BACKGROUND: Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors' workload, wages, and popularity among medical students by city population sizes. METHODS: We targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents' monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital's information and each hospital's website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance. RESULTS: The average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas. CONCLUSIONS Hospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians' working conditions in Japan, and such disparities need to be corrected.
Cities/statistics & numerical data* ; Geography ; Hospitals, Teaching/statistics & numerical data* ; Japan ; Physicians/statistics & numerical data* ; Population Density ; Salaries and Fringe Benefits/statistics & numerical data* ; Students, Medical/psychology* ; Workload/statistics & numerical data*

PURPOSE: The purpose of this study is to find out how much influence nursing students' environmental consciousness and knowledge of medical waste have on their attitudes toward medical waste. METHODS: The subjects were 211 nursing students recruited from 2 universities. Data were collected with a structured self-report questionnaire comprising measures of environmental consciousness, and knowledge of and attitude toward medical waste. Data analysis was conducted with the SPSS/WIN 25.0 program. RESULTS: A total of 211 copies of the questionnaire were used for the final analysis, except for 9 untrusted responses out of 220 that included missing values. Those subjects' environmental consciousness who received environmental education in middle and high schools was higher (t=3.15, p=.002). The higher their grades, the better their knowledge of medical waste (F=3.40, p=.035). Those subjects’ knowledge of medical waste who received medical waste education was relatively high (t=3.14, p=.002). Those subjects with clinical practice experience had more sensitive attitudes toward medical waste (t=2.06, p=.041). Those subjects' attitudes toward Medical waste who received medical waste education at the universities were relatively high (t=2.04, p=.043). The subjects' environmental consciousness was positively correlated with their attitudes toward medical waste (r=.44, p<.001). The most influential factor in their attitudes toward medical waste is their environmental attitudes and medical waste education. CONCLUSION: The higher the nursing students' environmental consciousness, the higher their attitudes toward medical waste. It is necessary to provide environment and medical waste education for nursing students in order to strengthen their environmental consciousness and attitude toward medical waste.
Consciousness ; Education ; Humans ; Medical Waste ; Nursing ; Statistics as Topic ; Students, Nursing

PURPOSE: Medical students construct their identity as a student physician through clinical clerkship. However, there is a lack of research on the effect of clinical clerkship on professional self-concept formation. The aim of this study is to analyze and ascertain the relationship between medical students' satisfaction with clinical clerkship and professional self-concept. METHODS: This investigation studied 84 third- and fourth-year medical students enrolled in the Ajou University School of Medicine and Graduate School of Medicine. Study measures tools included satisfaction with clinical clerkship and professional self-concept measurement. For data analyses, a descriptive analysis of the research variable characteristics was applied, gender differences in variables by years of medical school were analyzed with t-tests, and correlation analysis was used to check for relationships between variables. RESULTS: We found no statistically significant differences between satisfaction with clinical clerkship with respect to medical school year and gender. While professional self-concept did not show significant differences by year of medical school, we observed statistically significant differences by gender with respect to the subscales of professional practice and communication factor. In addition, satisfaction with clinical clerkship and professional self-concept demonstrated statistically significant positive correlation. The present research was able to confirm that there exists a correlation between medical students' clinical clerkship experience and professional self-concept formation. CONCLUSION: Our study outcomes shows that provision of positive assistance as a measure to enhance satisfaction with clinical clerkship via the curriculum and environmental improvement is envisaged to lead to medical students' professional self-concept formation.
Clinical Clerkship ; Curriculum ; Humans ; Professional Practice ; Schools, Medical ; Statistics as Topic ; Students, Medical

End-of-life care competencies have been perceived as important and essential, so it has been suggested that end-of-life care be studied in undergraduate medical education. However, end-of-life care curriculum has mostly focused on acquisition of knowledge and skills rather than attitudes. Therefore, we aimed to explore whether education about death affects medical students' attitudes towards care for dying patients and perception of death anxiety, meaning in life, and self-esteem. A total of 15 first- or second-year medical students were surveyed with questionnaires before and after completing a 6-week death education course. Paired data analysis showed that participants' attitudes towards caring for terminally ill patients and their caregivers improved significantly (t=−2.84, p=0.013) with an effect size of 0.73. In contrast, no significant changes were found in death anxiety, meaning in life, or self-esteem. All participants agreed that formal teaching about death and dying must be encouraged in medical schools. Our results suggest that death education may positively influence attitudes towards end-of-life care. Although replication with larger samples is necessary, this preliminary finding may support the importance of developmentally appropriate end-of-life care education in medical schools.
Anxiety ; Attitude to Death ; Caregivers ; Curriculum ; Education ; Education, Medical, Undergraduate ; Humans ; Schools, Medical ; Statistics as Topic ; Students, Medical ; Terminal Care ; Terminally Ill

INTRODUCTION: Postgraduate medical education in Singapore underwent a major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of sponsoring institution (SI) for residency among medical students during this transition period. METHODS: A questionnaire-based cross-sectional study of Singapore undergraduate medical students across all years of study was performed in 2011. Participants rated the degree of importance of 45 factors (including research, academia and education, marketing, reputation of faculty, working conditions, posting experience and influence by peers/seniors) to their choice of SIs on a five-point Likert scale. Differences in gender and seniority were compared. RESULTS: 705 out of 1,274 students completed the survey (response rate 55.3%). The top five influencing factors were guidance by mentor (4.48 ± 0.74), reputation for good teaching (4.46 ± 0.76), personal overall experience in SI (4.41 ± 0.88), quality of mentorship and supervision (4.41 ± 0.75), and quality and quantity of teaching (4.37 ± 0.78). The five lowest-rated factors were social networking (2.91 ± 1.00), SI security (3.01 ± 1.07), open house impact (3.15 ± 0.96), advertising paraphernalia (3.17 ± 0.95) and research publications (3.21 ± 1.00). Female students attributed more importance to security and a positive working environment. Preclinical students rated research and marketing aspects more highly, while clinical students valued a positive working environment more. CONCLUSION Quality of education, mentorship, experiences during clerkship and a positive working environment were the most important factors influencing the choice of SI.
Accreditation ; Cross-Sectional Studies ; Curriculum ; Education, Medical, Graduate ; economics ; organization & administration ; Education, Medical, Undergraduate ; economics ; organization & administration ; Female ; Humans ; Internship and Residency ; Male ; Mentors ; Models, Organizational ; Schools, Medical ; Singapore ; Students, Medical ; statistics & numerical data ; Surveys and Questionnaires ; United States ; Universities

BACKGROUND: Dundee Ready Educational Environment Measure (DREEM) is a 50-item tool to assess the educational environment of medical institutions as perceived by the students. This cross-sectional study developed and validated an abridged version of the DREEM-50 with an aim to have a less resource-intensive (time, manpower), yet valid and reliable, version of DREEM-50 while also avoiding respondent fatigue. METHODS: A methodology similar to that used in the development of WHO-BREF was adopted to develop the abridged version of DREEM. Medical students (n = 418) from a private teaching hospital in Madurai, India, were divided into two groups. Group I (n = 277) participated in the development of the abridged version. This was performed by domain-wise selection of items that had the highest item-total correlation. Group II (n = 141) participated in the testing of the abridged version for construct validity, internal consistency and test-retest reliability. Confirmatory factor analysis was performed to assess the construct validity of DREEM-12. RESULTS: The abridged version had 12 items (DREEM-12) spread over all five domains in DREEM-50. DREEM-12 explained 77.4% of the variance in DREEM-50 scores. Correlation between total scores of DREEM-50 and DREEM-12 was 0.88 (p < 0.001). Confirmatory factor analysis of DREEM-12 construct was statistically significant (LR test of model vs. saturated p = 0.0006). The internal consistency of DREEM-12 was 0.83. The test-retest reliability of DREEM-12 was 0.595, p < 0.001. CONCLUSION DREEM-12 is a valid and reliable tool for use in educational research. Future research using DREEM-12 will establish its validity and reliability across different settings.
Adolescent ; Cross-Sectional Studies ; Education, Medical ; statistics & numerical data ; Female ; Humans ; India ; Male ; Psychometrics ; methods ; Reproducibility of Results ; Students, Medical ; psychology ; Young Adult

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 explore the experience of medical teachers in the process of adapting flipped learning method through a phenomenological approach. METHODS: Semi-structured interviews with five medical teachers from two medical colleges and one medical school were conducted in December, 2017. Data analysis was done according to Colaizzi's descriptive phenomenological methodology. RESULTS: A total of 160 unique significant statements were extracted. These statements generated 17 formulated meanings that were categorized into seven theme clusters and four theme categories. Main themes were: (1) teacher with high levels of passion and motivation; (2) hurdles of flipped learning: students were still passive, struggling in preparing for flipped learning; (3) positive changes from flipped learning: changes to classroom environment and teachers' reflection through experience; and (4) challenges of flipped learning: remaining tasks for teachers, expansion of flipped learning. CONCLUSION: Through phenomenological approach, researchers were able to elucidate categories about the experience of medical teachers when attempting flipped learning. Although medical teachers did not have the exact same idea on how flipped learning was conducted and implemented, the perception of flipped learning, or difficulties in class activities, they were still wondering how they could teach students well. This study might draw more attention to flipped learning and stimulate educational and institutional supports to improve teaching and learning in medical schools.
Education, Medical ; Humans ; Learning* ; Methods ; Motivation ; Qualitative Research ; Schools, Medical ; Statistics as Topic ; Students, Medical*

Myers-Briggs Type Indicator (MBTI) is a personality type test book, which is widely used in the field of personal counseling, team organization, school education and research. This study carried out MBTI of 361 medical students in the second grade of premedical course of Keimyung University School of Medicine from 2014 to 2018, and analyzed the data to use them for the students' education. The personality type was mostly distributed to ISTJ, ISTP, ESTP and ESTJ in order among 16 types. According to preference tendency, it was found out that the introverted type was extroverted, the recognition type was intuition type, the thinking type was emotional type, and the recognition type was more distributed than the judgment type. The psychological functions were ST, SF, NF, NT. MBTI type analysis of medical students shows that it is possible to organize members in group activities to improve their ability to understand themselves and understand others in class scenes. In addition, we expect to be able to design for improvement of stress management, conflict management, and communication ability. In the career counseling scene, in addition to the MBTI data analysis, it is expected that it will be possible to recommend a major suitable for the student personality type in parallel with other psychological tests. In addition, we expect to study the preferred field of study, satisfaction with the major in the future research by continuous data accumulation and analysis.
Communication ; Counseling ; Education ; Education, Medical* ; Humans ; Intuition ; Judgment ; Personality Inventory ; Psychological Tests ; Statistics as Topic ; Students, Medical* ; Thinking ; Vocational Guidance

PURPOSE: Ineffective communication between healthcare professionals leads to medical errors and puts patients at risk of harm. The aim of this study was to examine the effects of interdisciplinary communication training in simulated settings on self-confidence in communication, observed communication behavior, and technical skill performances of nursing students. METHODS: A repeated measures design with one group was conducted. Data was collected from 92 nursing students through a self-administered questionnaire and an observed behavior checklist. Data analysis was performed using descriptive statistics, a paired t-test, the Wilcoxon signed rank test, the Friedmann test, a Repeated Measures ANOVA, and the Spearman correlation coefficient. RESULTS: Self-confidence in communication, observed Identification-Situation-Background-Assessment-Recommendation-Read Back communication behavior, and technical skill performances of nursing students were significantly improved. In observed communication behavior, the performance of Assessment and Read Back communication significantly improved. However, communication of Background, Assessment, and Recommendation did not improve to a satisfactory level. Observed communication behavior was not correlated with the overall technical skill performance. CONCLUSION: These results indicate that interdisciplinary communication training in simulated settings was effective in improving nursing students' confidence and communication skills with physicians. Longitudinal studies with larger samples are recommended in order to verify the effects of interdisciplinary communication training on clinical outcomes as well as communication competence.
Checklist ; Clinical Competence ; Delivery of Health Care ; Humans ; Interdisciplinary Communication* ; Longitudinal Studies ; Medical Errors ; Mental Competency ; Nursing* ; Simulation Training ; Statistics as Topic ; Students, Nursing*