Limits...
Decline of medical student idealism in the first and second year of medical school: a survey of pre-clinical medical students at one institution.

Morley CP, Roseamelia C, Smith JA, Villarreal AL - Med Educ Online (2013)

Bottom Line: We sought to identify differences in survey responses between first-year (MS1) and second-year (MS2) medical students at the beginning (T1) and end (T2) of academic year 2010 on three proxies for idealism, including items asking about: (a) motivations for pursuing a medical career; (b) specialty choice; and (c) attitudes toward primary care.MS2s placed more emphasis on status/income concerns (β=0.153, p<0.001), and much less emphasis on idealism as a motivator (β=-0.081, p=0.054), in pursuing a medical career; more likely to consider lifestyle and family considerations (β=0.098, p=0.023), and less likely to consider idealistic motivations (β=-0.066, p=NS); and were more likely to endorse both negative/antagonistic (β=0.122, p=0.004) and negative/sympathetic (β=0.126, p=0.004) attitudes toward primary care.The results are suggestive that idealism decline begins earlier than noted in other studies, implying a need for curricular interventions in the first two years of medical school.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA. morleycp@upstate.edu

ABSTRACT

Background: Idealism declines in medical students over the course of training, with some studies identifying the beginning of the decline in year 3 of US curricula.

Purposes: This study tested the hypothesis that a decline in medical student idealism is detectable in the first two years of medical school.

Methods: We sought to identify differences in survey responses between first-year (MS1) and second-year (MS2) medical students at the beginning (T1) and end (T2) of academic year 2010 on three proxies for idealism, including items asking about: (a) motivations for pursuing a medical career; (b) specialty choice; and (c) attitudes toward primary care. Principle component analysis was used to extract linear composite variables (LCVs) from responses to each group of questions; linear regression was then used to test the effect of on each LCV, controlling for race, ethnicity, rural or urban origins, gender, and marital status.

Results: MS2s placed more emphasis on status/income concerns (β=0.153, p<0.001), and much less emphasis on idealism as a motivator (β=-0.081, p=0.054), in pursuing a medical career; more likely to consider lifestyle and family considerations (β=0.098, p=0.023), and less likely to consider idealistic motivations (β=-0.066, p=NS); and were more likely to endorse both negative/antagonistic (β=0.122, p=0.004) and negative/sympathetic (β=0.126, p=0.004) attitudes toward primary care.

Conclusions: The results are suggestive that idealism decline begins earlier than noted in other studies, implying a need for curricular interventions in the first two years of medical school.

Show MeSH

Related in: MedlinePlus

Matrix questions and items used.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3750194&req=5

Figure 0001: Matrix questions and items used.

Mentions: The specific items were ranked on 5-item Likert scales, ranging from ‘Not important at all’ to ‘Very important’ for the medicine and specialty questions, and a 6-point Likert scale ranging from ‘Completely disagree’ to ‘Completely agree’, with ‘Neither agree nor disagree’ as a central anchor, and an additional ‘Not sure’ option, for the matrix of primary care attitudinal statements. Responses were scaled from 1 (Not important at all/completely disagree) to 5 (Very important/completely agree). Responses on the primary care statements marked ‘Not sure’ were incorporated into the neutral anchor category (coded as 3), so that all items were analyzed on a five-point scale. The three matrix questions and items are further described in Fig. 1.


Decline of medical student idealism in the first and second year of medical school: a survey of pre-clinical medical students at one institution.

Morley CP, Roseamelia C, Smith JA, Villarreal AL - Med Educ Online (2013)

Matrix questions and items used.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750194&req=5

Figure 0001: Matrix questions and items used.
Mentions: The specific items were ranked on 5-item Likert scales, ranging from ‘Not important at all’ to ‘Very important’ for the medicine and specialty questions, and a 6-point Likert scale ranging from ‘Completely disagree’ to ‘Completely agree’, with ‘Neither agree nor disagree’ as a central anchor, and an additional ‘Not sure’ option, for the matrix of primary care attitudinal statements. Responses were scaled from 1 (Not important at all/completely disagree) to 5 (Very important/completely agree). Responses on the primary care statements marked ‘Not sure’ were incorporated into the neutral anchor category (coded as 3), so that all items were analyzed on a five-point scale. The three matrix questions and items are further described in Fig. 1.

Bottom Line: We sought to identify differences in survey responses between first-year (MS1) and second-year (MS2) medical students at the beginning (T1) and end (T2) of academic year 2010 on three proxies for idealism, including items asking about: (a) motivations for pursuing a medical career; (b) specialty choice; and (c) attitudes toward primary care.MS2s placed more emphasis on status/income concerns (β=0.153, p<0.001), and much less emphasis on idealism as a motivator (β=-0.081, p=0.054), in pursuing a medical career; more likely to consider lifestyle and family considerations (β=0.098, p=0.023), and less likely to consider idealistic motivations (β=-0.066, p=NS); and were more likely to endorse both negative/antagonistic (β=0.122, p=0.004) and negative/sympathetic (β=0.126, p=0.004) attitudes toward primary care.The results are suggestive that idealism decline begins earlier than noted in other studies, implying a need for curricular interventions in the first two years of medical school.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA. morleycp@upstate.edu

ABSTRACT

Background: Idealism declines in medical students over the course of training, with some studies identifying the beginning of the decline in year 3 of US curricula.

Purposes: This study tested the hypothesis that a decline in medical student idealism is detectable in the first two years of medical school.

Methods: We sought to identify differences in survey responses between first-year (MS1) and second-year (MS2) medical students at the beginning (T1) and end (T2) of academic year 2010 on three proxies for idealism, including items asking about: (a) motivations for pursuing a medical career; (b) specialty choice; and (c) attitudes toward primary care. Principle component analysis was used to extract linear composite variables (LCVs) from responses to each group of questions; linear regression was then used to test the effect of on each LCV, controlling for race, ethnicity, rural or urban origins, gender, and marital status.

Results: MS2s placed more emphasis on status/income concerns (β=0.153, p<0.001), and much less emphasis on idealism as a motivator (β=-0.081, p=0.054), in pursuing a medical career; more likely to consider lifestyle and family considerations (β=0.098, p=0.023), and less likely to consider idealistic motivations (β=-0.066, p=NS); and were more likely to endorse both negative/antagonistic (β=0.122, p=0.004) and negative/sympathetic (β=0.126, p=0.004) attitudes toward primary care.

Conclusions: The results are suggestive that idealism decline begins earlier than noted in other studies, implying a need for curricular interventions in the first two years of medical school.

Show MeSH
Related in: MedlinePlus