1,721,057 research outputs found
La formazione alle soft skills nel Corso di laurea in Medicina : uno studio qualitativo sulle scritture riflessive di un campione di studenti
No full textEducating to soft skills is crucial in medical education. Among the diverse pedagogical strategies that could be chosen to develop those competences, which include both emotional and cognitive factors, reflective writing seems to have a prominent role.
This paper reports a qualitative study based on the reflective writings of a group of medical students, which were written during a course focused on soft skills, addressed to 2nd year medical students (University of Milan, San Paolo Teaching Hospital). Writings reported students’ first encounter with the patient, in the ward, which was aimed at gathering his/her illness experience.
Among the 101 collected writings, 70 were casually selected and later analyzed by three blinded researchers. In each writing, researchers evaluated the level of reflection (Moon scale) and looked for the presence of specific characteristics (selected from the REFLECT grid): the perception of patients’ emotions and the students’ own feelings, the reference to patient’s social context, the experienced difficulties in the relationship with the patient and lessons learned about the future medical professional role.
Data analysis showed a quite high level of reflection, slightly greater in females than males. Considering patients’ gender and age, variations in students’ reflections were not registered. Students’ writings seem to be mostly focused on their own feelings, while reflection on patients’ emotions appears slightly inferior. Patients’ social context is the aspect on which students reflect more in depth, while they are less focused on the encountered difficulties and considerations about medical profession.
Authors conclude that students’ response to this training can be considered good; they point out strengths and weaknesses of the educational project that could be useful for those who are planning educational activities similar to those reported in this study
Acupuncture for paroxysmal and persistent atrial fibrillation : An effective non-pharmacological tool?
No full textIn Traditional Chinese Medicine, stimulation of the Neiguan spot has been utilized to treat palpitations and symptoms related to different cardiovascular diseases. We evaluated whether acupuncture might exert an antiarrhythmic effect on patients with paroxysmal or persistent atrial fibrillation (AF). Two sets of data are reviewed. The first included patients with persistent AF who underwent electrical cardioversion to restore sinus rhythm. The second included patients with symptomatic paroxysmal AF. All subjects had normal ventricular function. Acupuncture treatment consisted of 10 acupuncture sessions on a once a week basis with puncturing of the Neiguan, Shenmen and Xinshu spots. In patients with persistent AF, the recurrence rate after acupuncture treatment was similar to that observed in patients on amiodarone, but significantly smaller than that measured after sham acupuncture treatment or in the absence of any antiarrhythmic drugs. In a small group of patients with paroxysmal AF, acupuncture resulted in a significant reduction in the number and duration of symptomatic AF episodes. In conclusion, we observed that acupuncture of the Neiguan spot was associated with an antiarrhythmic effect, which was evident in patients with both persistent and paroxysmal AF. These preliminary data, observed in 2 small groups of AF patients, need to be validated in a larger population but strongly suggest that acupuncture may be an effective non-invasive and safe antiarrhythmic tool in the management of these patients
Which images do medical students draw to discuss their early clinical experience, in reflection meetings?
No full textBackground
in 2010, a First Approach to the Patient (FAP) mandatory course (40 h) was developed at S. Paolo Teaching Hospital. It includes a 2-week nursing attachment, aimed at making first year students empathize with patients, observe healthcare teams and describe and deal with feelings accompanying their early clinical experience. After it, students attend reflection meetings, managed by a doctor and a pedagogist. They have to discuss in small groups their clinical experience and create a poster, which is later presented to the class, focusing on the patient’s experience, the healthcare team and the students’ emotions.
Summary of work
from 2010, 400 students have elaborated 60 posters on their early clinical experience. They were analyzed by 2 researchers and divided into two categories: schemes and images.
Summary of results
Forty-eight% of the students’ posters were schemes. Images were used to represent their experience in 52% of the posters, and were about: growth (trees), connection (bridge, path), exchange (cell, neurons), circulation (hearts), injection (syringe), balance (pair of scales), movement/raise (clouds, balloons, butterflies), ambivalence (sun/moon). White coats/medical doctors are also represented, but often without faces.
Conclusions
when reflecting on their early clinical contact, students can use schemes, but they can be very creative in producing images to express and share their experience. Teacher’s questions on those images can help students to deepen the meaning of their experience. Images/metaphors allow to present emotions that sometimes elude linguistic description.
Take-home message
drawing images can be an useful strategy to help students reflect on their early clinical experience and stimulate the debate
Storie di bevitori passivi: un progetto di formazione dei medici per favorire l'inclusione e la tutela del diritto alla salute
No full text
Efficacy of acupuncture in preventing atrial fibrillation recurrences after electrical cardioversion
No full textINTRODUCTION: In traditional Chinese medicine, stimulation of the Neiguan spot has been utilized to treat palpitations. We evaluated whether acupuncture might prevent or reduce the rate of arrhythmia recurrences in patients with persistent atrial fibrillation (AF).
METHODS AND RESULTS: We studied 80 patients with persistent AF after restoring sinus rhythm with electrical cardioversion. Twenty-six subjects who were already on amiodarone treatment constituted the AMIO reference group. The remaining patients were randomly allocated to receive acupuncture (ACU group, n = 17), sham acupuncture (ACU-sham group, n = 13), or neither acupuncture nor antiarrhythmic therapy (CONTROL group, n = 24). Patients in the ACU and ACU-sham groups attended 10 acupuncture sessions on a once-a-week basis. Only in the former group the Neiguan, Shenmen, and Xinshu spots were punctured. During a 12-month follow-up, AF recurred in 35 patients. Cumulative AF recurrence rates in the AMIO, ACU, ACU-sham, and CONTROL patients were 27%, 35%, 69%, and 54%, respectively (P = 0.0075, log-rank test). Ejection fraction (P = 0.0005), hypertension (0.0293), and left atrial diameter (P = 0.0361) were also significantly associated with AF recurrence. Compared with AMIO group, recurrence rate was similar in ACU patients (hazard ratio: 1.15, 95% CI: 0.38-3.49; P = 0.801) but significantly higher in ACU-sham and CONTROL patients (3.77, 1.39-10; P = 0.009 and 3.15, 1.23-8.06; P = 0.017, respectively) after adjustment for ejection fraction, hypertension, and left atrial diameter using Cox modeling.
CONCLUSION: Our data indicate that acupuncture treatment prevents arrhythmic recurrences after cardioversion in patients with persistent AF. This minimally invasive procedure was safe and well tolera
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