Torres Woolley

Sunburn in Australian men with a history of non-melanoma skin cancer.

OBJECTIVE To identify predictors of recent sunburn in north Australian men with a history of non-melanoma skin cancer (NMSC). METHODS A survey of men with previous NMSC was conducted (n = 300, response rate 62%). RESULTS Fifty-four percent of participants reported recent sunburn. Predictors identified included younger age, belief that NMSC is caused by childhood sun exposure, belief that sun protection will not help prevent further NMSC, wearing of casual clothes, and use of shade as the main sun-protection strategy. CONCLUSION Health promotion messages should emphasize the importance of sun protection throughout life and the use of stringent sun-protection measures.

The impact of socially-accountable health professional education: A systematic review of the literature

Abstract This literature review describes the impact of health professional schools with a social accountability mandate by identifying characteristics of medical education found to impact positively on medical students, health workforce, and health outcomes of disadvantaged communities. A critical appraisal tool was used to identify the strengths and weaknesses of the published articles. Data are presented as a narrative synthesis due to the variety of methodologies in the studies, and characterized using a logic model. Health professional schools aiming to improve health outcomes for their disadvantaged local communities described collaborative partnerships with communities, equitable selection criteria, and community-engaged placements in underserved areas as positively impacting the learning and attitudes of students. Students of socially accountable schools were more likely to stay in rural areas and serve disadvantaged communities, and were often more skilled than students from more traditional schools to meet the needs of underserved communities. However, published literature on the impact of socially accountable health professional education on communities and health outcomes is limited, with only one study investigating health outcomes. The findings of this literature review guide schools on the inputs likely to maximize their socially accountability outputs and increase their impact on students, local health workforce and local communities.

Workplace immersion in the final year of an undergraduate medicine course: the views of final year students and recent graduates.

Abstract Background: Most medical schools require formal competence assessment of students immediately prior to graduation, but variation exists in the approach to endpoint assessments. This article reports perceptions of senior students and graduates from a school with a six-year program which has introduced final year workplace immersion placements following a barrier examination at the end of the penultimate Year 5. Methods: Final year students (22) and recent graduates (4) attended focus groups and in-depth interviews exploring their perceptions of the value of the curriculum experience during the final two years, the structure and timing of assessment, and their preparation for internship. Findings: Participants felt that the penultimate year was more pressured, and focused on passing “artificial” examinations. In contrast, the final year was more relaxed, building skills for postgraduate work and later career development. As a result, students felt well prepared for internship with some indication that the self-directed nature of the final year promoted a lifelong learning approach. Conclusion: The final year workplace immersion model was regarded positively by senior students of this medical school. This model may be a better way of preparing students to be junior doctors than a traditional final year heavy on theoretical learning and assessment.

The impact of socially-accountable, community-engaged medical education on graduates in the Central Philippines: Implications for the global rural medical workforce

Abstract Introduction: Developing and retaining a high quality medical workforce, especially within low-resource countries has been a world-wide challenge exacerbated by a lack of medical schools, the maldistribution of doctors towards urban practice, health system inequities, and training doctors in tertiary centers rather than in rural communities. Aim: To describe the impact of socially-accountable health professional education on graduates; specifically: their motivation towards community-based service, preparation for addressing local priority health issues, career choices, and practice location. Methods: Cross-sectional survey of graduates from two medical schools in the Philippines: the University of Manila-School of Health Sciences (SHS-Palo) and a medical school with a more conventional curriculum. Results: SHS-Palo graduates had significantly (p < 0.05) more positive attitudes to community service. SHS-Palo graduates were also more likely to work in rural and remote areas (p < 0.001) either at district or provincial hospitals (p = 0.032) or in rural government health services (p < 0.001) as Municipal or Public Health Officers (p < 0.001). Graduates also stayed longer in both their first medical position (p = 0.028) and their current position (p < 0.001). Conclusions: SHS-Palo medical graduates fulfilled a key aim of their socially-accountable institution to develop a health professional workforce willing and able, and have a commitment to work in underserved rural communties.

The benefits of a tailor-made pilot primary health-care course for Indigenous high school students in remote Queensland

OBJECTIVE This study highlights the benefits of a tailor-made course for an Indigenous high school in a remote North Queensland community. DESIGN Qualitative research study using a Grounded Theory approach to allow thematic analysis of participants responses to a researcher-administered, pre-defined, semistructured questionnaire. SETTING Remote community college in Abergowrie, North Queensland. PARTICIPANTS Four male high school students and eight key stakeholders were interviewed over the telephone (n = 12). RESULTS Thematic analyses of the feedback from students and stakeholders showed a variety of benefits from the course for Indigenous students: increased knowledge of health issues, greater awareness and interest in health career pathways, increased pride, self-esteem and self-confidence, positive role-modelling and leadership behaviour in the students, and hope for future career development. Weaknesses identified were mainly associated with a lack of resources and support for the course. CONCLUSIONS This study demonstrates that a tailor-made primary health-care education course can create opportunities for Indigenous people to pursue health careers, promote health knowledge and leadership skills, inspire pride and self-esteem, and strengthen links within the community.

Challenges with maintaining clinical teaching capacity in regional hospitals.

[Extract] In 1999, a new medical school was established at James Cook University in an underserved region with specific needs in rural, remote and Indigenous health. Early data suggest graduates are contributing to the local workforce, but medical student places have increased further as part of the continued expansion of Australian medical education. As a result, the capacity for medical students to experience high-quality clinical opportunities is under challenge.

Addressing health workforce inequities in the Mindanao regions of the Philippines: Tracer study of graduates from a socially-accountable, community-engaged medical school and graduates from a conventional medical school

Abstract Developing and retaining a high-quality medical workforce in low-resource countries is a worldwide challenge. The Filipino Ateneo de Zamboanga University–School of Medicine (ADZU-SOM) has adopted a strong focus on socially accountable health professional education (SAHPE) in order to address the shortage of physicians across rural and urban communities in the Western Mindanao region. A cross-sectional survey of graduates from two Philippines medical schools: ADZU-SOM in the Mindanao region and a medical school with a more conventional curriculum, found ADZU-SOM graduates were more likely to have joined the medical profession due to a desire to help others (p = 0.002), came from lower socioeconomic strata (p = 0.001) and had significantly (p < 0.05) more positive attitudes to community service. ADZU graduates were also more likely to currently work in Government Rural Health Units (p < 0.001) or be generalist Medical Officers (p < 0.001) or Rural/Municipal Health Officers (p = 0.003). ADZU graduates were also less likely to work in private or specialist Government hospitals (p = 0.033 and p = 0.040, respectively) and be surgical or medical specialists (p = 0.010 and p < 0.001, respectively). The findings suggest ADZU-SOM’s SAHPE philosophy manifests in the practice choices of its graduates and that the ADZU-SOM can meet the rural and urban health workforce needs of the Western Mindanao region.

Socially accountable medical education strengthens community health services

Socially accountable health professional education (SAHPE) is committed to achieving health equity through training health professionals to meet local health needs and serve disadvantaged populations. This Philippines study investigates the impact of SAHPE students and graduates on child and maternal health services and outcomes.

Aligning an undergraduate psychological medicine subject with the mental health needs of the local region

BackgroundThe James Cook University (JCU) medical school recently revised its Year 2 human development and behaviour module to be more relevant and practical for students, and more aligned with the mental health priorities of the local region (north Queensland). This study reports medical students’ level of preparedness conferred by the re-designed ‘Psychological Medicine and Human Development’ (PMHD) subject for their later 4-week, rural clinical placement in Year 2.MethodsNon-randomized, controlled ‘naturalistic’ study with pre- and post-intervention surveys. The patient mental health experiences of Year 2 students who went on clinical placement after undertaking the PMHD subject were compared to those who went on placement before undertaking PMHD.ResultsA total of 209 JCU Year 2 medical students completed surveys from a possible 217 (response rate = 96%). Compared to students whom had not taken PMHD before going on placement, students going on placement after undertaking PMHD were significantly more likely to report: feeling comfortable discussing mental health issues with patients (p = 0.001); being prepared for mental health discussions with patients (p < 0.001); having an actual mental health discussion with a patient (p < 0.001); and, volunteering an opinion on the appropriateness of their supervising doctor’s response (p < 0.001). Students reported subject content involving information and classroom instruction on assessing and interviewing patients for mental illness to be of most use.ConclusionsProviding medical students with psychological medicine information on locally prevalent mental health conditions plus practical classroom experiences in conducting mental state exams better prepares them for interacting with patients experiencing psychological distress. This novel methodology – aligning formal teaching in a subject with an evaluation utilizing a proximate student placement to provide useful feedback on the curriculum content and assess the relevance of the material taught – could be used to revise other content areas of a medical course to be more locally relevant and practically focused, and then to evaluate the success of this revision.

Inclination towards research and the pursuit of a research career among medical students: an international cohort study

BackgroundInvolvement of clinicians in biomedical research is imperative for the future of healthcare. Several factors influence clinicians’ inclination towards research: the medical school experience, exposure to research article reading and writing, and knowledge of research. This cohort study follows up medical students at time of graduation to explore changes in their inclination towards research and pursuing a research career compared to their inclination at time of entry into medical school.MethodsStudents from medical schools in six different countries were enrolled in their first year of school and followed-up upon graduation in their final year. Students answered the same self-administered questionnaire at both time points. Changes in inclination towards research and pursuing a research career were assessed. Factors correlated with these changes were analysed.ResultsOf the 777 medical students who responded to the study questionnaire at entry into medical school, 332 (42.7%) completed the follow-up survey. Among these 332 students, there was no significant increase in inclination towards research or pursuing a research career over the course of their medical schooling. Students from a United States based school, in contrast to those from schools other countries, were more likely to report having research role models to guide them (51.5% vs. 0%–26.4%) and to have published in a peer-reviewed journal (75.7% vs. 8.9%–45%). Absence of a role model was significantly associated with a decrease in inclination towards research, while an increased desire to learn more about statistics was significantly associated with an increase in inclination towards pursuing a research career.ConclusionMost medical students did not experience changes in their inclination towards research or pursuing a research career over the course of their medical schooling. Factors that increased their inclination to undertaking research or pursuing a research career were availability of a good role model, and a good knowledge of both the research process and the analytical tools required.