post-education clinical performance scores were significantly higher than that of pre-education. CONCLUSION: Asthma-themed chest diseases elective internship program seems to be effective in increasing the clinical performance of the students.

The comparison of the efficiency of traditional lectures to video-supported lectures within the training of the Emergency Medicine residents.

OBJECTIVES: Recent developments in computer and video technology, multimedia resources enter quickest way possible into medical education and have started to gain popularity. The aim of this study is to evaluate the impact of video-supported lectures on leaning, with comparison to traditional lectures. METHODS: According to lecture techniques, two separate groups; one is the traditional lectures group (TLG) and the other is video-supported lectures group (VSLG), are formed. While the TLG is offered a traditional lecture the VSLG is offered a video-supported lecture with imbedded videos which are related to the topics in the traditional lecture. Both study groups take pretest and posttest with MCQs (multiple choice questions) and OSCEs (objective structured clinical examination). RESULTS: The study includes 30 volunteer residents in Dokuz Eylul University School of Medicine Department of Emergency Medicine. No difference is observed between TGL and VSLG in pretest and posttest scores (p = 0.949, p = 0.580). And additionally, comparing the scores of both groups, we cannot observe any difference between the pretest OSCE scores of each group (p = 0.300), however posttest OSCE scores shows a dramatic odd in-between (p = 0.010). When pretest MCQs and posttest MCQs mean scores are compared, both tests (TLG, VSLG) has not any significant difference (p=0.949, p = 0.580). Nevertheless, after comparing OSCEs pretest and posttest mean scores, we can see significant difference in mean scores of both (TLG, VSLG), (p = 0.011, p = 0.001). CONCLUSIONS: Taken into consideration, the findings of this study shows possibility of improving educational techniques to acquire clinical skills by using local resources and low-cost technology.

Transition to Virtual Microscopy in Medical Undergraduate Pathology Education: First Experience of Turkey in Dokuz Eylül University Hospital.

OBJECTIVE: Pathology education includes an important visual part supporting a wide range of theoretical knowledge. However, the use of traditional microscopes in pathology education has declined over the last decade and there is a lack of interest for microscopy. Virtual microscopy, which was first described in 1985 and has experienced a revolution since 2000, is an alternative technique to conventional microscopy, in which microscopic slides are scanned to form digital images and stored in the web. The aim of this study was to evaluate the use of virtual microscopy in practical pathology sessions and its effects on our students and undergraduate education at our faculty. MATERIAL AND METHOD: Second and third year medical students who were used to conventional microscopes were included in the study. The practical sessions were carried out via virtual slides and the effect of the new technique was investigated by a scale at the end of each session. Academic staff from the pathology department joined sessions to promote discussion and respond to questions. Student ratings were analysed statistically. RESULTS: The evaluation of the ratings showed that the students were easily adapted to the use of virtual microscopy. They found it user-friendly and thought that the opportunity of viewing slides at home was advantageous. Collaboration between students and interactive discussions was also improved with this technique. CONCLUSION: It was concluded that the use of virtual microscopy could contribute to the pathology education of our students.

An example of program evaluation project in undergraduate medical education.

Revisions to existing program evaluation approaches of the Dokuz Eylul University School of Medicine (DEUSM) were made by the Medical Education Department in June 2005. After considering several evaluation models, a mixed evaluation model was developed to meet institutional needs. The general program evaluation plan was structured as areas of inquiry under the three main program evaluation questions: what are the effects of the educational program on students and graduates, what are the effects of the educational program on trainers, and is the educational program being implemented as planned. The School's first report made through its new program evaluation approach was prepared in July 2006, leading to important revisions to the educational program. This article presents DEUSM's project to revise its program evaluation approach and briefly discusses its early implementation.

Determination of advanced life support knowledge level of residents in a Turkish university hospital.

The aim of the study was to determine the advanced cardiac life support (ACLS) knowledge level of residents and related factors in the departments of Anesthesiology, Emergency Medicine, Internal Medicine, and Cardiology in a university hospital. For this cross-sectional study, a total of 20 multiple-choice questions were prepared concerning several different topics, including: fatal dysrhythmias, oxygenation, ventilation and airway control, asystole, and pulseless electrical activity. Questions were given to residents before their periodic training meetings and collected in 30 min. There were 101 of 120 residents from four clinical departments (participation rate 84%) tested. Average point total and standard deviations of all residents were 66.3 +/- 17 out of 100 points. On a departmental basis, statistically significant differences were found in the knowledge level of residents (Emergency Medicine: 86.2 +/- 8.2, Cardiology: 66.7 +/- 12.9, Anesthesiology: 59.3 +/- 16.2, Internal Medicine: 56.1 +/- 13.5, F: 28.6, p < 0.0001). The factors that affect ACLS knowledge level of residents were "postgraduate ACLS training," "awareness of guidelines," and "resuscitation frequency." Postgraduate training and the frequency of ACLS practice seem to increase the ACLS knowledge level of residents. The present study emphasizes the necessity for a standardized systematic postgraduate ACLS training program for the residents of related medical disciplines. Further studies with larger groups are needed to investigate theoretical knowledge, resuscitation skill competency, and related factors.

Task-based learning programme for clinical years of medical education.

CONTEXT: Task-based learning (TBL) is an educational strategy recommended for the later years of the medical education programme. The TBL programme was adopted for clinical years in the 2000-2001 academic year in Dokuz Eylul University School of Medicine (DEUSM). OBJECTIVE: The aim of this paper is to describe the TBL programme of DEUSM. METHODS: DEUSM outlined 50 clinical tasks for fourth-year students and 37 for fifth-year students. The tasks were grouped into four and five blocks. Interdisciplinary practicals, lectures and patient visits were organised in each task's schedule. The tasks were the focus of learning and each discipline contributed its own learning opportunities to the attached tasks. Formative and summative methods were used to evaluate the programme. CONCLUSION: Based on the experience and feedback provided by the students and trainers, the authors considered TBL an applicable and advisable approach for the clinical years of medical education.

Comparison of knowledge scores of medical students in problem-based learning and traditional curriculum on public health topics.

BACKGROUND: The purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics. METHODS: We planned a cross-sectional study including the fifth and sixth year medical students of Dokuz Eylul University in Turkey. The fifth year students (PBL group, n = 56) were the pioneers educated with PBL curriculum since the 1997-1998 academic year. The sixth year students (traditional education group, n = 78) were the last students educated with traditional education methods. We prepared 25 multiple-choice questions in order to assess knowledge scores of students on selected subjects of Public Health. Our data were collected in year 2002. RESULTS: Mean test scores achieved in PBL and traditional groups were 65.0 and 60.5 respectively. PBL students were significantly more successful in the knowledge test (p = 0.01). The knowledge scores of two topics were statistically higher among PBL students. These topics were health management and chronic diseases. CONCLUSION: We found that mean total evaluation score in the PBL group was 4.5 points higher than in the traditional group in our study. Focusing only on the knowledge scores of students is the main limitation of our study. Upon the graduation of the first PBL students in the 2002-2003 academic year, we are planning additional studies regarding the other functions of a physician such as skill, behaviour and attitude.

Perceptions of first and third year medical students on self-study and reporting processes of problem-based learning.

BACKGROUND: The objective of this study is to investigate the perceptions of first and third year medical students on self-study and reporting processes of Problem-based Learning (PBL) sessions and their usage of learning resources. METHODS: The questionnaire applied to the students consisted of; questions about students' perceptions on searching and preparing phases of the self-study process, the breadth and depth of discussion during reporting phase and the usage of learning resources. RESULTS: First-year students spent more time for self-study and more highly rated the depth of discussion compared to third-year students. The searching and preparing phases of the self-study process were considered as statistically important factors strongly influencing the breadth and depth of discussion during the reporting phase. The effect of extensiveness of searching on the depth of discussion was negative among the first-year students, and positive among third-year students. CONCLUSIONS: The relative shortness of third-year students' self-study periods can be related to their mental weariness, decreased motivation or first-year students' slowness in accessing appropriate resources. The third-year students' more frequent use of textbooks may be due to the improvement of their abilities in reaching relevant learning resources. The findings implied that the increase in students' PBL experience paralleled the development of their discussion skills using different learning resources.

Opinions of Tutors and Students about Effectiveness of PBL in Dokuz Eylul University School of Medicine.

INTRODUCTION: The aim of this study is to determine the opinions of tutors and students about the effectiveness of Problem-based Learning in Dokuz Eylul University School of Medicine. METHODS: A questionnaire with a five-point Likert scale, with 1:minimum, 5;maximum, rating PBL effectiveness was administered in February and March of 2001 to tutors and students. Response rates of tutors and students were respectively 65.0% (130 out of 201) and 82.4% (346 out of 420). The reliability of the scale was high (Cronbach α= 0.90). RESULTS: Ratings of tutors and students respectively on identified outcomes of PBL varied between 3.80-4.69 and 3.69-4.27 out of 5 points. Both groups gave high ratings to the areas of clinical reasoning, communication and problem solving and gave lower ratings to gaining basic science knowledge. Basic science tutors rated the areas of problem solving, gaining basic science knowledge and intrinsic motivation of students significantly higher than did clinical science tutors. DISCUSSION: According to the results of this study, tutors and students opinions about PBL outcomes were similar to those previously reported in the literature. Both groups had positive opinions about PBL's effectiveness. As has been reported in other studies, tutors and students gave the lowest ratings to the area of gaining basic science knowledge. However, the ratings of basic science tutors were higher than those of clinical science tutors in this area. This may be due to preexisting beliefs of clinical science tutors regarding the effectiveness of PBL for teaching factual basic science knowledge.

Faculty Development Program in Dokuz Eylül School of Medicine: In the process of curriculum change from traditional to PBL.

INTRODUCTION: In Dokuz Eylül School of Medicine (DESM) a faculty development program is being carried out by the "Trainers' Training Committee?. DESM made a fundamental change in its curriculum from traditional to Problem-based Learning (PBL) in 1997. This was the first implementation of a PBL curriculum in Turkey. Faculty development activities were initiated in the same year. This paper describes the faculty development activities with a special emphasis on PBL courses. PROGRAM DESCRIPTION: Between 1997-2000 27 four-day long PBL courses were held for 343 participants. The curriculum consisted of PBL philosophy, PBL steps, role of the tutor and students in PBL process, effective case design, assessment principles and group dynamics. PBL simulations enabled the participants to play the roles of both tutors and students. Process evaluation: At the end of the program most of the participants stated that length of the program, content, training methods and the course organization was appropriate. The majority of the participants (89.5%) found the program very useful. PBL steps, PBL practices and PBL philosophy were found as the most useful sessions. DISCUSSION: These courses gave medical staff the opportunity to develop their understanding of PBL methodology and theory. PBL courses and continuous educational activities such as weekly tutor meetings are being held and new courses on advanced tutoring skills are being planned for the near future in DESM.