Attitudes and perceptions of medical students at the Univers

1. Attitudes and perceptions of medical students at the University of Jordan towards medical research

2. Investigators Mohammad I. Hirzallah, M.D* Abdulla M. Ehlayel, M.D* SawsanAmireh** Majd T. Ghanem** Ahmad Al-Samhouri** SuhaibQuneibi** Munir Abu-Helalah, MD MPH PhD (study supervisor) *Medical students at the time the study was conducted. ** Medical Students *** Assistant Professor in Epidemiology and Preventive Medicine, National Guard Health Affairs, Riyadh,KSA

3. Introduction – the physician scientist • We live in an era of exponential increase in human knowledge, this carries great potential for unprecedented improvements in the human well being. • This increases the demand on competent physician scientists, however . . . • The proportion of investigators applying for clinical research grants from the NIH who are physicians has declined from 40% 30 years ago to 25% today*. • The physician scientist . . . an “endangered species” ? *Nathan, David g. 1998. Clinical Research perceptions, reality, and proposed solutions. JAMA 280, no. 16: 1427-1531.

4. Sung, Nancy S, William F Crowley, Myron Genel, Stephen B Johnson, Veronica Catanese, Hugh Tilson, Kenneth Getz, et al. 2003. Central Challenges Facing the National Clinical Research Enterprise. JAMA 289, no. 10: 1278-1287.

5. “If clinical research is to flourish, medical students must become interested in the field.” NIH Director's Panel on clinical research; A panel of 15 experts that met over 2 years to recommend NIH policy changes that might encourage physician investigators to undertake careers in clinical research Nathan, David g. 1998. Clinical Research perceptions, reality, and proposed solutions. JAMA 280, no. 16: 1427-1531.

6. How does this concern us? • In developing countries the physician scientist is a “rare species” to begin with! • Exposing medical students to medical research early on in their careers increases the flux of physicians into the research pathway. • Research activities also increase interest in academic medicine.

7. Introduction – medical student involvement in research, more benefits • Medical professionals are consumers of medical publications; they need to be able to critically appraise the medical literature. • Research helps students: • Enhances their analytical thinking skills. • Become more informed about future career decisions. • Increase chances in getting into their residency of choice. • Involvement in medical research has been associated with success in future careers*. • Increase the publication output of their institutes. *Metcalfe, David. 2008. Involving medical students in research. Journal of the Royal Society of Medicine 101, no. 3 (March): 102-3. doi:10.1258/jrsm.2008.070393.

8. Introduction – aim of this study • Find out more about the level of participation of medical students in research and what determines their participation. • The outcomes of this study is intended to serve as a baseline for the Medical Student Research Club and other student-related research activities.

9. Methods • A structured, piloted questionnaire was designed by the investigators based on: • Review of the pertinent literature. • The authors’ experience. • Discussion sessions with other medical students. • The questionnaire was voluntary and self-administered, targeting medical students (from 2nd to 6th year) at the University of Jordan, Faculty of Medicine. • The data was collected and entered in a manner that insured confidentiality.

10. Results • STATA 10 was used for statistical analysis. • Population size (2nd to 6th year students) was 933 students. • Respondents: 463 students (90% Power).

11. Results – study participants

12. Do you think that participating in conducting medical research is directly important to you? % % %

13. Clinical vs. Basic: Do you think that participating in conducting medical research is directly important to you? P value = 0.903, no significant difference

14. GPA correlation: Do you think that participating in conducting medical research is directly important to you? P value = 0.5, no significant difference

15. Males vs. Females: Do you think that participating in conducting medical research is directly important to you? 44% 30% Males > females P value = 0.047 (marginal significance)

16. Are you aware of any research projects at the University of Jordan: faculty of medicine or at the Jordan University Hospital? (excluding 2nd and 3rd year community medicine projects)

17. Did you want to participate?

18. Did you participate in research?(excluding mandatory community medicine projects)

19. Correlation between gender and participation Males participated in research more than females, P value = 0.023

20. Correlation between year of study and participation in research Number of students P value = 0.008, on further analysis the main difference was clinical > basic (P = 0.002)

21. Participation in research projects at JU/JUH vs. outside Number of students

22. Publication output of research projects at JU/JUH vs. outside Number of students JU/ JUH Outside In general, only 7 students had their work published (1.5%) of these 4 students attained co-authorship (0.86%)

23. What stages did you participate in?(46 students) Number of students

24. Predictors of participation in research – using logistic regression • Variables entered in logistic regression model: • Year of study • Gender • GPA • Thinking that research is important. • Awareness of research projects • Basic vs. clinical • Considering a future career in academic medicine • Considering research as part of future career • Thinking that evidence based medicine is important in future career • Believing to have sufficient skills to write a medical article • Frequency of reading medical articles

25. Predictors of participation in research – using logistic regression

26. Research-related knowledge

27. Correlation between knowledge and academic year P < 0.001 [> 5 terms is positive]

28. Correlation between knowledge and participation in research Mean 5.3 (participants) > 4 (non-participants) P value = 0.001

29. Discussion • Medical students participants in medical research is limited. • Barriers to the participation of medical students in research include: time limitations, lack of financial support, lack of encouragement and insufficient training.

30. Discussion • Awareness of research activities at Jordan University and JU hospital is limited. This could be increased by activation of the role of the Medical Student Research Club. • Gender variations in engagement in research activities needs further evaluation. • Knowledge of common research terms is limited.

31. Discussion – the down slope of participation 74% think research is important 79% wanted to participate 26% were aware of any projects 0.9% attained co-authorship 5% participated in research 1.5% had their work published

32. Discussion • Khan, H., MrKhawaja, A. Waheed, M.A. Rauf, and Z. Fatmi. 2006. Knowledge and attitudes about health research amongst a group of Pakistani medical students. BMC Med Educ 6: 54. doi:10.1186/1472-6920-6-54. • Cursiefen, Claus, and AyhanAltunbas. 1998. Contribution of medical student research to the Medline TM -indexed publications of a German medical faculty. MEDICAL EDUCATION 32, no. 4: 439-440. doi:10.1046/j.1365-2923.1998.00255.x. • Jacobs, Charlotte D, and Patricia C Cross. 1995. The value of medical student research: the experience at Stanford University School of Medicine. Medical Education 29, no. 5: 342-346. doi:10.1111/j.1365-2923.1995.tb00023.x. http://blackwell-synergy.com/doi/abs/10.1111/j.1365-2923.1995.tb00023.x.

33. Conclusions and recommendations – what can be done: MSRC • The Medical Student Research Club • Students learn from students and activation of the role of the research club could increase awareness.

34. Conclusions and recommendations – what can be done: courses • The community medicine and biostatistics courses in 2nd and 3rd years need to be critically evaluated and re-structured to ensure maximum benefit. • A medical student scientific day should be dedicated to these projects with a special issue of the Jordan Medical Journal covering it.

35. Conclusions and recommendations – what can be done? • The policy and attitudes of faculty staff at our university towards medical students’ participation in research needs to be assessed. • Students and Staff should be encouraged to work together and produce publishable projects, for example, by introducing an incentive program.

36. Conclusion • Students participation in medical research is limited and there are very few publications made by medical students • Students knowledge of common research terms is low • There are several barriers to students participation in medical research and for including medical research in the degree requirement • There is a need for further assessment of reported barriers and predictors of medical students participation in medical research • Faculty, students and staff should be encouraged to unite their efforts in order to propose solutions and pilot projects to remove the reported barriers for medical students’ participation in research.

37. Thank you Contact e-mail: mihh1986@yahoo.com mhmd.hirz@gmail.com