Content Analysis of Reflective Journals in Early Clinical Experience

This study qualitatively analyzed medical students’ engagement of pre-clerkship early clinical experience and their implications based on reflective journals. The subjects were 60 third-year students who had taken the early clinical experience course offered by the Catholic Kwandong University College of Medicine. Students had to complete and submit a reflective journal at the end of the course. This study used the reflective journals students submitted as analysis data. Data were analyzed using Elo and Kyngäs’ inductive qualitative analysis. As a result of study, a total of 127 unique significant keywords and statements were extracted. These statements generated 11 formulated sub-categories and five theme categories. Five main categories were derived from the students’ reflective journals: understanding of patients, understanding of professionalism, understanding of other occupations, understanding of the hospital system, and motivation to learn. Students understood patients’ perspectives on diseases and improved their ability to empathize; they gained confidence in communication and clinical skills; they became more positive toward the underprivileged; and their interest in the medical system grew. The results suggest that early clinical experience can be applied as one beneficial educational program for medical students in the pre-clerkship curriculum.

Early Clinical Experience with Trifluridine/Tipiracil for Refractory Metastatic Colorectal Cancer: The ROS Study

Trifluridine/tipiracil is currently approved for metastatic colorectal cancer (mCRC) refractory to available therapies. However, there is no consensus on factors that predict treatment outcomes in daily practice. We assessed the early clinical experience with trifluridine/tipiracil in Spain and potential survival markers. This was a retrospective cohort study of mCRC patients who participated in the trifluridine/tipiracil early clinical experience programme in Spain. The primary outcome was overall survival (OS). Associations between OS and patient characteristics were assessed using multivariate Cox regression analyses. A total of 379 patients were included in the study. Trifluridine/tipiracil was administered for a median of 3.0 cycles and discontinued mainly due to disease progression (79.2%). The median OS was 7.9 months, with a 12-month OS rate of 30.5%. Cox analyses revealed that the following variables independently enhanced OS: ≤2 metastatic sites, no liver metastasis, alkaline phosphatase < 300 IU, trifluridine/tipiracil dose reductions, and neutrophil/lymphocyte ratio < 5. Grade ≥ 3 toxicities were reported in 141 (37.2%) patients, including mainly afebrile neutropaenia (23.2%), anaemia (12.1%), and thrombocytopaenia (5.3%). This study supports the real-life efficacy and safety of trifluridine/tipiracil for refractory mCRC and identifies tumour burden, liver metastasis, alkaline phosphatase, dose reductions, and neutrophil/lymphocyte ratio as survival markers.

Early Clinical Experience and Mentoring of Young Dental Students—A Qualitative Study

The literature reports that student transition between preclinical and clinical dental education can be traumatic and stressful for many reasons. Early clinical experience has been reported to provide some relief. In this qualitative study, twelve final year dental students were interviewed about their perceptions and experiences with a mentee/mentor (FOAL) program in Aarhus, Denmark, to see if it (1) counteracted stress perceptions from preclinical education to the clinic, (2) inspired professionalism and a sense of study relevance, (3) helped in learning to reflect on competencies and attitudes, (4) helped with clinical social perspectives (communication/contact), (5) helped with motivation to learn and (6) helped to reaffirm one’s professional study choice. Using qualitative description methods with purposeful sampling, data from interviews were collected, transcribed, analyzed and validated with a short questionnaire. The FOAL program, today, has several benefits for mentees, including partially helping in the preclinic to clinic transition and the increased insight into mentors’ clinical tasks and communication with patients. Informants described that FOAL also contributed positively to both mentee and mentor students’ learning motivation, collaborative skills and professional attitudes. Challenges were lack of organization/planning, not enough clinical hours, lack of clinical knowledge and persistent stress levels at the clinical transition. These issues are already being considered in the curriculum reform currently in progress and are also relevant to other dental curricula internationally.