Impact of Preclinical Exposure to Organ Donation on Knowledge and Attitudes of Medical Students

Abstract

Context—

Medical students receive little exposure to organ donation and procurement programs.

Objective—

To describe a student-run elective and its effect on participants' knowledge about and attitudes toward organ donation.

Intervention—

Preclinical students interacted directly with donor families, organ recipients, and donation representatives; many participated in an organ procurement with the surgical team.

Design—

Between 2005 and 2007, 13 students who participated in the elective and a procurement were compared with 72 students who took the elective but did not participate in a procurement and with 22 control students. Students who participated in a procurement wrote reflections about their experience. In 2010, 15 first-year students who participated in the elective and a procurement and 59 randomly selected control students completed a previously validated measure.

Outcome—

Themes included awe, surgical procedures, learning opportunities, and brain death. Regardless of procurement participation, the elective participants from 2005 to 2007 reported higher 4-item knowledge scores (P < .001) than control students reported, but their 4-item attitude scores did not differ (P = .21). The 2010 students did not differ from control students in their number of correct responses to the 20 knowledge questions (P = .48) or their individual responses to each of the 14 attitude questions (all P > .05).

Results—

Although elective participants reflected positively on their experiences and professed greater knowledge than control students via a researcher-made tool, these results were not sustained with a previously validated measure. These results point to the need for careful elective design and the need for more accurate measures to study the effectiveness of such interventions.

References

OPTN. 2010 Annual Data Report of the US Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients. 2010. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, Rockville, MD; United Network for Organ Sharing, Richmond, VA; University Renal Research and Education Association, Ann Arbor, MI. http://optn.transplant.hrsa.gov/ar2009/ar_archives.htm. Accessed September 2, 2011.

Siminoff

Arnold

Caplan

. Health care professional attitudes toward donation: Effect on practice and procurement. J Trauma. 1995;39(3):553–559.

Dutra

Bonfim

Pereira

. Knowledge about transplantation and attitudes toward organ donation: A survey among medical students in northeast Brazil. Transplant. Proc. 2004;36(4):818–820.

Essman

Thornton

. Assessing medical student knowledge, attitudes, and behaviors regarding organ donation. Transplant Proc. 2006;38(9):2745–2750.

Anker

Feeley

Friedman

Kruegler

. Teaching organ and tissue donation in medical and nursing education: A needs assessment. Prog Transplant. 2009;19(4):343–348.

Ohwaki

Yano

Shirouzu

. Factors associated with attitude and hypothetical behaviour regarding brain death and organ transplantation: Comparison between medical and other university students. Clin Transplant. 2006;20(4):416–422.

Schaeffner

Windisch

Freidel

Breitenfeldt

Winkelmayer

. Knowledge and attitude regarding organ donation among medical students and physicians. Transplantation. 2004;77(11):1714–1718.

Schütt

. 25 years of organ donation: European initiatives to increase organ donation. Transplant Proc. 2002;34(6):2005–2006.

Maudsley

Strivens

. Promoting professional knowledge, experiential learning and critical thinking for medical students. Med Educ. 2000;34(7):535–544.

10.

Spencer

. ABC of learning and teaching in medicine: Learning and teaching in the clinical environment. BMJ. 2003;326 (7389):591–594.

11.

Bransford

Brown

Cocking

, eds. How People Learn: Brain, Mind, Experience, and School: Expanded Edition. 2nd ed. Washington, DC: National Academies Press; 2000.

12.

Dornan

Littlewood

Margolis

. How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach. 2006;28(1):3–18.

13.

Yardley

Littlewood

Margolis

. What has changed in the evidence for early experience? Update of a BEME systematic review. Med Teach. 2010;32(9):740–746.

14.

Hepburn

Niemi

Chapman

. Service learning in college political science: Queries and commentary. Politic Sci Politics. 2000;33(3):617–622.

15.

Youniss

McIellan

Yates

. The role of community service in identity development: Normative, unconventional, and deviant orientations. J Adolesc Res. 1999;14(2):248–261.

16.

Edwards

Essman

Thornton

. Assessing racial and ethnic differences in medical student knowledge, attitudes and behaviors regarding organ donation. J Natl Med Assoc. 2007; 99(2):131–137.

17.

Essman

Thornton

. Assessing medical student knowledge, attitudes, and behaviors regarding organ donation. Transplant Proc. 2006;38(9):2745–2750.

18.

Schwind

Boehler

Rogers

. Variables influencing medical student learning in the operating room. Am J Surg. 2004;187(2):198–200.

19.

Sammann

Tendick

Ward

. A surgical skills elective to expose preclinical medical students to surgery. J Surg Res. 2007;142(2):287–294.

20.

Cloyd

Holtzman

O'Sullivan

. Operating room assist: Surgical mentorship and operating room experience for preclerkship medical students. J Surg Educ. 2008;65(4):275–282.

21.

Lima

Cerqueira

. Organ donation: Cross-sectional survey of knowledge and personal views of Brazilian medical students and physicians. Transplant Proc. 2010;42(5):1466–1471.

22.

Burra

De Bona

Canova

. Changing attitude to organ donation and transplantation in university students during the years of medical school in Italy. Transplant Proc. 2005;37(2):547–550.

23.

Dardavessis

Xenophontos

Haidich

A-B

Kiritsi

Vayionas

. Knowledge, attitudes and proposals of medical students concerning transplantations in Greece. Int J Prev Med. 2011;2(3):164–169.

24.

Almeida

Quireze

de Faria

. Organ donation and transplantation from medical students' perspective: Introducing the experience from an academic league in Brazil. Transplant Proc. 2011;43(4):1311–1312.

25.

Barron

Schwartz

Vye

. Doing with understanding: Lessons from research on problem- and project-based learning. J Learn Sci. 1998;7(3&4):271–311. http://www.jstor.org/stable/1466789. Accessed June 5, 2011.

26.

Eva

Regehr

. Knowing when to look it up: A new conception of self-assessment ability. Acad Med. 2007;82(10 suppl): S81-S84.

27.

Davis

Mazmanian

Fordis

. Accuracy of physician self-assessment compared with observed measures of competence: A systematic review. JAMA. 2006;296(9):1094–1102.

28.

Saub

Shapiro

Radecki

. Do patients want to talk to their physicians about organ donation? Attitudes and knowledge about organ donation: A study of Orange County, California residents. J Community Health. 1998;23(6):407–417.