INTRODUCTION: Medical school fees are rising globally. Student debt and financial background may affect residency choices, but few studies have been conducted in Asia. This study aimed to explore the relationship between financial background, student debt and postgraduate residency choices among medical students in Singapore. METHODS: An anonymised survey of all medical students in Singapore was conducted and had a response rate of 67.9%. RESULTS: 40.5% of our study population would graduate with debt. Medical students with monthly per capita household income < SGD 1,000 were more likely to graduate with debt (unadjusted odds ratio [OR] 2.0, 95% confidence interval [CI] 1.6-2.7; p < 0.001) and feel burdened by the cost of medical education (unadjusted OR 2.8, 95% CI 2.0-3.9; p < 0.001). Students with monthly per capita household income < SGD 1,000 (unadjusted OR 1.818, 95% CI 1.338-2.470, p < 0.001; adjusted OR 1.692, 95% CI 1.202-2.381, p = 0.003) and those with debt (unadjusted OR 1.623, 95% CI 1.261-2.090, p < 0.001; adjusted OR 1.393, 95% CI 1.048-1.851, p = 0.022) were more likely to rank at least one economic factor as 'very significant' in influencing their postgraduate training choices. CONCLUSION It is concerning that despite financial aid schemes, the cost of medical education remains a burden to students from lower-income households in Singapore. Student debt and financial background may distort postgraduate career choices, creating an undue push towards high-paying specialties.
Career Choice ; Choice Behavior ; Education, Medical ; economics ; Humans ; Internship and Residency ; economics ; Odds Ratio ; Schools, Medical ; economics ; Singapore ; Social Class ; Students, Medical ; statistics & numerical data ; Surveys and Questionnaires ; Training Support

PURPOSE: The purpose of this study was to describe the experience of Korean university students who participated in a therapeutic community. METHODS: Qualitative descriptive research was used. A focus group, in-depth interviews, participant-observation, and self-reports were used to collect data from 9 Korean university students. Participants lived with drug addicts for 6 weeks at DAYTOP in New York, USA. Thematic analysis was used for data analysis. RESULTS: Seven themes and 32 subthemes were found: 1) understanding myself through mutual observation: self-discovery, self-acceptance, self-differentiation, career choices, breaking an addictive habit; 2) healing emotional wounds: trust building, self-closure, recognition of emotional wounds, peaceful mind; 3) being honest with my emotions: understanding addicts, expression of emotions, attitudes about confrontation, confronting others: 4) expressing myself: time management, expression of thanks, I-message, behavior modification, taking a stand; 5) balancing responsibility: attitudes about leaders and work, sharing work, supplementing, sharing opinions; 6) becoming interested in others: understanding family members, recognition of differences, asking about concerns of others, asking for forgiveness, conversation with family members ; 7) becoming interested in the community: attitudes about community, keeping rules, role model, active participation. CONCLUSION: These results show that a therapeutic community can be effective in changing participants' inner selves and behaviors.
Behavior Therapy ; Career Choice ; Drug Users ; Focus Groups ; Forgiveness ; Humans ; Statistics as Topic ; Therapeutic Community* ; Time Management ; Wounds and Injuries

The goal of this study was to assess student perceptions of a variety of instructional practices and attitudes toward class attendance. Data were obtained and analyzed by administering a questionnaire to students of the Shifa College of Medicine, Pakistan in 2011 and 2012. The subjects positively assessed most instructional practices, and in particular felt that teaching sessions conducted in small groups were more valuable than formal lectures in large groups. Students did not like having to give presentations, quizzes, panel discussions, and journal club. A positive correlation was found between the perceived importance of attendance and levels of academic motivation. Of the students surveyed, 11.8% were against mandatory attendance, saying that it reduced motivation and that attendance should be optional. In conclusion, the students had a positive perception of a range of instructional practices, and felt especially positively about practices that involve student activity in small groups. Programmatic improvement in instructional practices might increase class attendance.
Choice Behavior ; Humans ; Learning ; Lectures ; Motivation ; Pakistan* ; Students, Medical*

PURPOSE: Traditional approaches to blueprint creation may focus on fine-grained detail at the expense of important foundational concepts. The purpose of this study was to develop a method for constructing an assessment blueprint to guide the creation of a new post-test for a two-day prehospital emergency medical services training program. METHODS: In order to create the blueprint, we first determined the proportions of the total classroom and home-study minutes associated with the lower- and higher-order cognitive objectives of each chapter of the textbook and the two-day classroom activities during training courses conducted from January to April 2015. These proportions were then applied to a 50-question test structure in order to calculate the number of desired questions by chapter and content type. RESULTS: Our blueprint called for the test to contain an almost even split of lower- and higher-order cognitive questions. One-best-answer multiple choice items and extended matching-type items were written to assess lower- and higher-order cognitive content, respectively. CONCLUSION: We report the first known application of an assessment blueprint to a prehospital professional development education program. Our approach to blueprint creation is computationally straightforward and could be easily adopted by a group of instructors with a basic understanding of lower- and higher-order cognitive constructs. By blueprinting at the chapter level, as we have done, item-writers should be more inclined to construct questions that focus on important central themes or procedures.
Choice Behavior ; Cognition ; Education* ; Emergencies* ; Emergency Medical Services* ; United States*

INTRODUCTIONThis paper reports the relationship between the difficulty level and the discrimination power of true/false-type multiple-choice questions (MCQs) in a multidisciplinary paper for the para-clinical year of an undergraduate medical programme.

MATERIALS AND METHODSMCQ items in papers taken from Year II Parts A, B and C examinations for Sessions 2001/02, and Part B examinations for 2002/03 and 2003/04, were analysed to obtain their difficulty indices and discrimination indices. Each paper consisted of 250 true/false items (50 questions of 5 items each) on topics drawn from different disciplines. The questions were first constructed and vetted by the individual departments before being submitted to a central committee, where the final selection of the MCQs was made, based purely on the academic judgement of the committee.

RESULTSThere was a wide distribution of item difficulty indices in all the MCQ papers analysed. Furthermore, the relationship between the difficulty index (P) and discrimination index (D) of the MCQ items in a paper was not linear, but more dome-shaped. Maximal discrimination (D = 51% to 71%) occurred with moderately easy/difficult items (P = 40% to 74%). On average, about 38% of the MCQ items in each paper were "very easy" (P > or =75%), while about 9% were "very difficult" (P <25%). About two-thirds of these very easy/difficult items had "very poor" or even negative discrimination (D < or =20%).

CONCLUSIONSMCQ items that demonstrate good discriminating potential tend to be moderately difficult items, and the moderately-to-very difficult items are more likely to show negative discrimination. There is a need to evaluate the effectiveness of our MCQ items.

Adult ; Choice Behavior ; Education, Medical, Undergraduate ; Educational Measurement ; methods ; Humans

PURPOSE: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. METHODS: A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. RESULTS: Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). CONCLUSION: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.
Adult ; Choice Behavior ; Female ; Humans ; Male ; *Medicine ; *Motivation ; *Personality ; Republic of Korea ; *Specialization ; *Students, Medical ; Surveys and Questionnaires

PURPOSE: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. METHODS: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. RESULTS: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). CONCLUSION: A FC/TBL format for ACLS marginally improved written test results.
Advanced Cardiac Life Support* ; California* ; Choice Behavior ; Humans ; Learning* ; Students, Medical* ; United States

OBJECTIVE:The study aimed to assess the valuation for cigarettes among UP Manila students aged 18-24 through direct and indirect stated preference methods.
METHODS: Direct (iterative bidding) and indirect (discrete choice experiment) stated preference methods were utilized to determine the smokers' Willingness-to-Pay (WTP) and non-smokers' Willingness-to-Accept (WTA). Median and interquartile range were used in describing both WTP and WTA. Fisher's Exact Test and T-test were performed using STATA v12 to determine the association between the identified factors. 
RESULTS: Of the 212 respondents, 21 (9.91%) were smokers. The smokers' direct and indirect WTP for a cigarette stick were PhP 6.00 and PhP 12.43, respectively. There was a significant difference (p=0.01) between the results of the two methods. Meanwhile, 40.84% of the non-smokers could be induced to smoke with PhP 0.00 as their WTA. No significant association was found between the smokers' stated preference and their smoking status and allowance. The WTP of the smokers was higher than the December 2013 retail prices of cigarettes.
CONCLUSION: The increased cigarette prices brought about by the Sin Tax Law were insufficient in stopping the selected UP Manila students to smoke. In addition, forty percent of non-smokers in the study could be induced to smoke. Thus, further price increase of cigarettes, as well as other tobacco control measures, is recommended to discourage smoking among the youth such as college students, specifically in UP Manila.

Human ; Male ; Female ; Adult ; Adolescent ; Tobacco ; Smoking ; Smoke ; Tobacco Use Disorder ; Choice Behavior ; Students ; Surveys And Questionnaires

In response to the increasing amount of drug information, the teaching strategy of Pharmacotherapeutics was changed from Teacher-based Classroom Lecture to Small Group Discussion ( SGD ) revolving around ten to twelve of the most prevalent diseases in the country.

OBJECTIVES: To investigate the effect of small group discussion on the performance of Pharmacology students by 1) Comparing the drug choices of students during Medical Internship with those of Pharmacology teachers for five selected clinical conditions 2) Describing the attitudes of Medical Students while in Medical Clerkship towards SGD 3) Determining areas of disagreements in prescribing choices between Clinical Consultants and Pharmacologists.

METHODS: Medical Interns and their pharmacology teachers were concurrently administered the same questionnaire testing their drug choices for five clinical conditions. Attitudes of Medical Interns during their Clinical clerkship towards SGD was determined using their reflection papers. A survey was also conducted among interns to determine which diseases showed more frequent disagreements in prescribing between clinical consultants and pharmacologists.

RESULTS: Ninety one medical interns participated in the study. Agreement on the choice of drugs was generally low ( 23%-44% ) except for Exercise-induced Asthma (89%). Majority of 147 reflection papers by clinical clerks expressed positive attitude towards SGD as a learning tool for Pharmacotherapeutics. Medical interns also perceived that drug choices of their clinical consultants/residents agree with what they were taught in Pharmacology 70% of the time. But it was actually 43% low when they were given five clinical cases to virtually treat. It is presumed that their drug choices only reflected their actual prescribing practice while under the supervision of their Residents/ Consultants. Most disagreements were observed in the treatment of Hypertension and UTI.

CONCLUSIONS: There was poor retention of knowledge about drug choices from undergraduate Pharmacology especially for eradication of H. pylori and recurrent UTI at 23% and 28%, respectively. Forty six percent of medical interns concur that Small Group Discussion is an acceptable strategy for case -based learning. It likewise positively influenced their prescribing decisions as Medical Interns. 

Human ; Male ; Female ; Students, Medical ; Internship And Residency ; Asthma, Exercise-induced ; Perception ; Choice Behavior ; Attitude ; Hypertension

This study was a correlation study to analyze the effects of smartphone usage time on food choice perceptions and behavior in middle school students in Seoul areas. The subjects to be surveyed were middle school students attending junior high schools in Mapo-gu, Seoul. A total of 133, 102, and 102 students were in the first second, and third grades, respectively. The usage time of smartphones was the weekday and weekend usage time except for the call function. Food choice perception and its behavior as dietary habits were constructed referring to previous research and food balance wheels data for the correct dietary habits of the Ministry of Health & Welfare and Korean Nutrition Society. The food choice behavior was categorized into non-recommended food and recommended food. The results are summarized as follows. First, the longer the time spent on smartphones, the less favorable the perception of correct food choices. Second, the higher the dependence on smartphones, the less favorable the perception of correct food choices. Third, the correct perception of food choices has been shown to reduce food choices, known as non-recommended foods. In addition, proper perception of food choices has been shown to increase the choice of recommended foods. In conclusion, the usage time and reliance of smartphones of middle school students was found to affect the food choice behavior by lowering the perception of correct food choices. This research is expected to form the basis for the development of programs and educational materials that can be of assistance to adolescents who are experiencing difficulties.
Adolescent ; Choice Behavior ; Eating ; Food Habits ; Humans ; Seoul ; Smartphone ; Statistics as Topic