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  • 1. Ahlborg, Liv
    et al.
    Weurlander, Maria
    Hedman, Leif
    Nisel, Henry
    Lindqvist, Pelle G
    Felländer-Tsai, Li
    Enochsson, Lars
    Individualized feedback during simulated laparoscopic training: a mixed methods study.2015In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 6, p. 93-100Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed to explore the value of individualized feedback on performance, flow and self-efficacy during simulated laparoscopy. Furthermore, we wished to explore attitudes towards feedback and simulator training among medical students.

    METHODS: Sixteen medical students were included in the study and randomized to laparoscopic simulator training with or without feedback. A teacher provided individualized feedback continuously throughout the procedures to the target group. Validated questionnaires and scales were used to evaluate self-efficacy and flow. The Mann-Whitney U test was used to evaluate differences between groups regarding laparoscopic performance (instrument path length), self-efficacy and flow. Qualitative data was collected by group interviews and interpreted using inductive thematic analyses.

    RESULTS: Sixteen students completed the simulator training and questionnaires. Instrument path length was shorter in the feedback group (median 3.9 m; IQR: 3.3-4.9) as compared to the control group (median 5.9 m; IQR: 5.0-8.1), p<0.05. Self-efficacy improved in both groups. Eleven students participated in the focus interviews. Participants in the control group expressed that they had fun, whereas participants in the feedback group were more concentrated on the task and also more anxious. Both groups had high ambitions to succeed and also expressed the importance of getting feedback. The authenticity of the training scenario was important for the learning process.

    CONCLUSIONS: This study highlights the importance of individualized feedback during simulated laparoscopy training. The next step is to further optimize feedback and to transfer standardized and individualized feedback from the simulated setting to the operating room.

  • 2.
    Alers, Margret
    et al.
    Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, the Netherlands.
    Verdonk, Margret
    Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, the Netherlands.
    Bor, Hans
    Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, the Netherlands.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lagro-Janssen, Antoine
    Radboud University Medical Center, Department of Primary and Community Care, Gender and Women's Health Unit,Nijmegen, the Netherlands.
    Gendered career considerations consolidate from the start of medical education2014In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 5, p. 178-184Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore changes in specialty preferences and work-related topics during the theoretical phase of Dutch medical education and the role of gender.

    Methods: A cohort of medical students at Radboudumc, the Netherlands, was surveyed at start (N=612, 69.1% female) and after three years (N=519, 69.2% female), on specialty preferences, full-time or part-time work, motivational factors, and work-life issues. Chi square tests were performed to analyze gender-differences, and logistic regression to explore the influence of gender on considerations.

    Results: A total of 214 female and 78 male students completed both surveys. After three years, the male students remained highly interested in surgery, but the female students increasingly preferred gynecology. These initial preferences were predictive. Four out of five male students versus three out of five female students continued to show a full-time preference. Women increasingly preferred part-time work. After three years, the combination of work, care, and patient contact motivated female students more, whereas salary remained more important to male students. Female students indicated that their future careers would influence their family life; male students assumed having a family would only affect their partners' careers.

    Conclusions: Against an international background of the feminization of medicine, our study shows that career considerations are reinforced early in medical studies. Women prefer to work fewer hours and anticipate care tasks more often. Students' preferences reflect Dutch cultural norms about working men and women. Therefore, guidance in choice-making much earlier in medical education can create opportunities.

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  • 3. Courteille, Olivier
    et al.
    Fahlstedt, Madelen
    Ho, Johnson
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Fors, Uno
    Von Holst, Hans
    Felländer-Tsai, Li
    Möller, Hans
    Learning through a virtual patient vs. recorded lecture: a comparison of knowledge retention in a trauma case2018In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 9, p. 86-92Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare medical students' and residents' knowledge retention of assessment, diagnosis and treatment procedures, as well as a learning experience, of patients with spinal trauma after training with either a Virtual Patient case or a video-recorded traditional lecture. Methods: A total of 170 volunteers (85 medical students and 85 residents in orthopedic surgery) were randomly allocated (stratified for student/resident and gender) to either a video-recorded standard lecture or a Virtual Patient-based training session where they interactively assessed a clinical case portraying a motorcycle accident. The knowledge retention was assessed by a test immediately following the educational intervention and repeated after a minimum of 2 months. Participants' learning experiences were evaluated with exit questionnaires. A repeated-measures analysis of variance was applied on knowledge scores. A total of 81% (n = 138) of the participants completed both tests. Results: There was a small but significant decline in first and second test results for both groups (F-(1,F-135) = 18.154, p = 0.00). However, no significant differences in short-term and long-term knowledge retention were observed between the two teaching methods. The Virtual Patient group reported higher learning experience levels in engagement, stimulation, general perception, and expectations. Conclusions: Participants' levels engagement were reported in favor of the VP format. Similar knowledge retention was achieved through either a Virtual Patient or a recorded lecture.

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  • 4.
    Danielsson, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professional Development.
    Hadding, Cecilia
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professional Development.
    Martin, Fahlström
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professional Development.
    Ottander, Ulrika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Lindquist, David
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professional Development.
    Medical students’ experiences in learning to perform pelvic examinations: a mixed-methods study2021In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 12, p. 233-242Article in journal (Refereed)
    Abstract [en]

    Objectives: We aimed to explore learning experiences among medical students learning to perform pelvic examinations and to identify factors that facilitate their training.

    Methods: A mixed-methods study including a web-based survey and focus group discussions (FGDs) was conducted among medical students who had completed their obstetrics and gynaecology (ObGyn) clerkship. The FGDs were recorded, transcribed and analysed using qualitative content analysis with systematic text condensation. Survey factors were compared using the χ2 test or Fisher's exact test.

    Results: 160 students (97 female, 61 male, two other) at six universities in Sweden responded to the survey. Two mixed FGDs were conducted. The majority (87%) of the students experienced confidence in performing pelvic examinations, stating that sufficient, repeated training opportunities and support from a clinical tutor were crucial components of the learning experience. Prior to the ObGyn clerkship, negative expectations were more common among male students. The male participants experienced having a disadvantage because of their gender, while female students considered their gender an advantage (p<0.001, N=121, Fisher's Exact Test). The clinical tutor and the use of professional patients (PPs) had a fundamental role in providing learning opportunities by including the student in patient care activities.

    Conclusions: The importance of the clinical tutor, as well as the use of PPs, are important factors when planning education in pelvic examinations, and this knowledge could be used when educating other intimate examinations during medical school. In addition, similar investigations on students' experience in training other intimate examinations could be considered.

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  • 5.
    Diderichsen, Saima
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Andersson, Jenny
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Verdonk, Petra
    VU University Medical Center, Department of Medical Humanities, EMGO Institute for Health and Care Research, Amsterdam, the Netherlands.
    Lagro-Janssen, Toine
    Department of Primary and Community Care, Centre for Family Medicine, Geriatric and Public Helth, Unit Women's Studies, Radboud University Nijmegen Medical Health Centre, The Netherlands .
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Swedish medical students' expectations of their future life2011In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 2, p. 140-146Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate future life expectations among male and female medical students in their first and final year.

    Methods: The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create statistically comparable themes and categories.

    Results: Students' written answers were coded, categorized and clustered into four themes: "Work", "Family", "Leisure" and "Quality of personal life". Almost all students included aspects of work in their answers. Female students were more detailed than male ones in their family concerns. Almost a third of all students reflected on a future work-life balance, but considerations regarding quality of personal life and leisure were more common among last-year students.

    Conclusions: Today's medical students expect more of life than work, especially those standing on the doorstep of working life. They intend to balance work not only with a family but also with leisure activities. Our results reflect work attitudes that challenge the health care system for more adaptive working conditions. We suggest that discussions about work-life balance should be included in medical curricula.

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  • 6.
    Lindberg, Ola
    Umeå University, Faculty of Social Sciences, Department of Education.
    Gender and role models in the education of medical doctors: a qualitative exploration of gendered ways of thinking2020In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 11, p. 31-36Article in journal (Refereed)
    Abstract [en]

    Objectives: To examine how 'gendered ways of thinking' relate to role models in medical education.

    Methods: This study employed an explorative, qualitative, and cross-sectional design. A total of 57 interviews were held with medical students (28 interviews) and with faculty members (29 interviews) at a Swedish medical school. Participants were asked to describe their role models and the attributes that made certain individuals role models. Data were analysed using an inductive approach in three separate steps that explored the relationship between role models and gender.

    Results: Males do not generally consider female doctors as role models, and male role models are generally viewed as more admirable than female role models. This was shown in all steps of the analysis and most prominently in how male role models were described as qualitatively more admirable than female role models. Male role models are thus more common (for male and female students) and described as more admirable. The results point to the persistence of 'gendered ways of thinking' that subtly shape medical students.

    Conclusions: Gendering role models is disadvantageous to female doctors in several ways, so the results have implications for women's career paths and opportunities. The results can thus form a basis for discussing and teaching the importance of gender in role modelling and in medical education in general.

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  • 7. Schlickum, Marcus
    et al.
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Fellander-Tsai, Li
    Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study2016In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 7, p. 56-61Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Methods: Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. Results: A good result in the first simulator trial correlated with higher self-determination index (r = -0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). Conclusions: This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.

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  • 8.
    van Tongeren-Alers, Margret
    et al.
    Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, the Netherlands.
    Verdonk, Petra
    VU Medical Centre, Department of Medical Humanities, EMGO INstitute for Health and Care Research, School of Medical Sciences, Amsterdam, the Netherlands.
    Bor, Hans
    Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, the Netherlands.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lagro-Janssen, Antoine
    Radboud University Medical Center, Department of Primary and Community Care, Gender and Women's Health Unit,Nijmegen, the Netherlands.
    How gender or culture affects first year Dutch and Swedish students' preferences for specialties and work-life issues2014In: International Journal of Medical Education, E-ISSN 2042-6372, Vol. 4, p. 214-220Article in journal (Refereed)
    Abstract [en]

    Objectives: We determine how gender or culture influence new medical students' specialty preferences and work-life issues and explore the relation between work-life issues and each specialty preference.

    Methods: In a cross-sectional study, we surveyed first year Dutch and Swedish medical students (N=1173, cohorts from 2006-2009) on their preferences for specialties, full-time or part-time work, and agreement to eleven work-life issues. We tested differences by gender or culture using chi square and logistic regression.

    Results: Over 93% of all students responded (N=1095). Almost no male first year student preferred gynecology as a specialty. Dutch male students were more often interested in surgery, Dutch female students in paediatrics. In the Netherlands, male students in particular preferred full-time work. In Sweden gender did not influence working hour preferences. Women in both countries expected equality in career-opportunities and care-tasks more than men, and agreed more often that their career would influence their family life. Women with a preference for surgery most often emphasized equality in career opportunities and care tasks. In most preferred specialties female gender related to a lower degree to full-time work. A gender gap in preferred working hours was larger for Dutch students preferring surgery or paediatrics than for Swedish students. For most of the specialty preferences studied, Swedish students anticipated childcare by day cares and Dutch students' informal day care.

    Conclusions: Early in training, medical students have gendered specialty preferences and work-life preferences which relate to each other. Gender differences are signifi-cantly more pronounced in the Netherlands than in Sweden.

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