It has been reported that medicalstudents become more cynical as they progress through medical school. This can lead to a decline in empathy. We fre- quently heard that the medical education makes the students “technical literates” but not “educated”. Medical colleges have often been dubbed as “ivory towers isolated from the social-cultural value system, National Health Service systems” which applies to the current scenario of teaching of Community Medicine in Nepal as well. Our country is in dire need for rural oriented health care practi- tioners. It reveals that there is weak relation between health practitioners and patients as well as community. The study will also help to find out the gaps in the doctor-patient relationship and patient care. Thus this study has investigated empathy more closely across the entirety of medical school education of Nepal while controlling for the potential confounding effects of age, gender, ethnicity, religion, marital status etc.
The emphasis placed during medical training on medical ethics, a considerate attitude towards the patient‟s wellbeing and a concentration on a patient centred approach might have increased empathy in second year and final year students. Furthermore, after the second year of medical school, there is constant patient exposure where students are required to learn history-taking skills and regular examinations that build the student‟s professional attitude and approach to gaining patient cooperation, factors may enhance student empathy. Subjects such as behavioural sciences and medical ethics are taught in the third year of medicine; integrating behavioural sciences at the undergraduate levels can help doctors-in-training to have a better understanding of behavioural issues in clinical settings later on. Hence, the training obtained throughout medical school may persuade students to implement empathetic manner in their interpersonal relationships with patients rather than a more emotional sympathetic behaviour.
A large proportion of students in both clinical and basic science have potential psychological problems. The stres- sors experienced by the students were mainly related to academics and psychosocial concerns. These stressors need to be analyzed further. There is need to address these stressors by student advisors, peer education and coun- seling. The coping strategies commonly used by the stu- dents were positive reframing, planning, acceptance, active coping self distraction and emotional support. No new coping strategies were discovered in our Nepalese set- ting. The students should be taught different stress man- agement techniques to improve their ability to cope with a demanding professional course. The living conditions of the students and their recreational facilities should be improved. There is also need to bring about changes in the quality of teaching and evaluation system.
Introduction: A medical humanities (MH) module is conducted for all first year students at at KIST Medical College, Lalitpur, Nepal. Objective: The present study was conducted to measure empathyamongstudents before and after a Medical Humanities (MH) module using Interpersonal Reactivity Index (IRI) a validated measure of empathy at KIST Medical College, Lalitpur, Nepal from February to May 2009. Method: IRI was administered to students before and on conclusion of the module. IRI measures four aspects of empathy: Perspective-taking (PT), Fantasy (FS), Empathic concern (EC) and Personal distress (PD). Students were invited to participate in the study. Demographic information (gender, method of financing of medical education, area of residence and occupations of parents) was collected. The pre-module and post-module scores were compared among different subgroups of respondents using appropriate non- parametric tests (p<0.05). Result: Sixty-four of the 75 students (85.3%) participated in the survey pre-module and 57 students (76%) post-module. Most were self-financing and from urban areas. Before the module the median (interquartile range) FS, PT, EC and PD scores were 20, 18 (15-20), 21 (18.25-24) and 15 (10-18) respectively (maximum score 28 for each subscale). The PD score was significantly higher among females (p<0.001) and students whose father was not a doctor (p=0.049). After the module the median (interquartile range) FS, PT, EC and PD scores were 20 (15-24), 20 (17.5-22), 21 (17.5-23) and 16 (13-19) respectively. The PT score was significantly higher after the module (p=0.023). Conclusion: The module increased PT scores (cognitive empathy) in first year students. Follow up studies and studies in larger populations are required.
compared to male students . Similarly, graduate entry course students, at a given point in their course, recorded higher mean scores than standard course stu- dents. Since they start medical education having com- pleted a first degree, graduate entry course students tend to be older and many have more relevant life experience than standard course students. Inconsistent results con- cerning the trajectory of empathy during medical educa- tion have been reported by studies both of students entering medical education typically at aged 18 [18, 30, 32, 52] and of those who do so having completed a first degree [20, 25, 27]. However in our study, students com- pleting their course did not record lower empathy scores than those starting their course regardless of whether they had entered medical education as standard or graduate course students.
although the sample in these two studies was Chinese medicalstudents, the scale used for measuring empathy was the student version of the Jefferson Scale of Phys- ician Empathy (JSPE-S). Research results concerning em- pathy in medicalstudents from other cultures were also inconsistent. A study with a sample of 320 medical stu- dents across the 1 st to 6th academic years in Brazil de- tected no significant differences in empathy considering students’ grade , whereas research in Iran indicated that the overall level of empathyamongmedical stu- dents in the preclinical period was higher than that in the clinical period . However, another study from India showed that medicalstudents’ empathy scores had a tendency to decline initially and then rebound over time . The contradiction in these findings may be due to the differences in measurement tools, cultures and the environment in which the empirical research was carried out. Another point worth mentioning is that no significant difference in the mean empathy score was found between males and females in the present study, which was in line with the conclusion of the study by Li , although a number of other studies revealed that female medicalstudents were more empathetic than males [31–34].
As many students complete their undergraduatemedical course every year, there is a tough competition to secure the seats for a postgraduation course of their interest in Nepal. However, the pattern of postgraduate studies, ie, either nonpay or pay-system, is currently under consideration by the Nepalese government for new rules and regulations. However, competition will be always prevalent because of the limited number of seats in postgraduate courses in differ- ent colleges (both government and private) and the high num- bers of aspirants for the course. Currently, medicalstudents have options for basic sciences, clinical sciences (medical and surgical), and public health for their postgraduation. 2
Previous reported studies have found that underreporting of ADRs is related with shortcomings in the knowledge and attitude among healthcare professionals. 12, 13 Therefore, in order to improve the reporting rate and for the successful running of Pharmacovigilance program, it is important to improve the knowledge, attitude and practices (KAP) of the healthcare professionals regarding ADR reporting and pharmacovigilance. The best time to do it is probably during the undergraduate training career of the doctors. Medicalstudents could play a major role and bring a paradigm shift in successful implementation of pharmacovigilance program if proper training regarding pharmacovigilance is imparted to them but at present they do not have any significant role which is due to inadequate training to them. 14, 15
India is currently in need of large number of public health specialists to combat the double burden of communicable and non-communicable diseases. But it is seen that medical graduates are not that much interested in a career as a public health specialists. This current study was an attempt to find out the preferred subjects for future specialization amongmedicalstudents and how they perceived Community Medicine as a future career option. According to the current study the most preferred subjects for specialization amongundergraduatemedicalstudents were internal medicine followed by surgery and Obstetrics and Gynecology. The most preferred subjects among males was medicine followed by surgery and among females was Obstetrics and Gynecology followed by medicine. These findings were similar with results of other studies done in India, Nepal and Bangladesh where clinical branches like medicine and surgery were mostly preferred for specialization. 5-8 In the present study it was also found that with progression of medical course the choice for future specialization also changed. Subjects like orthopedics and radio-diagnosis were more preferred by final year students than students from other professional years. This may be because students got exposure to these subjects in the final professional year. In the current study it was found that only countable number of participants (4%) chose Community Medicine as a career option which was similar to results of other studies done at different settings where the number of participants who chooses Community Medicine as a future career is also very less. 9,10 In the present study it was found that higher proportion of students from rural background opted Community Medicine as a career option in comparison to students from urban background which was similar to result of another study done by Singh et al. 4
Objectives: This descriptive study of 219 undergraduatemedicalstudents at Patan Academy of Health Sciences in Nepal was conducted to evaluate the re- lationships of their demographic variables with a health-promoting lifestyle profile. Methods: The Health Promoting Lifestyle Profile (HPLP) question- naire was used to studystudents’ lifestyles. We compared the HPLP scores according to gender, residence type, school background and year of study. One-way analysis of variance (ANOVA) and multiple comparison test were conducted to identify significant differences among university year (first, second, third and fourth) groups. Multiple regression analysis was used to analyze the effects of various demographics on the overall HPLP score and the six health-promoting lifestyle subscales. Results: The overall HPLP mean score of participants was 2.60 ± 0.29, with the highest mean scores being for spiri- tual growth (2.99 ± 0.42) and interpersonal relations (2.90 ± 0.35), and the lowest mean scores being for health responsibility (2.39 ± 0.39) and physical activity (2.25 ± 0.54), respectively. The overall HPLP score of the students was the highest for the first year students at 2.65 ± 0.26. The male students had a better overall HPLP score, although female students obtained better score in some sub-scales such as health responsibility, interpersonal relations and nu- trition. The students from a public school background had significantly higher scores for health responsibility, physical activity and stress management than those who graduated school level education from a private school. Conclu- sions: The results of this study reveal that the status of health promoting be- haviors among the students was acceptable with ample room for improve- ment. Implementation of health education and promotion programs with an How to cite this paper: Paudel, S., GC,
to identify reasons as available literature is not adequate particularly in developing countries. Several studies have investigated potential differences in empathy between students from different study year; however, there are still significant gaps in the literature.[13, 24, 28] Students in the second year of study had higher mean empathy score compared to students in other study years, whereas students in the fourth year had lowest empathy score in our study. Similar results can be seen in medical and dental students as well.[13, 24] This decline in student empathy appears to be a common phenomenon emerging in the literature.[14, 16, 20, 35] As empathy is a core “ingredient” of good health care professional- patient relationship,[2, 3] improving students’ empathy is one of the important tasks of medical education. However, empathy is generally only taught in a context where it is not formally evaluated and is rarely integrated into clinical teaching and learning. Our findings of junior students being more empathic than senior students could be partially explained by the fact that participating universities covered certain aspects of empathy in year one and year two. As time progress, they tend to forget and focus on other subjects, or students become ‘hardened’ or develop an emotional coping mechanism that distances themselves from the patients they work with once they gain clinical experience. Idealism or eagerness to show positive attributes of healthcare provider embraced by junior students erode as they progress through their professional education.[12, 18] Other reasons include stressful workload, limited bedside interactions with patients and environmental factors.[13, 42]
Background: CAM inclusion into the curricula of health training institutions, a strategy for its integration into the main stream healthcare delivery system is growing globally. Future healthcare professionals knowledge and perception of CAM are key determinants to its successful integration. Thus, the main objective of this study was to compare the use, attitude and interest to study CAM among final year undergraduatemedical, pharmacy and nursing students at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Methods: A questionnaire based cross-sectional survey was carried out among final year medical, pharmacy and nursing students enrolled at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Chi square, fisher exact two tailed test and Kruskal-wallis test were used to analyze data collected. Results: Close to two-thirds (61 %) of all the three groups of final year students used one form of CAM or the other with pharmacy (72.7 %) and nursing (55.6 %) students being the highest and least users respectively. No significant difference was observed among the three groups. In general, final year students in all three cadres demonstrated a positive attitude toward CAM (33.80 ± 3. 2) with medicalstudents showing more positive attitude than pharmacy ( p = 0.022) and nursing student ( p = 0.008). No significant difference in attitude was observed between students in pharmacy and nursing programs ( p = 0.354). More than three quarter (76.6 %) of the students in all the three groups indicated their interest in studying CAM, with preference for the subject to be taught as an elective module (81.6 %).
The course at Cambridge comprises: a Core Science component (Years 1-3) during which students learn core medical science (Year 3 comprising options which may not be medicine or science-related) with a small element of clinical experience; and a Clinical component (Years 4-6) during which students learn in a clinical environ- ment (Figure 1). Between 270 and 290 students, typically aged 18 years, enter the Core Science component. At the end of Year 3, approximately half of these continue into the Clinical component, joined by a small number of stu- dents from other universities. From September 2007, all students entering Years 1 and 4 (the first years of the Core Science and Clinical components respectively) were invited to take part in a longitudinal study comprising an annual questionnaire survey. To date, participants com- prise students entering the Core Science and Clinical components in 2007, 2008, 2009 and 2010. Students entering the Clinical Component in 2010 comprised those students who had entered the Core Science compo- nent in 2007, who remained in Cambridge.
and herbal medicines are also commonly used for self-medication because of their easy availability and accessibility; people have some knowledge about herbal remedies, and hold the perception that herbal products are safe and devoid of side-effects . Medicalstudents during their undergraduate years of study are not legally eligible to prescribe medicines despite their increasing knowledge about the pathophysiology of diseases and therapeutics. Thus they may be in a unique situation with regard to self-medication. Recent studies have shown self-medication to be common amongmedicalstudents and the incidence was high in medical colleges of South India (92%) , Karachi (76%)  and Egypt (55%) . Self-medication amongmedicalstudents may be more because they are empowered with good educational level, greater access to medicine and information, and knowledge of diseases [2,10]. The medical student should have good knowledge about self-medication so that they can practice responsible self-medication. [Table/Fig-1] compares few research articles conducted in India and Nepal on self-medication amongmedical and paramedical students. Self-medication is unavoidable in certain circumstances so the public should be motivated to practice responsible self-medication . Medicalstudents, future doctors and medical educators, with good knowledge about self-medication could advocate, motivate, and impart essential knowledge to their patients and the general public for responsible self-medication. Furthermore, doctors should be knowledgeable about the self-medication practice in the community so that they could enquire about self-medication by their patients before prescribing medicines. This could help them optimize therapy and avoid drug-drug interactions.
The higher empathy scores among senior medical stu- dents could be cohort effects, but could also reflect the influence of training. It is not known which educational elements might be associated with the latter possibility. One plausible candidate would be the curricular empha- sis on the principles of humanism and patient centered- ness in medical care. This begins in the four weeks of medical school. A vertically integrated humanities pro- gram running from year 1 up to year 6, maintains this emphasis. There are other important elements across the curriculum aimed at nurturing the development of empathy. The training of communication skills starts in the second year. Students interview a family at different points in time during the second and third years. Twenty per cent of the clinical clerkship time spent in primary care in urban, sub-urban and rural settings. Clerkship assessments include the clinical teachers ’ score of student “ professionalism ” . Each student is
A cross-sectional study was conducted among the undergraduatestudents of NepalMedical College. Prior to starting the study, an ethical approval was obtained from Institutional review committee of NepalMedical College and Teaching Hospital (IRC Ref. No.: 51-074/075). All the participants were informed regarding the aims and objectives of the study and at the meantime interested participants signed formal informed consent. The list of students was obtained from the academic section of the college and the samples were chosen using a lottery method. Based on the study of Mehta N. et al, 12 sample
Abstract: Empathy is important to patient care. It enhances patients’ satisfaction, comfort, self-efficacy, and trust which in turn may facilitate better diagnosis, shared decision making, and therapy adherence. Empathetic doctors experience greater job satisfaction and psychological well-being. Understanding the development of empathy of tomorrow’s health care professionals is important. However, clinical empathy is poorly defined and difficult to measure, while ways to enhance it remain unclear. This review examines empathyamongundergraduatemedicalstudents, focusing upon three main questions: How is empathy measured? This section dis- cusses the problems of assessing empathy and outlines the utility of the Jefferson Scale of Empathy – Student Version and Davis’s Interpersonal Reactivity Index. Both have been used widely to assess medicalstudents’ empathy. Does empathy change during undergraduate medi- cal education? The trajectory of empathy during undergraduatemedical education has been and continues to be debated. Potential reasons for contrasting results of studies are outlined. What factors may influence the development of empathy? Although the influence of sex is widely recognized, the impact of culture, psychological well-being, and aspects of undergraduate cur- ricula are less well understood. This review identifies three interrelated issues for future research into undergraduatemedicalstudents’ empathy. First, the need for greater clarity of definition, recognizing that empathy is multidimensional. Second, the need to develop meaningful ways of measuring empathy which include its component dimensions and which are relevant to patients’ experiences. Medical education research has generally relied upon single, self-report instruments, which have utility across large populations but are limited. Finally, there is a need for greater methodological rigor in investigating the possible determinants of clinical empathy in medical education. Greater specificity of context and the incorporation of work from other disciplines may facilitate this.
Demographic profiles were obtained from the students and these include their roll number, age, gender, race, religion, address, birth order, blood groups, handedness, family’s literacy, and This study also compares different personality types and the likelihoods of them donating an organ. The Big Five is a model based on common language descriptors of personality [14,15]. In a table, for each standardised question, a score disagreeing, 2 is for slightly disagree, 3 is for neutral, 4 is for slightly agree and 5 agrees. The scores should be between zero and forty. Five descriptive types are identified which are Extroversion (E), Agreeableness (A), Conscientiousness (C), ticism (N) and Openness to Experience (O). Extroversion (E) is the behavior of striving contentment from sources outside the self or in the community. High scorers tend to be very outgoing while low scorers prefer to work alone. individuals who adjust their conduct to suit others. High scorers are typically polite and gregarious. Low scorers have a tendency to speak their mind. Conscientiousness (C) is the personality trait of being honest and hardworking. High scorers tend de by rules and favor organised home environment. Low scorers may be messy and may tend to deceive others. Neuroticism (N) individuals are emotional and sensitive beings. Openness to Experience (O) is the personality trait of seeking new capabilities and scholarly pursuits. High scorers tend to daydream and fantasise. Low scorers are most likely people who are subservient and unassertive.
Abstract— Men cannot solely manage all the activities of our institutions; women also play tremendous role in management. However, some people have negative attitude towards women in management positions. The present study examined how gender differences influence attitude towards women in managerial positions. The study also examined whether attitude towards women in managerial positions is determined by the perceived integrity of the women. A total of two hundred (200) undergraduatestudents of the University of Ghana were selected using convenience sampling to complete the Perception of Integrity Scale and Leadership Scale Inventory. Data was analysed using the independent t-test and the Pearson r. Results revealed that females had significantly positive attitude towards women in management than males. Christians had significantly positive attitude towards women in management than Muslims. There was a significantly positive relationship between perception of integrity of women in management and attitude towards women in management. The implication of the study is that perceived attitude towards women is influenced by the integrity of the women. Keywords— attitude; integrity; management; women; perception; gender; religion.
Kuss DJ and Griffiths MD in their study report that MMORPG are the most preferred type of internet games, in which players often socialize in groups and cooperate with each other to achieve game-relevant goals. Moreover, such games are played by taking on virtual personalities. These personalities may be referred as avatars. These kinds of games enable the player to explore boundaries between the real and the imagined, between the fantasy and the reality, between the self and the other.