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Educating medical students on injury prevention: sense and sensibility
  1. E Petridou,
  2. A Klimentopoulou
  1. Social and Preventive Medicine, Athens University Medical School, 75 M Asias St, Athens 115 27, Greece epetrid{at}atlas.uoa.gr

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    Writing a regional report for injury prevention activities in Europe is not an easy task. One should first search through informal channels for noticeable, on-going research and action oriented activities as well as for the development of new strategies or regulations in the injury prevention and control field. Within a continent with diverse cultures and too many official languages, and which has recently undergone major political changes, this may be the first obstacle for a written scientific communication that aims to be based on collective experience. Secondly, one should attempt to foresee the utility of the reported information and question its value for the international readership of the journal. Given the limited time a reader can spend scanning through diverse sources and the continuous “showering” with information of questionable validity, I would rather save space in a high quality scientific journal for peer reviewed research publications. It would be useful to list regularly updated internet sites of interest and reports on the diverse aspects of injury control and prevention; this could be either published in the journal or uploaded to the ISCAIP site. Developing an informal network of national correspondents to make us aware of any developments in the field, alert colleagues to newly identified safety hazards, and screen for the accuracy of such information would be another option. However, the regional correspondent would have no other incentive to offer to the participants other than the moral obligation of sharing experiences with peers, something that is already done. Instead, it would be much more useful for the correspondent to write a short report or a letter to the editor of the journal; this also has the advantage of being cited by interested parties.

    An initiative for informal injury prevention education of undergraduate medical students in Athens

    Keeping the above in mind, it is worth noting the background and strong emphasis on injury prevention at a medical student symposium, which took place in Athens, Greece in May 2000. In the context of the preventive medicine course given by the Department of Hygiene and Epidemiology, Athens University Medical School, the medical students organized and actively participated in the second annual symposium entitled “Preventive medicine faces the challenges of the new millennium”. Students were invited to present topics from their course curriculum that were perceived by them as most important in the contemporary public health agenda. Injury prevention issues were highly prioritized and covered one third of the sessions of the one day symposium. It should be noted, however, that during the last two academic years, injury prevention and control has been taught as a separate module. Moreover, students who chose themes from the injury prevention module were also allowed restricted access to the Emergency Department Injury Surveillance System (EDISS) run by the Center for Research and Prevention of Injuries among the Young (CEREPRI). At the beginning of the semester and during the introductory session students were informed about the symposium. They were invited to participate—on a voluntary basis—in small groups and in short duration projects that aimed to assure adequate and supervised preparation for the presentations; the teaching staff volunteered to provide support on the selection of the topic and the mode of presentation. The assigned task was to identify an injury prevention issue that had not been adequately addressed, to describe the magnitude of the problem and the underlying causes, and to search for realistic solutions. The hidden agenda of the tutors and the postgraduate students of the department, who coached the undergraduates, was to familiarize the students with injury research methods and to assist them to develop medical reference searching, presentation, and writing skills. Students were then expected to make a presentation to the symposium, to release a report to attract mass media attention, and to prepare a manuscript for submission to a scientific journal.

    The experience

    Students confronted research methodology on injury prevention with comfort and perseverance. Lack of knowledge and inexperience did not impede enthusiasm nor did the struggle with unfamiliar datasets discourage them. EDISS served as their initial contact with raw data and their recording and coding systems for some of the projects, whereas when needed other sources of information were advised.

    One group of students expressed an interest in working on the epidemiology and prevention of fall injuries in childhood. With simple statistical analyses, they showed that in Greece fall injuries are the most frequent cause of morbidity in childhood injury, even higher in proportional terms than fall injuries in other countries. Yet, the issue has not drawn much attention on the part of prevention strategy policymakers, most probably because these are usually injuries of minor severity. This may also contribute to the low priority and the short time devoted in fall injury prevention counselling by pediatricians—the main childhood primary health care providers in Greece. An additional reason may be the pediatricians' lack of experience, as fall injuries are almost exclusively treated by surgical specialists. Furthermore, international comparisons of mortality data were made: students noticed that the proportion of injuries due to falls from windows or terraces in Greece is relatively low compared with other European Union member states. Given the wide windows and door openings and other construction deficiencies of Greek housing, this may be due to more cautious parental supervision in this part of the world.

    A second group looked into fall injuries from sporting activities during childhood. Falls were the main mechanism of sports injuries. The epicenter of the discussion that followed was the cost/benefit ratio for public health, given that encouragement of physical activity is an essential component of contemporary health promotion strategies. The students referred to the need to avoid conflicting health messages while stressing the fact that sports can nowadays be practised safely. Physicians and other public health workers and physical activity experts were encouraged to jointly confront the problem.

    Conclusion

    The symposium drew considerable attention from the national medical community and the mass media. The presentations were of high quality and the objectives of the hidden agenda were successfully met. The deputy director of a major medical journal who was invited by the department gave a presentation on how scientific journals select papers for publication. He addressed all the issues posed by the students and this led to discussion on how to prepare papers for submission to selected journals. Perhaps the most important result, however, was a proposition from the students to plan a “third” symposium in which students and tutors from all seven Greek medical schools would be invited to participate and contribute. Matching students' enthusiasm with the dedication of the personnel in our center, despite the limited resources, may be difficult but experience has shown that working with young people is worth the effort and the investment. Maybe colleagues working in similar settings can take the initiative and provide future injury prevention and world conferences with the freshness, the kindness, and the altruism that young minds can offer.

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