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      Perceptions of Clinical Clerks and Interns of the University of the Philippines College of Medicine towards Physical and Rehabilitation Medicine as a Medical Specialty

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          Abstract

          Objectives

          Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients.

          Methods

          This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis.

          Results

          Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited.

          Conclusion

          Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.

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          Most cited references11

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          Review of anatomy education in Australian and New Zealand medical schools.

          Anatomy instruction at Australian and New Zealand medical schools has been the subject of considerable debate recently. Many commentators have lamented the gradual devaluation of anatomy as core knowledge in medical courses. To date, much of this debate has been speculative or anecdotal and lacking reliable supporting data. To provide a basis for better understanding and more informed discussion, this study analyses how anatomy is currently taught and assessed in Australian and New Zealand medical schools. A mailed questionnaire survey was sent to each of the 19 Australian and 2 New Zealand medical schools, examining the time allocation, content, delivery and assessment of anatomy for the 2008 academic year. Nineteen of the 21 (90.5%) universities invited to participate completed the survey. There was considerable variability in the time allocation, content, delivery and assessment of anatomy in Australasian medical schools. The average total hours of anatomy teaching for all courses was 171 h (SD +/- 116.7, range 56/560). Historical data indicate a major decline in anatomy teaching hours within medical courses in Australia and New Zealand. Our results reveal that as there is no national curriculum for anatomy instruction, the curriculum content, instruction methodology and assessment is highly variable between individual institutions. Such variability in anatomy teaching and assessment raises an important question: is there also variable depth of understanding of anatomy between graduates of different medical courses?
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            Integration of gross anatomy in an organ system-based medical curriculum: strategies and challenges.

            The University of Alabama School of Medicine (UASOM) instituted a fully integrated, organ system-based preclinical curriculum in 2007. Gross anatomy and embryology were integrated with other basic science disciplines throughout the first two years of undergraduate medical education. Here we describe the methods of instruction and integration of gross anatomy and embryology in this curriculum as well as challenges faced along the way. Gross anatomy and embryology are taught through a combination of didactic lectures, team-based learning activities, and cadaveric dissection laboratories. Vertical integration occurs through third- and fourth-year anatomy and embryology elective courses. Radiology is integrated with anatomy instruction through self-study modules and hands-on ultrasound sessions. Our model of anatomy instruction is time efficient, clinically relevant, and effective as demonstrated by student performance on the United States Medical Licensing Examination(®) (USMLE(®) ) Step 1 examination. We recommend that medical schools considering full integration of gross anatomy and embryology (1) carefully consider the sequencing of organ system modules, (2) be willing to sacrifice anatomical detail for clinical application, (3) provide additional electives to third- and fourth-year students, and (4) integrate radiology with anatomical education.
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              Teaching medical students about disability and rehabilitation: methods and student feedback.

              The predicted increase in the prevalence of chronic and disabling diseases in the population over the next 30 years calls for a more effective approach to educating medical students about the assessment and management of disability. The introduction of a new postgraduate medical course at Flinders University of South Australia in 1996 allowed the development of a new topic on disability and rehabilitation. Over a 4-week period, students undertake four activities. First, they follow a particular patient in an inpatient rehabilitation setting and learn about the multidisciplinary approach to rehabilitation. Secondly, they each visit two people with a disability living in the community and assess their physical, mental, functional and social status. Thirdly, they each visit a service which supports those people in the community. Finally, they simulate having a disability which is randomly allocated to them. During these 4 weeks, students also participate in problem-based learning (PBL) and have 27 h of associated sessions or lectures. The PBL cases and associated sessions have a 'chronic disease' theme. We developed a questionnaire to obtain student feedback on this new topic in the first 2 years of its delivery. A 69% response rate has been obtained. Overall, the topic was well-received, and as a result most students felt more comfortable in dealing with disabled people. They were enthusiastic about ward work, and enjoyed learning about aspects of multidisciplinary team care. Exercises involving simulation of disability were largely acceptable. We believe that this topic helps our students to deal better with the problems of disabled people.
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                Author and article information

                Journal
                Acta Med Philipp
                Acta Med Philipp
                AMP
                Acta Medica Philippina
                University of the Philippines Manila
                0001-6071
                2094-9278
                26 January 2024
                2024
                : 58
                : 1
                : 42-50
                Affiliations
                Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila
                Author notes
                Corresponding author: John Albert A. Gonzales, MD, Department of Rehabilitation Medicine, Philippine General Hospital University of the Philippines Manila, Taft Avenue, Ermita, Manila 1000, Philippines. Email: jagonzales4@ 123456up.edu.ph . ORCiD: https://orcid.org/0009-0001-0536-0465
                Article
                AMP-58-1-5998
                10.47895/amp.vi0.5998
                11199358
                476d9a0a-b406-49cc-8538-e68631eb60dc
                © 2024 Acta Medica Philippina

                Articles are published under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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                Categories
                Original Article

                perception,rehabilitation medicine,medical students,curriculum

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