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BACKGROUND: This study assesses how pediatric assent is conceptualized and justified within the therapeutic context. Pediatric ethicists generally agree that children should participate in medical care decisions in developmentally appropriate ways. Much attention has been paid to pediatric assent for research participation, but ambiguities persist in how assent is conceptualized and operationalized in the therapeutic context where countervailing considerations such as the child's best interest and parental permission must also be weighed. METHODS: Searches were conducted in 11 databases including PubMed, Embase, Cochrane Library, and Web of Science. Articles published between 2010 and 2020 were screened in COVIDENCE for meeting each of four criteria: (1) focusing on pediatric assent, (2) focusing on clinical care, (3) including normative claims, and (4) containing substantive statements about the meaning of pediatric assent. Full texts were abstracted for (1) operational definitions of assent, (2) discussion of the temporal nature of assent, (3) description of the concept of "understanding," and (4) ethical justifications for soliciting assent. These excerpts were coded and code patterns formed themes presented in the results. RESULTS: The final analytic data set contained 29 articles. Analysis yielded three key themes. First, valid assent varies by treatment, population (e.g., younger versus older), and geographic/cultural context. Second, assent represents two distinct longitudinal processes: One involves eliciting preferences over a disease course or care episode; the other focuses on children's developmental maturation. Third, ethical justifications for assent draw variously on instrumental and intrinsic reasons, but often remain ambiguous. CONCLUSIONS: There is widespread agreement that assent is morally valuable, but there remain substantial ambiguities or disagreements about its meaning, process, and ethical justification.
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OBJECTIVE: To review the literature on the utility of the Conners CPT-3 in persons with ADHD. METHODS: A systematic review was conducted. Six databases were searched using inclusion criteria: research studies, year 2000+, English, and ages 8+. Two raters independently screened 1,480 title/abstracts and subsequently reviewed 399 full texts. Data extraction and critical appraisal were conducted. Reflective thematic analysis through inductive coding identified qualitative themes. RESULTS: Thirteen studies met inclusion criteria with five themes identified. Five studies found CPT-3 was a weak or poor predictor of ADHD diagnosis while two found it was an adequate predictor. Two studies found CPT-3 could differentiate clients with comorbid ADHD/anxiety from ADHD or ADHD from obsessive-compulsive disorder. One found CPT-3 could not differentiate ADHD from ASD or comorbid ADHD/ASD. CONCLUSIONS: Results revealed CPT-3 as a standalone measure is a weak or poor predictor of ADHD. Multiple measures for evaluating persons with ADHD are recommended.
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Attention Deficit Disorder with Hyperactivity , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Humans , Neuropsychological Tests , ChildABSTRACT
INTRODUCTION: Over the past two years, coronavirus disease (COVID-19) has greatly altered medical student education as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality medical education. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared medical educators for COVID-19? This scoping review investigated the educational and personal impact of recent pandemics on medical students. METHODS: This review followed the PRISMA-ScR guidelines for scoping reviews. Nine databases including PubMed, ERIC, and EMBASE were systematically searched using keywords and subject headings related to medical students and SARS, H1N1, MERS, Ebola, Zika, and COVID-19. Studies were limited to research studies published between 2000 and 2020 and in English. Based on exclusion and inclusion criteria, all studies were independently screened by two reviewers first by the title/abstract and then via full text. Data were extracted from the included studies and analyzed qualitatively using thematic analysis. RESULTS: A total of 174 studies fit the criteria. Seven major themes emerged from those studies: educational adaptations and online modifications, knowledge and attitudes of students, mental wellness of students, student involvement and use of telehealth, student vaccination, physical wellness of students, and stigma. CONCLUSION: This review provided insights into how medical students were affected by recent pandemics and their perceptions of pivoting to online education, mental health, and knowledge of the diseases. Additionally, this review showcases the various educational adaptations that emerged uniquely during the COVID-19 pandemic, such as telehealth services or video conferencing tools, that can be utilized in a post-pandemic environment.
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COVID-19 , Influenza A Virus, H1N1 Subtype , Students, Medical , Zika Virus Infection , Zika Virus , Humans , COVID-19/epidemiology , Pandemics , SARS-CoV-2ABSTRACT
Background: Public libraries serve as community centers for accessing free, trustworthy health information. As such, they provide an ideal setting to teach the local community about health and health literacy, particularly during public health crises like the COVID-19 pandemic. Since 2018, an outreach partnership between an academic medical library and public library has developed, delivered, and continuously evaluated a health education program targeting public library users. Case Presentation: Health education activities were integrated into three existing public library programs: adult workshops, child and family programming, and circulating family activity kits. Prior to COVID-19, events were held at the public library, which then pivoted online during the pandemic. An interprofessional team approach combined the expertise of academic medical and public librarians, medical school faculty and staff, and medical students in developing the educational programs. Twelve in-person and five virtual programs were offered, and five circulating health education family kits were launched. Activities were assessed using program evaluation surveys of the adult and children's programs and circulation statistics of the kits. Conclusions: This case report showcases the lessons learned from implementing a longitudinal outreach partnership between an academic medical library and public library before and during the COVID-19 pandemic. The interprofessional team approach and flexibility in program design and delivery in both the in-person and virtual environments proved critical to the success of the partnership. This partnership could serve as a model for other libraries interested in pursuing interprofessional collaborations in educating local communities on healthy behavior and health information-seeking practices.
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COVID-19 , Librarians , Libraries, Medical , Adult , Child , Health Education , Humans , PandemicsABSTRACT
Periods of academic transition are challenging and require medical students to adjust to new environments and expectations. Commonly cited areas of struggle include integrating into the interprofessional health care team, communication, organization and time management, and self-regulated learning. Consciously designing opportunities early in the preclinical curriculum to help students gradually build these competencies can be achieved within existing research training programs or projects. This perspective article reflects on how the medical student research training program at the Oakland University William Beaumont School of Medicine supports student growth in these areas beginning in the first year, so that students can directly apply these skills as they progress to the clinical years and beyond.
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OBJECTIVES: The purpose of this project was to evaluate and improve the oral presentation assessment component of a required research training curriculum at an undergraduate medical school by analyzing the quantity, quality, and variety of peer and faculty feedback on medical student oral research presentations. METHODS: We conducted a program evaluation of oral presentation assessments during the 2016 and 2017 academic years. Second-year medical students (n=225) provided oral presentations of their research and received narrative feedback from peers and faculty. All comments were inductively coded for themes and Chi-square testing compared faculty and peer feedback differences in quantity, quality, and variety, as well as changes in feedback between the initial and final presentations. Comparative analysis of student PowerPoint presentation files before and after receiving feedback was also conducted. RESULTS: Over two years, 2,617 peer and 498 faculty comments were collected and categorized into ten themes, with the top three being: presentation skills, visual presentation, and content. Both peers and judges favored providing positive over improvement comments, with peers tending to give richer feedback, but judges more diverse feedback. Nearly all presenters made some change from the initial to final presentations based on feedback. CONCLUSIONS: Data from this analysis was used to restructure the oral presentation requirement for the students. Both peer and faculty formative feedback can contribute to developing medical student competence in providing feedback and delivering oral presentations. Future studies could assess student perceptions of this assessment to determine its value in developing communication skills.
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Curriculum , Education, Medical, Undergraduate/methods , Research/education , Students, Medical , Communication , Faculty, Medical , Formative Feedback , Humans , Peer GroupABSTRACT
OBJECTIVE: The purpose of predatory open access (OA) journals is primarily to make a profit rather than to disseminate quality, peer-reviewed research. Publishing in these journals could negatively impact faculty reputation, promotion, and tenure, yet many still choose to do so. Therefore, the authors investigated faculty knowledge and attitudes regarding predatory OA journals. METHODS: A twenty-item questionnaire containing both quantitative and qualitative items was developed and piloted. All university and medical school faculty were invited to participate. The survey included knowledge questions that assessed respondents' ability to identify predatory OA journals and attitudinal questions about such journals. Chi-square tests were used to detect differences between university and medical faculty. RESULTS: A total of 183 faculty completed the survey: 63% were university and 37% were medical faculty. Nearly one-quarter (23%) had not previously heard of the term "predatory OA journal." Most (87%) reported feeling very confident or confident in their ability to assess journal quality, but only 60% correctly identified a journal as predatory, when given a journal in their field to assess. Chi-square tests revealed that university faculty were more likely to correctly identify a predatory OA journal (p=0.0006) and have higher self-reported confidence in assessing journal quality, compared with medical faculty (p=0.0391). CONCLUSIONS: Survey results show that faculty recognize predatory OA journals as a problem. These attitudes plus the knowledge gaps identified in this study will be used to develop targeted educational interventions for faculty in all disciplines at our university.
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Attitude of Health Personnel , Faculty, Medical/psychology , Needs Assessment , Open Access Publishing , Periodicals as Topic , Faculty/psychology , Humans , Open Access Publishing/standards , Periodicals as Topic/standards , Surveys and QuestionnairesABSTRACT
The Oakland University William Beaumont School of Medicine's (OUWB) service-oriented mission and vision is reflected in all aspects of the school including its culture, curriculum, research, community engagement, and the OUWB Medical Library. Though starting informally, the OUWB Medical Library's outreach program has matured and now sustains a wide array of activities each year. This outreach program has blossomed into a three-pronged model that is inclusive of activities and endeavors engaging the institution and local community: integrate, partner, and create. Among its successes and challenges, the library's ongoing outreach efforts have showcased the value of libraries in promoting community health and meaningfully contributing to the institutional mission.
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Academic Medical Centers/organization & administration , Intersectoral Collaboration , Libraries, Medical/organization & administration , Community-Institutional Relations , HumansABSTRACT
BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is also well established that HPV viruses are responsible for a variety of cancers. Little is known about the prevailing knowledge and attitudes toward the HPV vaccine in our future healthcare providers, a majority of whom were among the first in the target age group to receive the vaccine; the same vaccine that they will in turn be expected to recommend to their patients. The aims of this pilot study were to examine the HPV vaccination rate among medical students and determine their knowledge about HPV and attitudes toward vaccination. METHODS: To aid in the development of an HPV educational intervention, a needs assessment survey was administered to discover medical students' knowledge and attitudes toward the HPV vaccine. All medical students at a Midwestern US medical school were invited to complete the survey. RESULTS: Two hundred fourteen of 390 medical students completed the survey with 44% having been previously vaccinated. Although 82% of all respondents believed they would recommend the vaccine to family and friends, only 40% felt knowledgeable about the vaccine and 40% felt comfortable counseling patients. More positive attitudes and better knowledge scores were found in fully vaccinated students compared to non-vaccinated students. Provider recommendation was strongly associated with HPV vaccination status. CONCLUSIONS: This study revealed the unique perspectives of U.S. millennial medical students as the first group of future healthcare providers to have personally encountered the HPV vaccine. Overall, students' knowledge as well as their comfort level in counseling patients was lacking. This assessment has guided the development of targeted educational interventions to address knowledge gaps and prepare students to appropriately discuss the vaccine with patients and parents and help protect young people from life threatening cancers.
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Health Knowledge, Attitudes, Practice , Papillomavirus Infections/prevention & control , Papillomavirus Infections/psychology , Papillomavirus Vaccines/therapeutic use , Patient Acceptance of Health Care/psychology , Students, Medical/psychology , Adult , Attitude of Health Personnel , Female , Health Care Surveys/statistics & numerical data , Humans , Male , Patient Acceptance of Health Care/statistics & numerical data , Pilot Projects , Students, Medical/statistics & numerical data , United States , Young AdultABSTRACT
INTRODUCTION: A major step of the evidence-based medicine (EBM) process is to locate the most current evidence in support of clinical care. This requires identifying and searching appropriate evidence-based resources. Medical library faculty at the Oakland University William Beaumont School of Medicine teach these skills as part of a dedicated EBM course at the end of the second year of the medical school curriculum. METHODS: A 3-hour "Locating the Best Available Evidence" session is divided into two major components: an optional 50-minute didactic lecture followed by a mandatory 2-hour interactive lab. Students formulate a PICO (patient, intervention, comparison, outcome) question from a case, develop search strategies, and gather evidence. Formative feedback is provided to the students to help them prepare for a final case presentation. RESULTS: Session effectiveness is assessed using course evaluations and the case presentation grade. Course evaluations indicate that students find this session structure to be especially helpful in learning the breadth of available EBM resources, preparing for their course case presentations, and acquiring skills for clinical clerkships. Quality of the case presentations also indicates students have acquired the necessary skills to be successful in practicing EBM skills in clerkship rotations and residency. DISCUSSION: Whether institutions have a dedicated EBM course or integrate EBM skills into the medical school curriculum, this session could easily be adapted and implemented. It could also be tailored for graduate or continuing medical education environments in any specialty.
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BACKGROUND: Librarians often teach evidence-based practice (EBP) within health sciences curricula. It is not known what teaching methods are most effective. METHODS: A systematic review of the literature was conducted searching CINAHL, EMBASE, ERIC, LISTA, PubMed, Scopus, and others. Searches were completed through December 2014. No limits were applied. Hand searching of Medical Library Association annual meeting abstracts from 2009-2014 was also completed. Studies must be about EBP instruction by a librarian within undergraduate or graduate health sciences curricula and include skills assessment. Studies with no assessment, letters and comments, and veterinary education studies were excluded. Data extraction and critical appraisal were performed to determine the risk of bias of each study. RESULTS: Twenty-seven studies were included for analysis. Studies occurred in the United States (20), Canada (3), the United Kingdom (1), and Italy (1), with 22 in medicine and 5 in allied health. Teaching methods included lecture (20), small group or one-on-one instruction (16), computer lab practice (15), and online learning (6). Assessments were quizzes or tests, pretests and posttests, peer-review, search strategy evaluations, clinical scenario assignments, or a hybrid. Due to large variability across studies, meta-analysis was not conducted. DISCUSSION: Findings were weakly significant for positive change in search performance for most studies. Only one study compared teaching methods, and no one teaching method proved more effective. Future studies could conduct multisite interventions using randomized or quasi-randomized controlled trial study design and standardized assessment tools to measure outcomes.
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Evidence-Based Practice/education , Teaching , Humans , Libraries, MedicalABSTRACT
Fostering cultural competence in higher education institutions is essential, particularly in training future health care workers to care for diverse populations. The opportunity to explore techniques to address diversity and cultural competence at a new medical school was undertaken by a multidisciplinary team of librarians, faculty, staff, and medical students. From 2011 to 2015, the team sponsored a voluntary programming series to promote cultural competence and raise awareness of health care disparities for the medical school. Thirteen events were hosted with 562 participants across all. This approach to diversity proved effective and could be adapted in any higher education setting.
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Cultural Competency/education , Curriculum , Schools, Medical , Education, Medical, Undergraduate , Healthcare Disparities , Humans , Librarians , Michigan , Organizational Case Studies , Surveys and QuestionnairesABSTRACT
PURPOSE: The research assessed a three-year continuing medical education-style program for medical students in a Midwestern academic medical library. METHODS: A mixed methods approach of a survey and two focus groups comparing attendees versus non-attendees assessed the program. RESULTS: Eleven students participated in the focus groups. Attendance was driven by topic interest and lunch. Barriers included lack of interest, scheduling, location, and convenience. CONCLUSIONS: Although attendance was a challenge, students valued opportunities to learn new skills. This study show cases a reproducible method to engage students outside the curriculum.
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Education, Medical, Continuing , Libraries, Medical , Models, Organizational , Students, Medical , Focus Groups , Humans , Qualitative Research , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Vaccination of health care workers (HCW) reduces transmission of influenza among patients, yet uptake of vaccination remains low. If vaccination education is integrated into the early medical school curriculum, will student attitudes toward the vaccine change? The objectives of the study were to: (1) Determine influenza vaccination rates among entering medical students; (2) Assess the attitudes toward influenza vaccination; (3) Evaluate the effects of a multifaceted educational intervention on attitudes to vaccination. METHODS: Entering medical students were surveyed before and after an intervention at the beginning of the influenza season. This intervention provided by an inter-professional team, included education about influenza, importance of vaccination for HCWs, followed by vaccination administration practice, and ended with students vaccinating consenting classmates. RESULTS: The pre-intervention surveys and intervention were completed by 124 of 125 (99%) students. Pre-intervention survey revealed 60 (48%) of students had been previously vaccinated. Of the vaccinated students 91% had been recommended vaccination by their healthcare provider compared to 43% of non-vaccinated students. More positive attitudes were noted in the vaccinated students compared to non-vaccinated students: importance of vaccination (p<0.01); HCWs should be vaccinated (p<0.01); recommendation of vaccine to family and friends (p<0.01). 97 (78%) students completed post-intervention surveys. Significant improvement in these attitudes was noted post-intervention compared to pre-intervention: importance of vaccination 93% versus 71% (p<0.01); HCWs should be vaccinated 95% versus 83% (p<0.01); recommendation to family and friends 93% versus 73% (p<0.01); comfort with vaccine counseling 92% versus 41%; comfort with vaccine administration 84% versus 22% (p<0.01). CONCLUSION: Educating medical students and promoting the importance of vaccination early in a medical student's career using such an intervention is relatively simple and easily integrated into the curriculum. This intervention was successful in vaccinating all students, and demonstrated a marked positive shift in attitudes toward influenza vaccination.