Knowledge, attitude and reservations of medical students about organ transplantation: results of a survey during the first year of study

AIM: Establish a list of first year medical students' attitudes, doubts, and knowledge in the fields of organ transplantation and donation. METHOD: Anonymized questionnaire handed out to students during class lectures. RESULTS: 183 questionnaires were distributed and 117 returned (participation: 64%). The average age of the students was 21.6 +/- 2.7 years (range 18 to 38 years); the sample included 71 women (60.7%) and 48 men (39.3%). Only 2 students (2%) were not interested in the subject of organ donation. The students knew very little of the legal aspects of organ donation and 1/4 of them thought there was even a Federal law regarding organ transplantation. When asked if they knew whether a law existed in the Canton of Berne, 44% replied yes, but only 24 (20%) knew that this is contradictory. There was no gender difference in the answers to these question. From 57 students (48%) 246 individual comments on doubts and concerns were analyzed. In this respect, the students mainly questioned whether the donor was truly dead when donation took place (n = 48), if illegal transplantation could be eliminated (n = 44) and if transplantation was truly necessary (n = 43). Some also mentioned religious/ethical doubts (n = 42). In regard to organ donation by a living individual, 27 students were concerned about the health of this donor. 20 students had doubts regarding the pressure possibly applied by family members and friends and as many voiced doubts in regard to premature diagnosis of brain death of potential donors. Only 2 students were concerned about the post-mortem presentation. 45 students (48%) indicated discomfort with the donation of certain organs. They ranked the kidney as the first organ to donate, followed by the pancreas, heart, cornea, intestine, lung and liver. CONCLUSION: The interest in organ donation and transplantation is already strong in fist year medical students in the pre-clinical stage. However, differences from lay public are not readably detectable at this stage of medical training. Adequate information could influence future physicians in their mediatory role.     

Traumatic dissection of the vertebral artery: a case report

OBJECTIVE: To investigate the attitudes toward organ transplantation, organ donation and recipients in young people in Beijing, Shanghai, and Wuhan. METHODS: A questionnaire was designed for 3012 young people aged 20-45 years (999 in Beijing, 990 in Shanghai, and 1023 in Wuhan). The data of questionnaire were processed with SPSS software. RESULTS: Over 90% of the respondents knew that human organs can be transplanted; over 85% considered that organ transplantation is a welfare undertaking; more than 85% thought that when someone's organ is in critical condition, it is necessary to perform organ transplantation; over 70% expressed willingness to receive organ transplantation if it is needed or possible. In the mode of organ donation, 70% emphasized that organ donation should be dependent on volunteers and the donor should be rewarded in a certain form. Organ recipients in sequence are relatives, specialized medical institutions, friends, members of volunteer organizations, and others. The factors affecting the attitudes towards organ transplantation are analyzed. CONCLUSION: There is a better attitude toward organ transplantation among young people in cities. The conventional attitudes and feudal habits are one of the major obstacles to the course of organ donation in China.     

Endothelial changes following repeated effect of vasoconstrictive substances in vitro

A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10-item attitude assessment about abusive behaviour were administered to the first- and fourth-year medical students at a mid-west US university medical school. The first- and fourth-year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth-year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.     

Knowledge and attitudes of nurses on a regional neurological intensive therapy unit towards brain stem death and organ donation

The study aimed to explore nurses knowledge and attitudes towards brain stem death and organ donation. An ex post facto research design was used to determine relationships between variables. A 16 item questionnaire was used to collect data. Statistical analysis revealed one significant result. The limitations of the sample size is acknowledged and the conclusion suggests a larger study is required.     

The immunological aspects of systemic enzyme therapy in the combined treatment of recurrent nephrolithiasis

BACKGROUND: Despite the popularity of complementary therapies with the public, knowledge and use of these therapies among doctors appear limited. However, studies show that physicians and medical students are positive toward complementary therapies and have a high level of interest in learning about them. METHODS: The attitudes of medical students toward complementary therapies were examined using a questionnaire distributed to 800 first-, third-, and fifth-year medical students at two universities in Melbourne, Australia. RESULTS: The survey revealed that whereas Australian medical students were positive toward complementary therapies, their self-reported knowledge was low, with 56% having no knowledge of the principles of complementary therapies. Attitudes toward different therapies were found to vary widely, with students having little knowledge of chiropractic and naturopathy, the two therapies most commonly used by Australians. Students consistently scored meditation, massage, and acupuncture the highest with regard to knowledge, perceived usefulness, intended patterns of referral after graduation, and desire for education in the undergraduate degree. CONCLUSIONS: When the medical course included some tuition on complementary therapies, students were more positive toward them. A single lecture on complementary therapies was found to have significant impact on medical students' views. Medical students have a high level of interest in complementary therapies that is not being satisfied by their undergraduate curricula.     

Psychiatric disorders in Wolfram syndrome heterozygotes

BACKGROUND: Data on the attitudes of medical and nursing students towards blood donation are scanty. Since this group is a potential but under-utilized source of blood donors, studying their attitudes could provide insights into donor-related behaviour and, hence have implications for donor recruitment programmes. METHODS: The attitudes towards blood donation and frequency of donation of 307 medical and nursing students were studied using a scale to measure affect, behaviour and cognition. RESULTS: The attitudes were found to be positive in all three scales. While the behaviour scale significantly discriminated donors from non-donors, no significant differences were observed in the affect and cognition scales. CONCLUSION: In a medically-oriented population, donors and non-donors do not differ significantly in their sentiments towards blood donation. Other social variables may account for donor behaviour which need to be studied further.     

Tobacco use disorder]

PURPOSE: To compare first- and fourth-year medical students' opinions about primary care practice. METHOD: A cross-sectional survey was made of medical students at New York Medical College (NYMC) and East Carolina University School of Medicine (ECUSOM) over three years (1993-94, 1994-95, and 1995-96). Three consecutive classes of first-year students from both schools (n = 807), two consecutive classes of fourth-year NYMC students (n = 373), and three consecutive classes of fourth-year ECUSOM students (n = 221) were given a self-administered questionnaire about professional aspects of primary care practice. Responses to ten items about primary care practice were the independent variables in a logistic regression analysis. Career choice, categorized as primary care or non-primary care, was the dependent variable. Independent, two-tailed t-tests were employed to compare the responses of the first-year students interested in primary care careers with those of the fourth-year students interested in primary care careers. RESULTS: In all, 639 (79%) of the first-year students and 396 (67%) of the fourth-year students returned completed questionnaires. The first-year students interested in primary care careers were significantly more likely to believe that primary care practice has more prestige, has more intellectual stimulation, needs a large knowledge base, and involves work that is more important than that of non-primary care physicians, and were significantly more likely to disagree with the assertion that in primary care practice, physicians have more control over their working hours. With one exception (prestige of primary care practice), all these independent variables were significant for the fourth-year students as well. The comparison of the first- and fourth-year students indicated that the fourth-year students were significantly more likely to believe that primary care practice has more intellectual stimulation, needs a large knowledge base, and requires knowledge that non-primary care practice may not; they were also significantly more likely to disagree with the assertions that primary care practice is adequately compensated, has more prestige, and allows more control over working hours. CONCLUSION: It appears that students' positive perceptions about primary care practice may change as realistic perceptions about the professional demands on primary care physicians develop during medical school.     

Service-learning for graduate students

OBJECTIVES: The European Commission funded EUROTOLD Project sought to examine the legal and ethical implications of living donor organ transplantation within Europe, facilitated by a multi-centre study acquiring data on practices, laws, policies, attitudes and decision-making processes. METHODS: Methods involving primary sources included interviews with clinical staff and past and present organ donors and recipients, and questionnaire surveys of transplant centres, individual clinical staff and legal experts. These strategies were supplemented by an examination of secondary sources such as official reports, transplantation literature, etc. RESULTS: The surveys generated substantial new evidence relating to transplant centre policies and practices, and the attitudes of physicians toward living donation generally and the use of certain specific classes of donor. The latter was facilitated by the use of case scenarios, providing a window upon factors influencing judgments in this sphere. The interview data confirmed earlier findings about donor decision-making. CONCLUSIONS: Responding centres and clinicians displayed a fairly liberal attitude toward living donation but substantial diversity nonetheless exists with regard to living donor transplant volumes between centres and surrounding acceptable waiting times for transplant. Further research is required to identify precisely the reasons underpinning such disparity.     

Breast cancer screening knowledge and skills of students upon entering and exiting a medical school

PURPOSE: To assess needs for breast cancer screening education by comparing medical students' training and knowledge of breast cancer screening upon their entry to and exit from medical school. METHOD: Seventy-seven medical students at one medical school completed questionnaires as first-year students (in 1992) and again as fourth-year students (in 1996) that assessed their breast cancer screening knowledge. The fourth-year questionnaire included additional questions about the students' clinical training in breast cancer screening skills and their perceptions of needs for further training. RESULTS: Although the students performed significantly better on the knowledge-based questions in their fourth year than they did in their first year, considerable room for improvement remained. The students reported learning the most from surgery rotations and more from standardized patients than from faculty. Women medical students performed significantly more clinical breast examinations than did men students. CONCLUSIONS: Most of the medical students reported needing additional training in clinical breast examination. More curricular time devoted to education about breast cancer screening is needed.     

Organ donation from the viewpoint of the medical students

A questionnaire survey was carried out to examine the attitudes of 125 medical students, aged 19-37 years, toward organ donation. 73 of them were in their first semester and 52 senior students in their last year of the study. A return rate of 88% (senior students: 58%) was achieved. Although 59% (71%) expressed willingness to donate their organs, only 30% (50%) had signed an organ donor card. Concerns regarding definition and declaration of death, benefit of organ donation and feelings of the donor's family were identified in 51% (38%) of the students. 71% (79%) had already discussed this issue with their families. In summary, results of the study indicate that more intensified interdisciplinary discussion and information during the study of medicine could bring about an even more positive attitude toward organ donation.     

Decrease of insulin resistance after splenectomy in a diabetic patient with liver cirrhosis and portal hypertension. Physiopathologic evaluation

OBJECTIVE: To evaluate the effects of a course in physical diagnosis on the knowledge, skills, and attitudes of internal medicine trainees. DESIGN: A controlled, prospective assignment of housestaff to a year-long curricular program, linked to a set of pre- and posttests. Houseofficers who could not attend the teaching sessions functioned as control subjects. SETTING: An internal medicine training program at an urban medical school. SUBJECTS: 56 (86.1%) of 65 eligible internal medicine housestaff (post-graduate years 1 through 3) participated in the intervention and assessment. A comparison group of 14 senior medical students participated in the pretest. INTERVENTION: 12 monthly lectures emphasizing skills useful in emergencies or validated by the literature. MEASUREMENTS: The pre- and posttests included: 1) a multiple-choice questionnaire to assess knowledge; 2) professional standardized patients to assess selected skills; and 3) Likert-type questionnaires to assess self-motivated learning and attitude toward diagnosis not based on technology. MAIN RESULTS: The residents expressed interest in the program and on a six-point scale rated the usefulness of lectures and standardized patients as 3.5 +/- 1.3 and 4.3 +/- 1, respectively. For no system tested, however, did they achieve more than 55.2% correct answers (range: 24.2%-55.2%, median = 41.04), and their performance did not differ from that of the fourth-year medical students. There was no significant difference in pre/posttest improvement between the control and intervention groups. CONCLUSIONS: These data confirm the deficiencies of physical diagnostic skills and knowledge among physicians in training. These deficiencies were not corrected by the classroom lecture series. Improvement in these skills may require a more intense experiential program made part of residency requirements.     

Assessment at one school of students' abilities and confidence in diabetic patients' education

PURPOSE: To determine medical students' experiences in working with diabetic patients, their cognitive competence and their confidence in meeting diabetic patients' educational needs, and changes in their expertise with advancing education. METHOD: The study was conducted in March 1994 at the University of Illinois College of Medicine, where students work with ambulatory patients in a longitudinal primary care experience from their second year through graduation. A combined questionnaire and objective quiz was developed and distributed to 138 second-, third-, and fourth-year students. The students were asked whether they had had experience in seeing a newly diagnosed diabetic patient, in what setting, and whether they felt confident in educating such patients on various common topics. They were also asked about their interests in and preferences for learning about diabetic patients' education. A 50-item objective quiz on the management of diabetes followed the questionnaire. Data were analyzed with several statistical methods. RESULTS: In all, 65 of the students (47%) responded; the majority were third- or fourth-year students. The percentages of students who felt confident ranged from 83% who felt confident about counseling about exercise to only 16% who felt confident about pre-conception counseling. All of the students but one felt that diabetic patients' education was an important topic, and all but two were interested in it. The students' quiz scores showed no significant difference by year of training; for all the students the average score was 39.6% correct, with no increase in score for increased training. Also, the students who were more confident about their abilities to provide patient education on a certain topic were no more likely to have accurate information about that topic than were those who were not confident. CONCLUSION: Although they were clearly interested in diabetic patients' education, the students did not feel confident in providing it, nor did they have the cognitive competence to do so. Medical schools have a responsibility to students and to their patients to formally address the issues of patient education.     

Evaluating Learning Approaches of Construction Students in Hong Kong through a Matrix Framework

Learning is a process of acquiring knowledge, and students may adopt different learning approaches to achieving their learning goals. While educationalists can draw up what they believe is a good construction curriculum for students, students’ learning would depend on their own learning approaches and attitudes. Acknowledging a lack of research on the learning attitudes of construction students, a matrix framework of learning approaches (MFLA) based on the relationships between three learning motives and three learning strategies is proposed in this paper. The MFLA enabled a major empirical survey to be carried out in Hong Kong to examine the learning characteristics of construction students. A questionnaire based on Biggs’s study process questionnaire was distributed to five groups of construction-related students in three universities in Hong Kong. The results of the survey indicate that seven of the nine hypothetical learning approaches exist in construction education in Hong Kong. The assortment of learning approaches used varied across the five student groups. As a result, different teaching and learning factors should be adopted by educators of construction students to meet the distinctive characteristics of students in various universities.     

Prognostic value of dipyridamole thallium-201 screening to minimize perioperative cardiac complications in diabetics undergoing kidney or kidney-pancreas transplantation

A survey of knowledge, attitude and practice (KAP) regarding human immunodeficiency virus infection was performed on 899 students from 3 government-administered high schools located in the Bangkok Metropolitan area. Initially, all students completed a written questionnaire (pre-test) regarding HIV/AIDS. Following this, they attended a slide lecture presentation given by a specialist physician. The same test questionnaire was then completed by the same students six weeks (post-test) later for comparison of their previous KAP. The subjects composed of male to female ratio equal to that of the median age 15-16 years old. Sixty-seven per cent of the subjects were living with their parents, 16.3 per cent with relatives and 15 per cent with friends. Ninety nine per cent of the subjects had received information on HIV/AIDS before enrollment to this study. The source of knowledge ranged from television (89.1%), teachers (81.6%), pamphlets (80.2%), newspapers (75%), radio (55%), health care workers (53.4%), friends (38.6%) and only 32.5 per cent from their parents. The subjects' knowledge about HIV/AIDS and risk factors in the post-test questionnaire was significantly increased (P < 0.001) from the pre-test status. However, their attitudes to an HIV infected person were not significantly changed in the post-test questionnaire: only the "attending school" question showed significantly (P < 0.05) increased numbers of agreement. Similarly, the attitudes and practices to prevent HIV infection were not significantly (P > 0.05) different between pre-test and post-test questionnaires. The result of this study is to recommend regular school-based programs of education to increase awareness of preventive strategies for HIV/AIDS and sexually transmitted diseases.     

A solution to the problem of jail suicide

In American studies in the sixties and seventies caregivers, including physicians, showed a negative attitude towards the elderly. There are indications that such a negative attitude affects the quality of care and the communication with the elderly. Based on predominantly American literature this article reviews research on medical students' knowledge about and attitudes towards older people as well as the impact of geriatric training on the image of older patients and physician-patient communication. In medical students who did not receive a geriatric training, attitudes improved in the eighties and nineties up till a slightly positive level but general gerontological knowledge displayed as many shortcomings as in former days. A few studies show that instructional modules in geriatrics do not have an impact on the attitude towards the elderly. Several studies show that contact with aged persons has a positive influence. Rather than geriatric residency or work in a nursing home, contact with healthy elderly has favourable effects. Attitude improvement based on interactions with older people is maintained during medical education. A program in gerontology as well as geriatric instructional modules can lead to knowledge improvement. Since significantly positive correlations between knowledge and attitude are sometimes demonstrated, increasing gerontological knowledge may lead to more positive attitudes.     

The “ick” factor, anticipated regret, and willingness to become an organ donor.

Objective: This research tested the role of traditional rational-cognitive factors and emotional barriers to posthumous organ donation. An example of an emotional barrier is the “ick” factor, a basic disgust reaction to the idea of organ donation. We also tested the potential role of manipulating anticipated regret to increase intention to donate in people who are not yet registered organ donors. Design: In three experiments involving 621 members of the United Kingdom general public, participants were invited to complete questionnaire measures tapping potential emotional affective attitude barriers such as the “ick” factor, the desire to retain bodily integrity after death, and medical mistrust. Registered posthumous organ donors were compared with nondonors. In Experiments 2 and 3, nondonors were then allocated to a simple anticipated regret manipulation versus a control condition, and the impact on intention to donate was tested. Main Outcome Measures: Self-reported emotional barriers and intention to donate in the future. Results: Traditional rational-cognitive factors such as knowledge, attitude, and subjective norm failed to distinguish donors from nondonors. However, in all three experiments, nondonors scored significantly higher than donors on the emotional “ick” factor and bodily integrity scales. A simple anticipated regret manipulation led to a significant increase in intention to register as an organ donor in future. Conclusions: Negative affective attitudes are thus crucial barriers to people registering as organ donors. A simple anticipated regret manipulation has the potential to significantly increase organ donation rates. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

HIV prevention interventions: The effects of role-play and behavioural commitment on knowledge and attitudes.

Investigated the effects of active versus passive participation, as well as behavioral commitment, on the knowledge and attitudes of adolescents in an HIV-prevention intervention. Following completion of an HIV attitudes and knowledge test, a group of 144 9th grade students were randomly assigned to 1 of 4 treatment conditions that included either role-play, video, lecture, or no treatment. Half the participants in each condition were required to commit to attend to HIV-prevention information and educate another student about such issues. A post-test conducted at 4-wk follow-up indicated that students in the active participation condition (i.e., role-play) demonstrated increased knowledge about AIDS and HIV. Behavioral commitment to further HIV-prevention information did not moderate (i.e., enhance) the effects of active participation; however, commitment did lead to more positive attitudes toward HIV-prevention. The findings suggest that a role-play intervention may be a viable alternative to traditional lecture and video methods for enhancing knowledge towards HIV-prevention in adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric nursing education: doing the impossible?

Historically, psychiatric nursing has struggled to attract sufficient numbers of graduates of comprehensive nursing programs. Limited available research suggests that psychiatric-nursing education can produce more positive attitudes towards psychiatric-nursing practice and the care of the mentally ill. This article describes the results of a research project undertaken in Victoria, Australia, to extend existing knowledge by determining the impact of education in augmenting interest in psychiatric nursing as a future career option. The results of this quasi-experimental study suggest education can significantly increase the popularity of psychiatric nursing as a profession.     

A study of hospital nurses' attitudes toward continuing education in Kaohsiung City, Taiwan

The purpose of this study was to investigate hospital nurses' attitudes toward continuing education. Continuing education was defined as non-credit organized educational programs designed for nurses by hospitals, nursing institutions, or other related organizations to maintain or improve professional competence. It included "in-service education", "on-the-job training", and other synonymous educational activities. Six hundred and seventy-four randomly selected hospital nurses in Kaohsiung City participated in this study. The data was collected by delivering a 34-statement questionnaire through the directors of nursing. Cronbach's Alpha Coefficient was applied to determine the reliability with a value of 0.79. Factor analysis and a group of experts' suggestions were applied to determine the validity. Frequency distribution, Analysis of Variance, Scheffe' test, and Multiple Regression Analysis were conducted to analyze the research questions. The level of significance was set at 0.05 or less. The results indicated that the majority of nurses (92.65%) hold positive attitudes toward continuing education (M = 86.32). Nurses' attitudes toward continuing education were related to selected personal and professional characteristics, and hospital policies regarding continuing education. To maintain nurses' positive attitudes and to develop positive attitudes for those who hold negative attitudes, some strategies for continuing education should be considered by nursing administrators.     

Addressing a state''s physician workforce priorities through the funding of graduate medical education: the TennCare model

OBJECTIVE: To investigate differences in second-, third-, and fourth-year medical students' knowledge of bloodborne pathogen exposure risks, as well as their attitudes toward, and intentions to comply with, Universal Precautions (UP). DESIGN: Cross-sectional survey. PARTICIPANTS AND SETTING: Surveys about students' knowledge, attitudes, and intentions to comply with UP were completed by 111 second-year (preclinical), 80 third-year, and 60 fourth-year medical students at Washington University School of Medicine in the spring of 1996. RESULTS: Preclinical students knew more than clinical students about the efficacy of hepatitis B vaccine, use of antiretroviral therapy after occupational exposure to human immunodeficiency virus, and nonvaccinated healthcare workers' risk of infection from needlestick injuries (P<.001). Students' perceived risk of occupational exposure to bloodborne pathogens and attitudes toward hepatitis B vaccine did not differ, but preclinical students agreed more strongly that they should double glove for all invasive procedures with sharps (P<.001). Clinical students agreed more strongly with reporting only high-risk needlestick injuries (P=.057) and with rationalizations against using UP (P=.008). Preclinical students more frequently reported contemplating or preparing to comply with double gloving, wearing protective eyewear, reporting all exposures, and safely disposing of sharps, whereas students with clinical experience were more likely to report compliance. Clinical students also were more likely to report having "no plans" to practice the first three of these precautions (P<.001). CONCLUSIONS: Differences in knowledge, attitudes, and intentions to comply with UP between students with and without clinical experience may have important implications for the timing and content of interventions designed to improve compliance with UP.