Judith Searle

Teaching anatomy without cadavers

Background  Anatomy learning is generally seen as essential to medicine, and exposure to cadavers is generally seen as essential to anatomy learning around the world. Few voices dissenting from these propositions can be identified.

New perspectives--approaches to medical education at four new UK medical schools.

With the expansion in UK medical student numbers, four new medical schools have been established. The authors, all senior faculty members at these new schools at the time of writing, discuss how much the schools have in common in their approaches to medical education

Assessment of progress tests

Background  Progress testing is a form of longitudinal examination which, in principle, samples at regular intervals from the complete domain of knowledge considered a requirement for medical students on completion of the undergraduate programme. Over the course of the programme students improve their scores on the test, enabling them, as well as staff, to monitor their progress.

Medical specialty prestige and lifestyle preferences for medical students.

In the context of doctor shortages and mal-distributions in many Western countries, prestige and lifestyle friendliness have emerged as significant factors for medical students when they choose a medical specialty. In this study, we surveyed two samples of Australian medical students and had them rank 19 medical specialties for prestige (N = 530) and lifestyle friendliness (N = 644). The prestige rankings were generally consistent with previous ratings by physicians, lay people and advanced medical students, with surgery, internal, and intensive care medicine ranking the highest, and public health, occupational, and non-specialist hospital medicine ranking lowest. This suggests that medical students have incorporated prevailing prestige perceptions of practicing doctors and the community. Lifestyle rankings were markedly different from prestige rankings, where dermatology, general practice, and public health medicine were ranked the most lifestyle friendly, and surgery, obstetrics/gynaecology and intensive care were ranked least friendly. Student lifestyle rankings differed from physician and author-generated rankings, indicating that student preferences should be considered rather than relying on ratings created by others. Few differences were found for gender or year of study, signifying perceptions of prestige and lifestyle friendliness were consistent across the students sampled. Having access to and understanding these rankings will assist career counsellors to aid student and junior doctor decision-making and aid workforce planners to address gaps in medical specialty health services.

Selection for medical school: just pick the right students and the rest is easy!

Background/Aims The new Peninsula Medical School (PMS) admitted its first undergraduate cohort in September 2002. Development of a new school has given rise to opportunities for critical appraisal of best practice in selecting students for medical school and development of new ways forward.

Environments for Healthy Living (EFHL) Griffith birth cohort study: background and methods.

The health of an individual is determined by the interaction of genetic and individual factors with wider social and environmental elements. Public health approaches to improving the health of disadvantaged populations will be most effective if they optimise influences at each of these levels, particularly in the early part of the life course. In order to better ascertain the relative contribution of these multi-level determinants there is a need for robust studies, longitudinal and prospective in nature, that examine individual, familial, social and environmental exposures. This paper describes the study background and methods, as it has been implemented in an Australian birth cohort study, Environments for Healthy Living (EFHL): The Griffith Study of Population Health. EFHL is a prospective, multi-level, multi-year longitudinal birth cohort study, designed to collect information from before birth through to adulthood across a spectrum of eco-epidemiological factors, including genetic material from cord-blood samples at birth, individual and familial factors, to spatial data on the living environment. EFHL commenced the pilot phase of recruitment in 2006 and open recruitment in 2007, with a target sample size of 4000 mother/infant dyads. Detailed information on each participant is obtained at birth, 12-months, 3-years, 5-years and subsequent three to five yearly intervals. The findings of this research will provide detailed evidence on the relative contribution of multi-level determinants of health, which can be used to inform social policy and intervention strategies that will facilitate healthy behaviours and choices across sub-populations.

The Development and Initial Validation of Social Cognitive Career Theory Instruments to Measure Choice of Medical Specialty and Practice Location

Social cognitive career theory served as the basis for the instrument development for scales assessing self-efficacy, outcome expectations, and goals to predict medical career choice. Lent and Browns conceptualization of social cognitive constructs guided the development of items to measure choice of medical specialty and practice location. Study 1 involved four stages: identification of attitudes and beliefs, generation of scale items, evaluation of scale items by experts, and a pilot study. The pilot study tested the item pool with 293 medical students and allowed item and exploratory factor analyses. Study 2 administered the scales to a second sample of 499 medical students. Confirmatory factor analysis assessed consistency and validity, and identified six psychometrically sound instruments. Initial validity for the scales was found encouraging, with further testing of these measures expected to support their use. Implications for use in research are discussed.

Graduate entry medicine: what it is and what it isn't.

Two new medical schools and 234 extra medical students. So ran the title of a recent announcement by the Australian Minister for Health and Ageing. Both of these Australian schools are to offer 4-year graduate entry programmes. Over the last 10 years both the UK and Australia have been politically encouraged to consider graduate entry programmes over traditional school-leaver entry, an approach which is commonplace in North America. What has driven this change in these countries and, more particularly, how informed have the decisions to make the changes been? Does this trend represent real advances in medical education?

Emotional Labour, Training Stress, Burnout, and Depressive Symptoms in Junior Doctors.

Junior doctors are at risk of work-related burnout and mental health problems due to training workload demands and responsibilities. This study investigated the predictors of work-related burnout and depressive symptoms in junior doctors. Participants were 349 Australian doctors in postgraduate years 1–4, who completed a web-based survey assessing emotional labour (surface and deep acting), training stress, work-related burnout, and depressive symptoms. We tested a model in which surface acting and training stress were associated positively with work-related burnout, where deep acting was associated negatively with work-related burnout, where work-related burnout was associated positively with depressive symptoms, and where work-related burnout mediated the relationship between emotional labour, training stress, and depressive symptoms. Surface acting and training stress were associated with work-related burnout and depressive symptoms in the expected directions, deep acting and work-related burnout were associated with depressive symptoms, and work-related burnout fully mediated the relationships between training stress, surface acting and depressive symptoms. The results suggest that assisting junior doctors to manage workload demands and patient contact will have beneficial effects on their work enthusiasm and mental health.

Factors influencing the practice choices of Australian medical students: a feasibility study.

Choice of specialty, practice location and hours of work are critical issues in the context of shortages in the medical workforce and emerging trends in medical careers. Trends such as doctors becoming more focused on lifestyle, wellbeing and family and choosing to work less hours are likely to contribute further to the medical workforce shortage and mal distribution in Australia and thus impact on the access to appropriate medical services for many communities. Understanding how, where and what our future doctors wish to practise has become increasingly important. This cross-sectional pilot study explored the role of personality, values, wellbeing and social cognitive variables in explaining the practice choices of medical students. The study aimed to develop and test a theoretical model, new and existing research instruments, and assess the feasibility of recruitment for a planned national longitudinal cohort study. Two-hundred and thirty-one first and final year medical students from six Australian universities participated in a Web-based survey. First year students were recruited via a face-to-face meeting and final year students recruited via email. Logistic regression analyses showed that values, professional outcome expectations and barriers were associated with choice of specialty; age, values and a rural background was associated with choice of practice location; and gender and values were associated with preferred hours of work. This study extends knowledge of the determinants of practice choices and has provided a solid foundation for the researchers’ current nationalcohort study that is tracking medical students’that is tracking career choices over time.