Letters to the Editor

The uptake of podcasting and portable media players amongst UK medical students

Dear Sir

There is an increasing drive in medical education to utilize technology to augment teaching and learning. Portable media players facilitate the accessibility of materials and allow e-learning whilst away from desk-based computers. Audio and video podcasts are becoming more popular as bandwidth increases, allowing for larger files such as videos to be used. Teaching videos are not novel, but the availability of portable media players allows ubiquitous consumption. Studies have previously demonstrated the effectiveness of audio podcasts as a teaching medium (Atreja et al. 2008; Shantikumar 2009). An anonymous questionnaire was designed to probe the knowledge and use of podcasting among medical students.

The uptake of podcasting was high with 98% having used audio podcasts and 53% video podcasts (100 responses). 94% of students have a media player capable of playing audio files and 60% video files. Students were very interested in using podcasts on portable players with 46% rating it 10/10 (mean 8.27/10). When asked if podcasting could replace teaching sessions, the mean score was 2.59/10. The mean score increased to 9.11/10 in response to being asked whether podcasts should augment existing teaching (p ≤ 0.0001, Students t-test).

A key advantage of podcasting is that it allows students to take their revision with them on the move. Media players allow students to utilize both audio (94%) and video (60%) podcasts at home or in the hospital. E-learning provides a suitable medium for those unable to attend didactic lectures. Students on the whole were keen to see podcasts being utilized as a part of their curriculum; however the idea of podcasting replacing teaching sessions was rejected. Those involved in the teaching of medical students should be aware of the current high uptake of podcasts by students. Teachers considering making available their own content should be encouraged as it will be well received and widely utilized.

T.A. Coughlin, K.I. Jones, J.N. Lund

R.G.E. Clement & C.L. Longman

Department of Orthopaedics, Royal Derby Hospital

England, UK

Keaton Jones

Faculty of Medicine and Health sciences,

University of Nottingham, Queen's Medical Centre,

Nottingham NG7 2UH, UK

*E-mail: [email protected]

Lifestyle and psychological distress in medical school students

Dear Sir

Training for a career in medicine and nursing is associated with significant stressors. The relationship between lifestyle and psychological distress in medical students is not fully elucidated. In fact, there are few studies comparing medical and nursing students. We used General Health Questionnaire (GHQ)-30 and additional questions that were focused on current lifestyle to examine lifestyle and psychological distress in 312 medical and nursing course students of first and second school year. To further investigate the relationship between exercise and psychological distress, we measured the extent of a movement over seven days. We chose year 1 and year 2 students to avoid the distress of bedside training that begins after year 2. One hundred and sixty-three medical students completed the study. Overall average GHQ-30 score was 8.9 ± 5.9. There are no differences between male and female students. The mean GHQ-30 score was significantly higher in students with short sleeping hours, binge eating and unsatisfactory oral health, suggesting a relationship between sleep and oral health condition with psychological status. One would expect that preventing overeating and reducing obesity would be important contributors to physical and mental health in medical students. GHQ score in subjects with pedometer count less than 40,000 was significantly higher than those with pedometer counts from 50,000 to 60,000, suggesting that the exercise may be associated with better mental health in medical students (Ohta et al. 2007). The average GHQ-30 score in nursing students was significantly higher than those of medical students. Nursing students showed significant higher GHQ-30 score in physical symptoms, social dysfunction and anxiety/dysthymia elements compared with those of medical students. The reason for the differences in GHQ-30 score is unclear. However, the data suggest that course-sensitive support should be needed for better mental health in medical school students. There were important limitations of this study, in particular, small sample size and the cross-sectional design. A larger, longitudinal study would help resolve these limitations. Regardless, the present study suggests a need for counseling during early stage medical training, particularly in nursing students.

Kayo Sugimoto, Yufu Ogasahara, Miwa Saito

Akiko Fujita & Toshihiro Takao

Department of Community Nursing, Kochi Medical School,

Nankoku 783-8505, Japan

E-mail: [email protected]

Assessing the effects of curricula change on student learning: An ethnographic methodology

Dear Sir

Curricula changes in higher education are commonplace; however the effects of such changes on student learning are rarely evaluated. Curricula assessments within clinical professional courses require multi-model assessments of student learning outcomes (Robley et al. 2005). These are particularly important for assessing student preparedness and competency for autonomous clinical practice to ensure that the professional and legal requirements of clinical courses are maintained.

The undergraduate physiotherapy curriculum at the University of Otago has recently undergone change. No other research detailing the evaluation of the effects of curricular change in physiotherapy could be found; therefore we have developed a novel methodological approach to address this issue.

We will employ a longitudinal ethnographic research design to investigate the effects of the curriculum on a range of clinical competencies, including student preparedness for and knowledge integration in clinical practice and professionalism as an autonomous practitioner. This observational study will compare two cohorts of final-year physiotherapy students from different curricula. A mixed methods approach will be used to collect data from each cohort across three disciplines of physiotherapy (musculoskeletal rehabilitation, neurorehabilitation and tertiary care/cardiopulmonary rehabilitation). We will collect data from a variety of sources: student clinical assessment grades; student on-line surveys will investigate preparedness for clinical practice; student and clinical educator focus groups will look at the effects of the curriculum on student learning and an employer survey one year post graduation will assess competencies as an autonomous practitioner. Analyses will compare student learning outcomes between the two curricula. Themes generated from focus groups will also be used to triangulate the data and assess for divergence.

This ethnographic approach explores experiences of student learning within a community of practice (O’Donnell et al. 2009), allowing exploration of student learning within the context of the institution and the wider community. This methodology provides a framework for clinical programs to assess curricula change and the outcomes generated will provide information of the effects of curricular change from a range of stakeholders surrounding physiotherapy education. The results will lend evidence-based support to the education of physiotherapy students and have the potential to form a template for curricula evaluation in clinically-based professional courses.

P.A. Hendrick, L.S Claydon, G. Sole & J. Conroy

Department of Physiotherapy,

University of Otago, New Zealand, Dunedin, New Zealand,

E-mail: [email protected]

C.A. Wassinger

Department of Physical Therapy,

East Tennessee State University, Johnson City, TN, USA

Journal club at a Chinese university for international medical students

Dear Sir

Journal clubs have been used as a teaching format in academic medicine for over a century. Club affiliates comprise of groups of people who meet regularly to critically discuss a published article of common interest. The article is usually written by researchers and clinicians over a defined topic in any field of medicine. Club activity provides professionals with an opportunity to present scientific papers orally to their peers and develop their debating skills. Participants become familiar with scientific literature and develop a better understanding of epidemiology and biostatistics.

Jiujiang University (JJU) is located in Jiujiang City, Jiangxi Province of the People's Republic of China. JJU has more than 30,000 full-time Chinese students with over 150 foreign medical students. Most of the students are from India, with the rest coming from Pakistan, Bangladesh, Afghanistan, Nigeria and Ghana. The instruction medium for the International MBBS program is in English.

The Journal club at JJU for International Medical Students is a formalized club composed of undergraduate medical students. The aim is to involve students in critical appreciation of scientific literature. Club meetings are held once every week and fits conveniently into the teaching schedule. Presentation is compulsory and to optimize participation credit is given for attendance. A student committee is responsible for overseeing club activities and students voluntarily suggest articles relevant to their studies. According to a standard agenda, on the day of meeting the presentation is made orally in English followed by queries which often generate a lively debate. A guest faculty who is an expert on the concerned topic is often invited to stimulate the discussion. A faculty member (MTR) acts as the mentor and is responsible for assessing and suggesting improvements in club activities.

China has emerged as a growing hub for medical education. Increasing number of foreigners are attending MBBS programs here due to high demand for medical education coupled with raised tuition fees in their respective countries. Challenges in studying have included the need for English speaking faculty and curriculum. Response towards the Journal club at JJU has been overwhelming and has generated greater interest towards advanced learning among students.

Md. Tanveer Raza, Pranav Vaidya & Ravi Chandu

International Office, Jiujiang University

551 Qianjin Donglu, Jiujiang, Jiangxi 332005

P.R. China

Fax: [phone]

E-mail: [email protected]

Humanities and ethics education at Chinese medical schools

Dear Sir

What constitutes a proper medical education has changed significantly over the years, but recently, changes have been occurring more rapidly than ever before. This is because today's doctor must be more versatile, skilled in a number of areas that previously may have been deemed unnecessary or extraneous (Harden 2006). Today's doctor is not just a scientist but is also a humanist.

Medical schools have responded to this change by introducing courses on Humanities and Ethics. Although China is set to become a world economic leader, the state of its medical system has yet to be thoroughly examined. The teaching of medicine on a global scale has already gained much attention in the UK and US, but it is necessary for medical educators to develop a greater awareness of the reciprocal education that medical students in other countries receive (Kanter 2008). The goal of this study is to determine how and to what extent Chinese medical schools use the Humanities and Ethics in the training of future physicians.

Data was collected by survey at the Twelfth Medical Education Conference for China Mainland, Hong Kong, and Taiwan. The annual conference gathers medical faculty from the top medical universities in each region. Most of the participants are ranked in the top 50 best Chinese medical schools, and their annual participation in the distinguished Medical Education Conference reflects their sustained and profound commitment to influencing the direction of future medical education initiatives in China.

Most Chinese medical curriculum designers have embraced the Humanities and Medical Ethics. 31 (96.9%) Chinese medical schools offer courses in the Humanities, and all 32 (100.0%) Chinese medical schools surveyed offer courses on Ethics. While most schools have mandatory courses in both subjects, more schools have electives in the Humanities than in Medical Ethics. This suggests that the Chinese medical institutions in our study tend to view Ethics as a subject that is less suitable for elective classes than for Humanities classes, although both topics are equally important for mandatory classes.

A.P. Fan, T.P. Su, Y.A. Chen, C.H. Chen & C.H. Lee

Faculty of Medicine

National Yang-Ming University, Taipei, Taiwan

E-Mail: [email protected]

W. Tang & Q. Chen

NanJing Medical University, NanJing, China

L. Guo

Bejing University, Beijing, China

R.O. Kosik

UCLA School of Medicine, Los Angeles, USA