A four-hour integrated teaching session on clinical decision analysis has been developed and introduced as part of the Life Long Learning Skills course for medical students at The Chinese University of Hong Kong. The feasibility and effectiveness of teaching the principles and practice of clinical decision analysis to final-year undergraduate medical students was evaluated. One hundred and thirty-two students were randomly assigned to medical (intervention) and surgical rotations (control) and were assessed two weeks before and three weeks following a teaching session. The students' performance was assessed in response to 10 A-type multiple choice question items that incorporated various clinical scenarios requiring decision making and interpreting cost-effectiveness ratios and sensitivity analysis graphs. More students in the intervention group improved their overall performance scores compared with those in the control group (23.4% vs. 7.4%; 16.1% difference; 95% confidence interval [CI], 3.8-28.5%; p = 0.01). Improvements were in interpretation of decision making (22.2% difference; 95% CI, 10.1-34.4%; p < 0.001). No improvements were seen for calculating cost-effectiveness ratios or interpreting sensitivity analysis graphs. The overall educational intervention was well received by students and effective in improving students' clinical decision analysis skills under simulated conditions. Practice points Clinical decision-making skill is an important aspect of evidence-based medicine. A randomized controlled trial assessed the effect of teaching clinical decision analysis to undergraduate medical students. An integrated teaching session consisting of three 40-minute lectures on the principles and practice of clinical decision analysis, followed by two 1-hour workshops is effective in undergraduate final-year medical students.
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There has been much recent attention on psychological well-being and pastoral care for medical students. This study examines psychological morbidity (depression, anxiety and stress) in Hong Kong medical students, as well as their concerns, coping mechanisms and their help-seeking. Medical students in Hong Kong reported a higher level of psychological morbidity as compared with other tertiary education students. Their main concerns include examinations, stress, career, adjusting to the new medical curriculum and commitment to the course. The coping skills adopted were largely adaptive. Maladaptive coping skills like `denial', `self-blame' and `behavioural disengagement' were highly correlated with depression, anxiety and stress scores. Most of the students concerned wanted support services that were specifically tailored to their needs and at least partly provided by people who had been through medical training themselves. The faculty at the University of Hong Kong is establishing a Programme for Effective Transition and Student Support (PETSS) to provide a multi- faceted support system for its medical students. The findings in this study help to ensure that the services provided will be relevant, accessible and acceptable to the students.
[Copyright of Medical Teacher is the property of Informa Healthcare . Full article may be available at the publisher's website:
http://dx.doi.org/10.1080/01421590500237945]