Uncertainties and ambiguities: measuring how medical students cope

Merrill, Joseph M.; Camacho, Zenaido; Laux, Lila; Lorimor, Ronald J.; Ji, Thornby; Vallbona, Carlos

doi:10.1111/j.1365-2923.1994.tb02719.x

Cited by 80 publications

(64 citation statements)

References 7 publications

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“…How they tolerate ambiguity has been shown to possibly affect their choice of residency as well as their attitudes toward patients. 15,33-36 How their mentors and teachers tolerate ambiguity is no less important.…”

Section: Implications and Recommendations For Medical Educationmentioning

confidence: 99%

The Ethics of Ambiguity

Domen

2016

Academic Pathology

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Understanding and embracing uncertainty are critical for effective teacher–learner relationships as well as for shared decision-making in the physician–patient relationship. However, ambiguity has not been given serious consideration in either the undergraduate or graduate medical curricula or in the role it plays in patient-centered care. In this article, the author examines the ethics of ambiguity and argues for a pedagogy that includes education in the importance of, and tolerance of, ambiguity that is inherent in medical education and practice. Common threads running through the ethics of ambiguity are the virtue of respect, and the development of a culture of respect is required for the successful understanding and implementation of a pedagogy of ambiguity.

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Section: Implications and Recommendations For Medical Educationmentioning

confidence: 99%

The Ethics of Ambiguity

Domen

2016

Academic Pathology

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“…Medical students tend to become less idealistic, more cynical, less benevolent, less humanitarian, and less tolerant of vulnerable patients as they progress through the medical education system (Eron, 1958;Gordon and Mensh, 1962;Gray et al, 1965;Kopelman, 1983;Merrill et al, 1994;Merrill et al, 1991;Merrill et al, 1995Merrill et al, , 1996Reinhardt and Gray, 1972;Rezler, 1974;Testerman et al, 1996). Their attitudes are very different at graduation compared to when they entered medical school SONIA J.S.…”

Section: Medical Student Attitudesmentioning

confidence: 99%

Medical Students’ Attitudes Toward Underserved Patients: A Longitudinal Comparison of Problem-Based and Traditional Medical Curricula

Crandall

Reboussin

Michielutte

et al. 2006

Adv Health Sci Educ Theory Pract

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Medical education has been shown to negatively influence student attitudes toward certain types of patient populations. Past research does not inform current educational practice because today's medical school environment is different from when most of the published research was conducted. There are more female students, curricular innovations such as problem-based learning have changed the framework for educational delivery, and longitudinal studies, which could inform when interventions may be needed, are uncommon. The purposes of this longitudinal, prospective cohort study were to compare the attitudes of Problem-based learning and Traditional curriculum students toward providing care for medically indigent patients as they progressed through the four-year undergraduate medical education curriculum, and to determine if gender differences were apparent and persisted over time. Attitudes of one cohort of students enrolled in separate curricula were studied. The outcome measure was the Medical Student Attitudes Toward the Underserved questionnaire, which was administered three times. A linear mixed effects regression analysis was performed to examine changes in factor scores over time and whether these changes differed between Problem-based and Traditional students, and males and females. Longitudinal findings revealed that commitment to caring for the medically underserved was greater when students entered medical school than when they graduated. Students in both curricula, as well as male and female students, experienced increasingly negative attitudes over the four year period. Decline in attitudes toward medically underserved patients was similar to previous research results. This study showed that attitudes of students were not influenced by the preclinical curriculum they experienced.

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“…Although medical students have been used as study participants in the creation and validation of a variety of questionnaires aimed at elucidating anxiety and depressive symptoms, studies examining how these symptoms relate to their own perceived performance in medical school have been limited [Enns et al, 2001;Merrill et al, 1994;Trijsburg and Duivenvoorden, 1987]. In this article, we examine the phenomenology of obsessive and anxiety symptoms, along with contributing comorbid symptoms of depression and attention deficit among medical students.…”

Section: Introductionmentioning

confidence: 99%

Anxiety symptoms and perceived performance in medical students

2007

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Medical students represent a highly educated population under significant pressures. During the transition to clinical settings in the third year, they may experience a loss of external control and may counter this with an increase in obsessionality and/or other anxiety symptoms. Our study examines the phenomenology of obsessive-compulsive and other anxiety symptoms in medical students at two U.S. medical schools and relates these symptoms to self-perception of performance. Subjects anonymously completed a battery of questionnaires regarding obsessive-compulsive symptoms, attentional problems, anxiety symptoms, depressive symptoms, and perceived performance in medical school. A factor analysis of obsessional symptoms showed four primary factors: checking/doubts, contamination, long time/detail, and unpleasant thoughts/worries. These four factors were similar to those found among college students and other nonclinical populations. Anxiety, attentional, and depressive symptoms were highest in the third-year medical students. In contrast, obsessional symptoms were highest in the first-year students and lower for subsequent years. Perceived performance was not significantly correlated with obsessionality, although lower perceived performance was associated with higher levels of anxiety and depressive symptoms. Students with lower perceived performance in medical school were significantly more likely to be female, depressed, or older. The progressive decrease in number of obsessional symptoms across years and the lack of correlation with perceived performance suggest that these symptoms may be developmentally appropriate, and perhaps adaptive. In contrast, other anxiety symptoms appear to be maladaptive responses to external stressors.

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Uncertainties and ambiguities: measuring how medical students cope

Cited by 80 publications

References 7 publications

The Ethics of Ambiguity

The Ethics of Ambiguity

Medical Students’ Attitudes Toward Underserved Patients: A Longitudinal Comparison of Problem-Based and Traditional Medical Curricula

Anxiety symptoms and perceived performance in medical students

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