RESUMO
BACKGROUND AND OBJECTIVES: Medical student distress and mental health needs are critical issues in undergraduate medical education. The imposter phenomenon (IP), defined as inappropriate feelings of inadequacy among high achievers is linked to psychological distress. We investigated the prevalence of IP among first-year medical school students and its association with personality measures that affect interpersonal relationships and well-being. METHODS: Two hundred fifty-seven students at a large, urban, northeastern medical school completed the Clance Impostor Phenomenon Scale (CIPS), Jefferson Scale of Empathy, Self-Compassion Scale, and Zuckerman-Kuhlman Personality Questionnaire immediately before beginning their first year of medical school. At the end of their first year, 182 of these students again completed the CIPS. RESULTS: Eighty-seven percent of the entering students reported high or very high degrees of IP. Students with higher IP scores had significantly lower mean scores on self-compassion, sociability self-esteem (P<.0001 for all), and getting along with peers (P=.03). Lower IP scores were related to lower mean scores on neuroticism/anxiety and loneliness (P<.001 for both). Women obtained a higher mean IP score than men. IP scores at the end of the school year increased significantly compared with the beginning of the year (P<.001), both in frequency and intensity of IP. CONCLUSIONS: IP was common in matriculating first-year medical students and significantly increased at year's end. Higher IP scores were significantly associated with lower scores for self-compassion, sociability, self-esteem, and higher scores on neuroticism/anxiety.
Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Transtornos de Ansiedade , Empatia , Feminino , Humanos , Masculino , AutoimagemRESUMO
BACKGROUND AND OBJECTIVES: New standards announced in 2017 could increase the failure rate for Step 2 Clinical Skills (CS). The purpose of this study was to identify student performance metrics associated with risk of failing. METHODS: Data for 1,041 graduates of one medical school from 2014 through 2017 were analyzed, including 30 (2.9%) failures. Metrics included Medical College Admission Test, United States Medical Licensing Examination Step 1, and clerkship National Board of Medical Examiners (NBME) Subject Examination scores; faculty ratings in six clerkships; and scores on an objective structured clinical examination (OSCE). Bivariate statistics and regression were used to estimate risk of failing. RESULTS: Those failing had lower Step 1 scores, NBME scores, faculty ratings, and OSCE scores (P<.02). Students with four or more low ratings were more likely to fail compared to those with fewer low ratings (relative risk [RR], 12.76, P<.0001). Logistic regression revealed other risks: low surgery NBME scores (RR 3.75, P=.02), low pediatrics NBME scores (RR 3.67, P=.02), low ratings in internal medicine (RR 3.42, P=.004), and low OSCE Communication/Interpersonal Skills (RR 2.55, P=.02). CONCLUSIONS: Certain medical student performance metrics are associated with risk of failing Step 2 CS. It is important to clarify these and advise students accordingly.
Assuntos
Estágio Clínico/normas , Competência Clínica/normas , Avaliação Educacional , Licenciamento em Medicina/normas , Estudantes de Medicina/estatística & dados numéricos , Educação de Graduação em Medicina/normas , Avaliação Educacional/normas , Avaliação Educacional/estatística & dados numéricos , Humanos , Critérios de Admissão Escolar , Estados UnidosRESUMO
OBJECTIVE: To understand attitudes and decision making regarding neonatal male circumcision. METHODS: Parents (n = 150) with a son 3 years old were interviewed regarding demographics, communication with a medical provider, attitudes, and process by which the neonatal circumcision decision was made. RESULTS: Thirty-three percent of sons were circumcised. In univariate analyses, choosing male circumcision was associated with parents being interviewed in English, the father being circumcised, positive attitudes, being informed of the advantages of circumcision, making a decision before birth, and being offered a choice. In the final model, parents who came from a culture and family that believed in circumcision and who believed that it was not too risky were more likely to circumcise their sons. CONCLUSIONS: Decisions regarding circumcision appear to be influenced by values, risk perceptions, and medical providers. Future research should address ways of ensuring that families have the opportunity to make an informed decision.
Assuntos
Circuncisão Masculina/etnologia , Tomada de Decisões , Hispânico ou Latino/psicologia , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adulto , Pré-Escolar , Circuncisão Masculina/psicologia , Circuncisão Masculina/estatística & dados numéricos , República Dominicana/etnologia , Feminino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Modelos Logísticos , Masculino , Análise Multivariada , Cidade de Nova Iorque , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estudos Retrospectivos , Saúde da População UrbanaRESUMO
We sought to determine whether the interval between menarche and age of first sexual intercourse is associated with subsequent human papilloma virus (HPV) infection and if so, whether the association is independent of the age of first sexual intercourse. Female university students completed a survey and were screened for cervicovaginal HPV infection. HPV-positive subjects were matched to HPV-negative subjects (n = 504). Mean subject age was 20.4 +/- 2.1 years, age of first sexual intercourse 16.7 +/- 1.8 years, and interval 4.4 +/- 2.0 years. The interval was associated with HPV infection, but the association became nonsignificant in univariate stratified analyses and multivariate models estimating the association between the interval and HPV infection. A short interval is associated with HPV infection, but the association is not independent of age of first sexual intercourse. Age of first sexual intercourse should be considered an important and identifiable risk factor for subsequent HPV infection in research and clinical settings.
Assuntos
Coito , Menarca , Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Infecções Tumorais por Vírus/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Modelos Logísticos , Fatores de Risco , Fatores de TempoRESUMO
Os cuidados médicos do paciente com câncer abrangem uma ampla variedade de rotinas diagnósticas e terapêuticas para diferentes tipos de tumores e problemas do hospedeiro. São comuns e disponíveis muitos livros-texto de Oncologia; a maioria deles são tão volumosos e detalhistas que fica difícil extrair uma abordagem prática e completa para um paciente. Oncologia Prática: cuidados com o paciente é dirigido para internistas, médicos de família, residentes, estudantes de medicina e enfermeiras que necessitem de uma revisão de Oncologia Clínica sucinta, porém compreensível e completa. O escopo deste livro é amplo, mesmo com apresentação compacta. Da carcinogênese e oncogenes a recentes tendências em imunoterapia e transplante de medula óssea, este livro serve como uma introdução ao envolvente campo da oncologia. Os capítulos iniciais revisam os princípios básicos de patologia oncológica, radiologia, radioterapia e farmacologia de agentes antineoplásicos. São apresentadas disciplinas especializadas da ginecologia, psicologia e enfermagem oncológica, com revisões atualizadas do manuseio da dor, náuseas e vômitos, cuidados com paciente terminal, fatores de crescimento e infecções no hospedeiro imunocomprometido. Também são considerados cânceres específicos, com detalhes pertinentes do diagnóstico, estadiamento, tratamento e prognóstico. O câncer representa um desafio preocupante. A cancerologia teve grandes avanços e espera-se para frente muito mais, num futuro bem próximo. Nós esperamos que este livro seja para nossos colegas e estudantes um guia (confiável) valioso no estado da arte atual da oncologia e na perspectiva de novos avanços