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Background: Women comprise more than two-thirds of the academic medicine faculty and half of the general population in Pakistan, yet their representation in healthcare leadership roles remains disproportionately low. Aim: The study aims to explore the experiences of Pakistani women in healthcare leadership positions to unravel the challenges they face in acquiring and sustaining leadership positions and to identify the factors that help them overcome these challenges. Methods: An exploratory qualitative study based on semi-structured interviews was conducted. Purposive sampling was utilized. Telephonic interviews of ten women in healthcare leadership positions were conducted, recorded, and transcribed. Thematic analysis was performed by manual coding. Results: A total of 14 subthemes were generated that finally emerged as 5 themes. The challenges of women in healthcare leadership positions included unsupportive work environment, lack of confidence and leadership skills, and struggle to balance family and work. Personal strategies, family support, and women-centric organizational policies were identified as aids to professional advancement. Conclusion: Most of the challenges faced by women in acquiring and sustaining leadership positions in Pakistan are rooted in a patriarchal culture that assigns conventional roles and expectations to women. Professional competence and strategic acumen along with inclusive work environment and policies can help promote gender equality. [ABSTRACT FROM AUTHOR]

Background: It is high time we acknowledged that the IT industry will determine our destiny given its rapid development. The demand to use smartphones and other forms of technology into healthcare is growing in tandem with the population. A great deal has been accomplished because of developments in computer science. This also needs to be a part of our educational practices. It would be incredibly beneficial to use cellphones to improve the learning possibilities for our medical students, since nearly all students and faculty members use them in some form. We need to gauge the faculty's openness to new technologies and their thoughts on smartphones as a teaching tool before we can move forward with formal adoption. Methodology: The faculty members of all the dental colleges in KPK were given a verified questionnaire. The survey was divided into two parts. The first one included data on population composition. The second survey enquired about the faculty's present smartphone use to support their teaching. Results: Our research found that teachers are already making use of smartphones in the classroom (Mean 2.65). Regardless, neither the college nor the university have formally launched using smartphones as a learning device. Conclusions: Our investigation found moderate smartphone adoption among dental faculty in KPK (mean = 2.65/5.0), with significant variations across institutions and departments. While faculty members recognize potential benefits, current usage patterns suggest the need for structured implementation approaches and further infrastructure development. [ABSTRACT FROM AUTHOR]

Objective: To explore teacher's perspectives regarding co-teaching classes. Methods: Online interviews of participants were conducted through Zoom meetings at a suitable time the researcher and the participant decided beforehand. Teachers' perspective regarding co-teaching classes were studied. The study design was qualitative, and phenomenological. A purposive sampling technique was opted in which participants involved in co-teaching in the field of medicine for not less than one year were chosen. Data was collected through a semi structured interview, with nine open ended question, after validation from experts. Results: Thematic analysis of the data was done in three phases. Fifty-three codes were identified from the transcriptions of the interviews in the initial coding. Twelve codes were derived in axial coding and finally, five themes were formed. Overall teachers showed a very positive response towards co-teaching. They discussed a lot of benefits of co-teaching. The opportunities and challenges in the co-teaching classes were also discussed. and most importantly the interaction of the co-teachers in the planning phase of the session, during the class and in the assessment were explored. Conclusion: Teachers described their experience of co-teaching as productive, pleasant, and enriching. The professional growth of teachers is fostered through co-teaching. Collaborative harmony develops among co-teachers. Teacher's satisfaction also increases by comprehensive knowledge transfer. Although some challenges were faced by teachers in co-teaching classes. The most common challenge of co-teaching was time management. Dominating nature or irresponsible teachers was also a challenge to deal with. [ABSTRACT FROM AUTHOR]

Objective: This study is designed to identify the attributes of Evidence-Based Practice demonstrated by postgraduate residents in tertiary care hospitals in KPK, Pakistan. Material and Methods: A cross-sectional study was conducted at tertiary care government hospitals in the Khyber Pakhtunkhwa (KPK) province from March to August 2023. To achieve a 95% confidence level with a margin of error of 5%, the study aimed to collect data from a sample of 301 participants. This sample size was determined based on the assumption that the expected proportion of the population with the characteristic of interest is 31%. The instrument to assess healthcare professionals ‘perceptions, behavior, self-efficacy, and attitudes toward evidence-based health Practice (I-SABE) was used to collect data, and SPSS version 23 was used for data analysis. Results: Nearly half, or 48.4% (152 respondents), of the overall sampled population identified as male. This is a little higher than the percentage of women, which was 38.9% (122), with the majority in their second residence year 29.6% (93 respondents). With an average age of 34, the three main specialties represented were medicine, surgery, and gynecology. Self-efficacy, attitude, behavior, and patient care outcome scores of 24.22, 14.35, 30.07, and 24.49 on average were reported by residents, showing a modest level of confidence in their EBP skills. Confidence intervals and clinical trial measures were unclear to 42% (132) of respondents. Insufficient data (8.9% or 28 respondents) and problems with resource availability and time restrictions (14.3% or 45) were obstacles to the deployment of EBPs. Despite widespread support for medical research methods, consistent implementation was absent. Residents’ confidence grew as training continued, with little significant gender difference in self-efficacy scores. Increased confidence correlated with improved behavior. Conclusion: Although medical research techniques are generally appreciated, their consistent implementation remains a challenge. The adoption of evidence-based practices (EBP) faces various obstacles, including limited resources and knowledge gaps. As residents progress through their program, their confidence and use of EBP concepts increase. [ABSTRACT FROM AUTHOR]

Objective: Dental institutes continue to face challenges in making the transition from a discipline-based to an integrated curriculum. The need analysis is often the first step in the development and implementation of any curriculum. This study intends to carry out a needs analysis for a contemporary dental curriculum in private and public sector dental colleges of Peshawar, KPK, Pakistan. Methods: The mixed method study was carried out at public and private dental institutes in Peshawar from April to July 2022. To guarantee triangulation, data were gathered from three sources. The first source was an analysis of the Pakistan Medical and Dental Council's dental curriculum accreditation standards. The second source was gathering the experts' perspectives, and the final source was a systematic literature search to explore the necessity for an integrated undergraduate dental curriculum from the experiences and expertise of contemporary curricula. Results: Thematic analysis identified the need for the dental curriculum to be a five-year BDS program, involvement of students, and inclusion of digital dentistry and environmental sustainability in the dental curriculum. PMDC accreditation standards focus on alignment in mission, vision, curricular outcomes, an integrated curriculum, and a quality assurance system for assessment. Experts identified the need for a patient-centered curriculum focusing on integrated patient care. They also identified that the current educational environment should be improved to sustain a contemporary dental curriculum in Pakistan. For the literature review, nine articles were included in the final review. Conclusion: The current dental curriculum is not accommodating to the needs of the students in Peshawar. The current dental education environment lacks the infrastructure, logistics, and teacher training to sustain the standards set by PMDC. [ABSTRACT FROM AUTHOR]

Introduction: Blended learning, which integrates classroom face-to-face teaching with both asynchronous and synchronous online learning elements, has swiftly gained acceptance in educational environments. However, the implementation of blended learning presents challenges that impact all stakeholders, necessitating thoughtful consideration. Teachers play a central role in shaping the instructional experience among these stakeholders. To fully realize the potential of comprehensive blended learning, it is imperative to identify the challenges faced by these teachers and develop strategies that sensibly address and overcome them. Methodology: A qualitative exploratory study was conducted with twelve teachers involved in the postgraduate blended learning health professions program at Khyber Medical University, Peshawar in 2022. One-on-one semi-structured Interviews were conducted via WhatsApp/ZOOM, transcribed by Otter AI, coded on NVivo & analyzed using Braun/Clarke's Thematic Analysis. Results: Three themes of challenges faced by teachers of postgraduate blended learning programs were constructed namely (1) Skills, such as (i) digital, (ii) instructional, and (iii) online class management, and (2) Administrative barriers in terms of (iv) resources (iv) training, and (3) Faculty resistance. Conclusion: This study provides profound insights into the daunting challenges that postgraduate blended learning program teachers encounter in terms of skills, administrative barriers, and faculty resistance. These findings offer a valuable opportunity for program directors to identify the critical requirements of these faculties in their pursuit of effective teaching and learning, ultimately transforming the landscape of blended education. This study emphasizes the need for ongoing faculty development and institutional support to address the identified challenges and improve the quality of postgraduate blended-learning programs. [ABSTRACT FROM AUTHOR]

Background: The development of a medical curriculum is a multi-layered and complicated process, demanding teamwork among diverse stakeholders, including undergraduate medical students and faculty members. This study investigates the underexplored realm of stakeholder perceptions, specifically those of undergraduate medical students and faculty, regarding their engagement in the intricate process of medical curriculum development. Methods: The research, conducted at Azad Jammu & Kashmir Medical College Muzaffarabad, employs a qualitative exploratory approach, with participants selected from the 4th and 5th years based on academic performance. Through two Focus Group Discussions (FGDs) and successive thematic analysis, the study discovers valuable understandings of the level of commitment, influencing factors, and recommendations for development articulated by the stakeholders. Results: The findings underscore the vital status of subject incorporation for improved understanding and constant student engagement. Cognitive and emotional engagement emerge as serious elements for optimal curricular outcomes, impacting academic presentation and attendance. Integrated programs, aimed at linking basic and clinical sciences, are shown to enhance critical thinking and problem-solving skills, the development of a solid understanding of medical concepts. Particularly, involving students in the curriculum development process is identified as an empowering strategy, leading to heightened motivation and improved academic performance. Conclusion: The insights gained from this study have implications for humanizing curriculum development processes, ultimately benefiting both students and the healthcare system. [ABSTRACT FROM AUTHOR]

Objective: To determine residents' perceptions of supervisors as clinical teachers. Study Design: Crosssectional study. Setting: Three Public Sector Teaching Hospitals in Peshawar. Period: August 2019 to May 2020. Material & Methods: For assessing the perceptions of residents in the three public sector teaching hospitals located in Peshawar, a structured questionnaire was used. (N=163) residents were taken as a sample. The response rate was 100% from the three teaching hospitals. For analyzing data SPSS version 22 was used and P < 0.05 was considered as significant. Results: Out of the whole sample (N=163), 63.8 % residents were from medical and allied health specialties, and 36.2 % were from surgical and allied health specialties with Mean ± SD = 1.36 ± 0.836. The findings of this study revealed that the vast majority of trainees were found strongly agreed with the questionnaire responses about their supervisor's role as a clinical teacher. Regarding the supervisor's role as a clinical teacher, negative perceptions in minority of trainees were found with few problems. Conclusion: In their perceptions of a good clinical teacher, most residents emphasize the teacher's characteristics. It is important to note that the trainees want to establish a positive relationship with their clinical teacher. Clinically, our residents received high marks from their supervisors. [ABSTRACT FROM AUTHOR]

Objective: This study explored the factors influencing the development of empathy in a dentist-patient relationship. Design: An exploratory qualitative study. Place and duration of the study: Khyber Medical University KPK, Pakistan October 2019 to April 2020.was conducted during 2019-2020. Methodology: This exploratory qualitative study was conducted during 2019-2020. It was conducted on 12 dental surgeons, recruited from four major dental clinical specialties. A purposive sampling technique was used. In -depth interviews were conducted through a semi-structured format. The interviews were audio recorded, transcribed verbatim and analyzed, using the thematic analysis framework. Results: Three themes were extracted from the data. 1) Institutionalization of empathy 2) Barriers in the path of empathetic attitude and 3) Cultivating a Culture of empathy for better health care provision. The participants of the study observed tha t the development of empathy in a dentist-patient relationship includes a wide range of factors, ranging from curricular, personal, social, organizational, and cultural. These factors elaborate that empathy is a multidimensional phenomenon with roots deeply entrenched in professional and personal domains. Conclusion: Various factors are involved in developing an empathetic relationship between a dentist and a patient. The content about empathy in our present dental curriculum is very deficient. Contextual academic workload and time constraints affect the execution of empathy. However, empathy is a teachable attribute, hence the factors hampering empathy can be addressed, modified, and re-employed to enhance empathy. [ABSTRACT FROM AUTHOR]

Objectives: To identify the mechanisms to reduce gender bias during assessments in undergraduate medical education. Material and Methods: A qualitative study with a phenomenological study design was conducted at a Public and Private Medical College in Peshawar, Pakistan, from July 2020 to October 2020. In this qualitative study, four gender-specific focal group interviews with undergraduate medical students and 10 individual interviews with senior faculty members were conducted by using a pre-tested & validated semi-structured interview guide. The interviews were recorded and transcribed verbatim. The thematic analysis of the data was done where codes were developed and organized into distinct categories giving rise to discrete themes. Data triangulation was done to increase the credibility and authenticity of the study. Results: Out of 24 students and 10 faculty members, half of the participants were females who shared their perceptions about mechanisms to counteract gender bias in medical education. The analysis revealed 24 codes that were labeled and organized into 10 categories. The 4 themes deducted from these categories were Anti-Bias Training, Surveillance of Examination, Psychological Evaluation of Students & Faculty, and Transparency & Accountability. Conclusion: Gender bias can substantially affect medical students' capacity to learn and succeed in their careers, is a well-established fact. Thus, to reduce gender bias in medical education, medical schools must take more excellent initiatives and promote anti-bias awareness sessions & workshops, post-examination feedback & reporting systems, and strict surveillance & accountability. Similarly, psychological evaluation of teachers & students, structured examination patterns, and promoting a panel of assessors for high stake exams are other strategies to counteract this issue in undergraduate medical education. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine medical students' perceptions of their clinical teachers as role models during the clinical years of a medical program. Materials and Methods: In this cross-sectional study, a pre-validated questionnaire, Role Modeling Apperception Tool was used and completed by Final year medical students selected from affiliated medical institutions of Khyber Medical University, Peshawar i.e. four graduating cohorts, comprising about 600 students. Participants were selected following universal sampling and data was analyzed for descriptive and inferential statistics. Results: The response rate to Role Modeling Apperception Tool was 75.1% n=451. The total number of students participating in this study from Private sector medical colleges was 157 34.8% and Public Government was 294 65.2%. The mean age of the students was 23.71 years SD=0.77, Range=22-26. Male respondents comprised 42.4% n=191 and females were n=260 57.6% of the study sample. Altogether, 92.9% of students experienced positive role models while 72% had negative role models among academic staff in their medical colleges. Mostly, medical students perceived male clinical teachers as their role models in comparison to their female counterparts. Moreover, clinical teachers were more considered positive role models than basic sciences teachers. Private-sector medical college students rated their clinical teachers higher among all domains Clinical, Personal, and Teaching in comparison to Public sector medical college students. A strong positive correlation was noted among domains tested on Role Modeling Apperception Tool. Conclusion: Clinical instructors are inveterately considered by students as their role models in medical colleges and significance are conferred on their position. Altogether, doctors with teaching roles must be cognizant of their responsibilities and their influence on the professional growth and performance of students. Eventually, components related to Personal, Clinical, and Teaching attributes were suggested as major traits perceived in role models. [ABSTRACT FROM AUTHOR]

Objective: To explore the perceptions of students and faculty about gender bias during assessments in undergraduate medical education. Material and Methods: The study was conducted at a Public and Private Medical College in Peshawar, Khyber Pakhtunkhwa Pakistan, from June 2020 to October 2020. It was a qualitative study with a phenomenological approach in which, 4 focal group interviews with undergraduate medical students and 10 individual interviews with faculty members were undertaken by using a validated semi-structured interview guide. The interviews were recorded and transcribed verbatim. The thematic analysis of the data was done where codes were developed and arranged in different categories giving rise to discrete themes. Data triangulation from students and faculty results was done for convergence and correspondence to increase the credibility and authenticity of the study. Results: Out of 24 students and 10 faculty members, half of the participants were females who shared their perceptions about gender bias in medical education. The analysis revealed 30 codes that were labeled and collated into 9 categories. The themes deducted from these categories were Lack of awareness, discriminatory attitude, the societal projection of the phenomenon, and the gendered climate in medical education. Conclusion: Most of the students are not aware of the concept of gender bias. The study emphasizes that bias is a natural phenomenon but society and culture multiply the effect of this phenomenon. Most of the participants do believe that the assessment environment is made more comfortable and positive for female students. The study also revealed that gendered cultures of learning and assessment still exist in Gynaecology/Obstetrics and General Surgery departments. [ABSTRACT FROM AUTHOR]

Objective: To develop entrustable professional activities for a one-year house job in dentistry. Study Design: Qualitative study (Interpretive Paradigm). Place and Duration of Study: Khyber College of Dentistry and Sardar Begum Dental College, Peshawar Pakistan, from Sep 2017 to May 2018. Methodology: A five-step approach was used to develop four EPAs for a one-year house job. Using maximum variation sampling, faculty members from eleven disciplines of dentistry working in public and private dental colleges of Khyber Pakhtunkhwa and charge of training dental interns participated in the study. Three focus group interviews and three in-depth interviews were conducted. Data was transcribed and thematic analysis was done. Results: The EPAs were developed for a one-year house job using the five-step approach. This process resulted in developing the content of four EPAs in detail, analysing the results into competencies aligned with Pakistan medical and dental council, assessment methods such as multisource feedback, direct observation, mini CEX assessment with peer coaching and role modelling teaching strategies for each activity. Participants agreed on trusting the house officer to perform independently with a gradual shift of supervision scale from direct action to indirect and finally enacting the EPAs unsupervised. Conclusion: This study presents the foundation for using specific EPAs in dentistry, a step towards a competency-based approach. The content of EPAs for a transition period of a one-year house job in dentistry was developed using the 5-stage approach. These EPAs can provide explicit guidance for the engagement of dental house officers in clinical workplace activities. [ABSTRACT FROM AUTHOR]

Objective: To find out factors which are affecting student's perception towards teaching faculty evaluation. Study Design: Quantitative Cross-sectional Research. Setting: Nowshera Medical College, Nowshera. Period: March 2020. Material & Methods: A pre-validated questionnaire of Student's evaluation of teaching instrument comprising 21 items, were administered. A total number of 208 students from different classes were agreed for participation. All participants were given equal preference. Data was entered in Excel sheet and analyzed through SPSS version 24. Results: It is evident that majority of students' i.e.51.27 % had a positive perception towards the factors related to teachers in the student's evaluation of teaching Tool. Similarly, it has been depicted that majority of students i.e. 79.46 % have shown highly positive significance towards the factors related to them in the instrument where as 40.6 % has a positive perception towards the factors related to coursework. Conclusion: It was concluded that the faculty age, sex, qualification and medium of teaching are the major features which affect their evaluation by the students. Similarly, class size and students' grades were found to be major factors related to course and students in the tool. Thus, we conclude that overall perception of students towards Students evaluation of teaching was positive and highly significant. [ABSTRACT FROM AUTHOR]

Objective: To determine the challenges being faced by vascular surgeons in acceptability of their specialty by the medical community of Pakistan. Study Design: Qualitative case study. Place and Duration of Study: Various training institutes & teaching hospitals all over the Pakistan, from Sep 2019 to Feb 2020. Methodology: Semi structured interview format comprising of a series of open ended and broad questions to get maximum relevant information, were sent to 13 surgeons (vascular and part time vascular surgeons) practicing vascular surgery at least for the last five years in various training institutes and teaching hospitals of Pakistan. Interviews were audio recorded on telephone and in persons. The data was transcribed, cleansing was done, and analyzed through inductive and thematic content analysis. Results: Handful of qualified vascular surgeons, inadequate vascular training program, part time vascular surgery and unawareness/misconceptions/myths about vascular diseases, were the major challenges being faced by the vascular community for their separate identity. Conclusion: The vascular community is facing great challenges of shortage of qualified vascular surgeons and technicians, inadequate training centers, part time vascular surgery and misconceptions/myths/unawareness about vascular diseases. [ABSTRACT FROM AUTHOR]

Objectives: Assessment drives learning and improving the quality of assessment has a remarkable impact on the quality of learning. Objective Structured Clinical Examination is termed more reliable and valid as compared to conventional practical examination. Objective: The objective of this study was to find the perception of postgraduate family medicine trainees about the OSCE assessment method and compare those having previous experience with those having no previous experience. Material & Mothods: This was a cross-section study conducted at the end of exit examination of diploma in family medicine at the Family Medicine Department. Khyber Medical University Peshawar. Data were collected on an eleven items questionnaire on a five-point Likert Scale. Study participants were categorized based on their previous experience of the OSCE. and were grouped into two categories. Data were analyzed by using Fisher's Exact test and a p-value of < 0.05 was considered statistically significant. Results: Out of 60. 56 candidates returned completed questionnaires. The response rate was 93.33% where the majority were males 52(92.9%). Participants with experience of the OSCE were 22 (39.3%) while 34 (60.7%) were having no experience of the assessment method. There was a significant difference (p= 0.001) in the perception about the OSCE with the simulated patient than real patient, fairness and reliability of the OSCE. stress and length of the OSCE and reduction of bias in the OSCE. The perception about weightage to be given to the OSCE in any examination was significantly different (p=0.004) between the two groups. Conclusion: Participants of both groups (experienced vs non-experienced) agreed on some aspects of the OSCE. Their opinion differed about the fairness, validity and stress related to the OSCE assessment method. This difference is probably explained by the inadequacy of an experience to form an opinion. [ABSTRACT FROM AUTHOR]

Background: Evaluation of the educational environment is key to the delivery of high-quality medical education. Especially, when an institute is in the transition phase of curriculum. In curriculum transformation phase of Ayub Medical College Abbottabad, no such evaluation has been done. This study aimed to find the direction of Educational environment in the transition phase curriculum of Ayub Medical College Abbottabad and compare different domains of educational environment with gender, residency, pre-medical education’s medium of instruction, and doctors among sibling or parents. Methods: This descriptive cross-sectional survey was conducted among students of integrated and traditional curriculum of Ayub Medical College, Abbottabad from 1st December 2019 to 29th February 2020. By Non-probability convenience sampling technique, pre-validated Dundee Ready Educational Environment Measure questionnaire was used. Descriptive and inferential statistics were calculated in SPSS v22. Results: A total 149 (100%) participants, 66 (44.3%) males and 83 (55.7%) females with mean age of 20.5±1.07 years responded. Among total, 76 (51%) were from integrated curriculum and 73 (49%) were of traditional curriculum. Significant difference was found among different aspect of education environments and both classes. Conclusion: The current transitional phase of curriculum at Ayub Medical College Abbottabad is more positive than negative. Some areas like student social-selfperception still need improvement. Moreover, gender and place of birth affect student’s perception about their learning environment. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to evaluate the knowledge and attitude of undergraduate medical students toward research. Study Design: Cross sectional study. Setting: Private Medical Colleges of Khyber Pakhtunkhwa. Period: November 2018 to July 2019. Material & Methods: A total of 938 final year medical students participated in the study. A validated self administered questionnaire was used for the collection of data. The student’s perception was assessed through questionnaire based on 5-point Likert scale. For the assessment of knowledge MCQs were marked as 1 in case of correct answer and 0 in case of incorrect answer. Results: Out of 1300 students, 938 returned the questionnaire resulting in a 74% response rate. 481(51%) participants were male and 457(49%) were females. The participants had a mean knowledge score of 6.103 out of a total of 15 questions and mean attitude score of 76.29. Conclusion: This study concludes a low knowledge score coupled with a positive attitude of doing research. More attention must be placed on these parameters in the curriculum to improve student knowledge in health research. [ABSTRACT FROM AUTHOR]

Objectives: To identify the importance of role plays as a learning and teaching modality and find out its effectiveness in improving the communication and critical thinking skills of students. Material and Methods: This Quasi-Experimental study was conducted in Kabir Medical College Peshawar that is a private sector medical institute situated in the north of Peshawar, Pakistan. Probability technique of simple random sampling was used to select 100 students from Year-3, and role plays sessions were conducted by dividing the students into 2 groups with 50 students each. Groups 1 performed the role plays followed by feedback. Group 2 was given brief video demonstration of a breaking bad news sessions only and then asked to give their feedback. Data was collected from both groups by filling a self-designed questionnaire that was previously pilot tested amongst 7 students. The data was analyzed using SPSS version 23. Chi-square test was used to compare the responses of two groups with a P value of less than 0.05 was considered significant. Results: In group 1, 47 out of 50 students (94%) and in group 2, 32 out of 50 students(64%) admitted that role-play scan improve critical thinking and communication skills (p=0.02). Regarding role plays as a teaching modality, 46 out of 50 students (92%) in group 1 and 28 out of 50 (56%) in group 2, rated it to be effective (p=0.02). Considerably small number of students had any previous participation in role plays, 14 in group 1 and 15 in group 2 (p value=0.21). Conclusion: Role plays as a teaching and learning modality is an innovative style of teaching in improving the communication and critical thinking skills of students. [ABSTRACT FROM AUTHOR]

To assess the perceptions of undergraduate medical students about peer assisted learning (PAL). Study Design: Cross sectional study. Setting: Peshawar Medical College. Period: From March 2016 to August 2016. Materials and Methods: A total of 84 students from second year MBBS were included to record the perceptions about peer assisted learning. A total of six topics of urogenital module were selected for PAL session. A validated questionnaire having 17 close ended questions was used to evaluate PAL on Likert-scale. The participants consented and evaluated the questionnaire, from which data was gathered and analyzed to reveal the degree of satisfaction by the PAL. Results: There were equal number of males and females (40 each). About 65--75% agreed that PAL was more informative than classical lecture system; topic discussed was clearer and found answers to their questions. 60--70% liked to incorporate peer assisted learning in their modules, showed satisfaction to the contents covered, felt easy to communicate with peer tutor and were of the view that peer tutors performed well in their teacher's role. Among peer tutors, 70--80% agreed that the endeavor improved their confidence in teaching, presentation and communication skills. Over 62% agreed that teaching at undergraduate level was a beneficial experience. Conclusion: The participants' found the peer assisted learning teaching method as useful. Therefore, this strategy may be introduced in the college. [ABSTRACT FROM AUTHOR]

Background & Objective: An admission criterion is one of the key indicators of academic success. The purpose of admission process is to select best candidates for the particular program who will complete the program successfully. Thus rigorous admission criteria can predict academic performance, decrease failure rate and successful completion of degree. The objective of this study was to determine the relationship between various variables in the existing admission criteria and academic performance. Methods: A cross sectional study design was chosen. Data (2009-2017) was gathered from the records of Institute of Nursing Science, Khyber Medical University. Variables in the admission criteria included age, gender, previous academic performance, entry test score and experience. The dependent variable was academic performance measured in CGPA. The data was analyzed using correlation and regression analysis through SPSS and STATA. Results: The results reported a significant relationship between admission criteria and the academic performance of nursing students. Various variables in the admission criteria i.e. SSC marks (r=0.32, p=>0.001), previous academic score at diploma level (r=0.48, p=>0.001) and entry test scores (r=0.26, p=>0.001) have significant relationship between academic performance. However, previous academic scores at diploma level were better predictors of the academic performance. Conclusion: The study concludes to use integrated admission criteria for the selection of students and bring changes in the traditional admission process. [ABSTRACT FROM AUTHOR]

Sometimes, knowledge or information becomes difficult to understand and/or memorize. Cognitive load theory aids a learner to gain information effectively. It provides a scientific roadmap to the design of learning materials. Through a complex set of mental processes, information is acquiring, process, retain, and comprehend information. Applying mental effort for remembering is a very crucial phenomenon. The core of memory process is apprehending and saving of information into long term memory. Because of limited capacity of working memory, delivering or acquiring of information should not be overloaded with irrelevant materials. Based on cognitive load theory dozens of strategies can be intervened at different loci of cognitive process and every piece of information is easily remembered. Not only learners, but teachers can also get benefits from them. In this commentary, John Sweller ideology is further discussed and strategies are presented for better comprehension and memorization of difficult information. [ABSTRACT FROM AUTHOR]

Objectives: To assess the clerkship experiences and self-perceived competence of Undergraduate medical students in clinical and procedural skills at Bolan Medical College, Quetta, Balochistan. Study Design: Cross-sectional study. Setting: Bolan Medical College, Quetta, Balochistan. Period: February 2016 to August 2016. Methodology: Undergraduate medical Students of 2nd, 3rd and final profession MBBS at Bolan Medical College, Quetta. Multistage stratified random sampling method was used; making a total sample size of 166. A self-administered questionnaire was used with item responses based on 4-point Likert Scale for the number of times a clinical skill was performed and 3-point Likert scale for the number of times a clinical skill competence was perceived by the performer respectively. The questionnaire contains mainly three parts. The first part mainly contained information on socio demographic data like age, gender, monthly income, marital status; student's year of study and completed clinical clerkship. The second part contained information regarding clinical and procedural skills that is physical skills examination and the third part includes information about the number of times a clinical skill is performed and the competence achieved or not by the participant. SPSS version 16 was used to carry out the statistical analysis. Results: Among nine listed basic physical examination skills, both 2nd and 3rdproff students were having low exposure or experience i.e< 50% have performed the skills at least two times and among 12 listed procedural skills only 4thproff (final year) students were having high level of experience i.e ≥ 70% have performed the skills. Among 9 listed basic physical examination skills, only 4thproff (final year) students were having high level of competence i.e ≥ 70% reported to be very confident. Similarly among 12 listed procedural skills the 4thproff (final year) students were having high level of competence i.e ≥ 70% reported to be very confident. There was a strong positive linear correlation between level of exposure and self-perceived competence (r=0.92). Conclusion: The level of performing the basic physical skills and clinical procedures was low for majority of the variables. However, on several occasions an important clear connection was appeared performing physical skills and practical course of action and confidence level of students. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effect of guided and minimally guided teaching methods in acquiring practical skills in anatomy in Peshawar Medical College. Study Design: A randomized control trial. Setting: Peshawar Medical College, Peshawar. Period: March 2016 to August 2016. Methods: 80 students of 2nd year MBBS who gave consent to participate in the study. Students were divided into control & intervention group. Each of the group consisted of 40 students, respectively. OSPE was used as the tool of assessment in this study. Students of both groups appeared in Pre-test OSPE after which controlled group was given 2 weeks time and were minimally guided for the selected anatomy dissection topics, however, intervention group spent 2 weeks under direct instruction and guidance of their teacher who was teaching them in dissection classes the same topics. Post- test was carried out after the completion of the 2 weeks time for both the groups. Cross over of the groups was done to minimize bias. Results: There were 20 males and 20 females in the intervention group that were matched according to gender and academic performance with the control group. Pre-test scores of the control group and the intervention groups were 6.15±2.69 and 5.05±1.75 respectively. The post test scores of control and the intervention groups were (18.95±2.64 SD) and (19.20±2.25SD) respectively. Independent sample t test was applied to academic scores of OSPE of both the groups. P value of 0.351 depicts that there was no significant difference between academic scores of both the groups taught by guided and minimally guided teaching respectively. Thereby deducing that guided and minimally guided are both good teaching and learning strategies. Further, paired sample t test was applied within respective groups to find out the difference in academic performance between pre and post OSPE test scores, p value of <0.007 & 0,031 was obtained respectively which was signifying & further proving that both teaching methodologies were comparable. Conclusion: It is concluded that guided and minimally guided teaching strategies are equally effective in small group anatomy classes. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of Directly Observed Procedural Skills (DOPS) and Traditional Method of Learning of Procedural Skills in Ophthalmology at undergraduate Level. Setting: Armed Forces Institute of Ophthalmology Rawalpindi. Period: Nov 2015 to June 2016. Study Design: It is an interventional study and is based on randomized pre and post-test comparison of DOPS with Traditional method of teaching & learning procedural skills. Methods: After obtaining informed consent; a batch of 40 students were equally assigned to interventional and non interventional study groups through stratified randomization. The Objective Structured Clinical Examination (OSCEs) was used as data collection instrument after validation. Pre and post test were taken from both groups before and after intervention. The data were analyzed using SPSS version 20. Results: By comparison of means of post test of two groups it was found that Post test torch examination traditional group had a mean of 5.35 and post test mean of DOPS group was 6.80 with a p value <0.05 which was significant. Post test Fundoscopy had a mean of 4.70 in traditional group and post test mean DOPS group was 6.50 with p value < 0.05. Conclusion: There is significant difference between the two groups and the students in DOPS group performed better than their counterparts in traditional group. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare the effectiveness of " summarize, narrow, analyze, probing, management plan, select a topic" (SNAPPS) model, one-minute preceptor (OMP) and traditional clinical teaching in developing clinical reasoning skills of final year undergraduate female medical students in pediatrics clinical setting. METHODS: This randomized control trial was conducted at Department of Pediatrics, Peshawar Medical College from February to July 2016. Students were randomly distributed in three groups i.e. SNAPPS, OMP and traditional teaching with 20 students in each group. All 60 students were exposed to pretest including 4 Key Feature Problems (KFPs). Students were then taught on pre-identified 4 topics with one topic /week by respective teaching methodology. Each topic was followed by post-test using 4 KFPs. The pre-test and post-test results were recorded and analyzed on SPSS-20. ANOVA was used as test for finding significance. RESULTS: All 60 female students of final year completed the study and none dropped out. The mean marks of pretest of three groups were 12.50±0.15 with minimum number of 4±1 marks and maximum of 23±1. There was no significant difference in pre-test among the groups using ANOVA (p=.984). However, significant difference (p<0.001) was observed in post-test among groups after intervention. There was statistically significant difference (p<0.001) in favor of SNAPPS as compared to traditional teaching methodology. There was no significant difference between OMP and traditional method. CONCLUSION: SNAPPS is significantly more effective in improving clinical reasoning than OMP and traditional teaching method in female undergraduate medical students in pediatrics clinical setting. [ABSTRACT FROM AUTHOR]

Objectives: To explore perception of Khyber Medical University teachers regarding challenges in provision of timely feedback to students. Setting: Khyber Medical University, Peshawar. Period: March 2016 to September 2016. Methods: A qualitative multiple case study in which seven focus group discussions with seven constituent institutes of Khyber Medical University have been conducted, each institute is taken as one case, selected through purposive maximum variation sampling technique. Each FGD was audio-recorded, transcribed verbatim, analyzed and themes were identified. Results: Total forty faculty members participated in seven focus group discussions. Three themes that emerged were "institutionalization of feedback" indicating need of establishing a feedback culture so that it is taken as a norm both by teachers and students; "Lapses in feedback priority" indicating teachers don't give priority to feedback due time constraints, work overload, lack of training and resource deficiencies: "establishing manageable model of feedback at organizational/institutional level" indicating a need for developing a feasible feedback model compatible to university contextual needs instead of implementing any ideal feedback model. Conclusion: The concept of providing and receiving feedback is deficient and its significance with respect to teaching and learning is lacking. Contextual academic workload and time constraints may impact the quality and timing of feedback provided. There is need of collaborations between university administration and faculty so that feedback can be utilized effectively in the learning process. [ABSTRACT FROM AUTHOR]

Objective: To find the frequency/pattern of Early Childhood caries (ECC) and to find out the relationship of different risk factors with ECC. Methodology: A cross sectional survey was conducted in both pediatric departments present in the dental hospitals of Peshawar, Pakistan from August 2013 to January 2014 . All children with age range of 3-6 years that visited pediatric department were selected. The diagnosis of ECC was solely based on clinical assessment. A parent or a caregiver was asked to complete a questionnaire regarding information about the child, their oral hygiene, demographics and feeding practices. The data was arranged categorically and analyzed using Statistical Package of Social Sciences (SPSS 16). Chi Square test was used to calculate statistical significance set at <0.05 Results: A total number of 320 children were selected. The Mean age of our sample was 4.2 +1.14 years Majority of children were males (n=184, 57.5%) while females were (n=136, 42.5%) The frequency of Early Childhood Caries was 85 %(272). Anterior teeth had more caries (n=139, 43.4%) than posterior and upper jaw teeth had more caries (n=171, 53.4%) than lower jaw. Feeding habits, Age, mother's age, adult supervision, and knowledge of parent were found to be significantly related with Early Childhood Caries (p<.005), while the gender and who applies the tooth paste were found not significant Conclusion: There is a high occurrence of early child hood caries among children visiting dental hospitals in Peshawar. Anterior upper teeth are more prone to caries. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to explore the faculty's opinion regarding factors impeding practical transition from traditional to integrated medical curriculum at the outset and a few years after the process., Methods: This qualitative exploratory study was conducted from April 2018 to October 2018 at two undergraduate medical colleges; one where integrated curriculum was at the outset and the second running it successfully. A total of 12 semi-structured interviews (six from each college) were recorded and transcribed. Thematic content analysis was carried out and faculty's perceptions about factors impeding practical transition to integrated curriculum were explored at two stages, i.e., at the outset and after its implementation., Results: Four impediments identified at the outset were deemed genuine by faculty who had gone through the experience including, faculty's resistance, lack of training, lack of incentives, and insufficient resources. Four more impediments were identified after the experience including lack of leadership, lack of attention to faculty's concerns, lack of communication and difficulties in setting appropriate assessment., Conclusions: Several factors if ignored can result in failure of integration of curriculum in undergraduate medical colleges. Relevantly appropriate policies should be outlined by the regulatory body to ensure the control on the impediments., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To determine correlation between emotional intelligence and academic stress., Methods: The quantitative correlational study was conducted in 2016 at the Khyber College of Dentistry, Peshawar, Pakistan, and comprised undergraduate dental students in the 2015-16 session regardless of age, gender and the academic year. Emotional intelligence and dental environmental stress were calculated and compared. Data was analysed using SPSS 20., Results: Of the 298 students, 98(32.89%) were males and 200(67.11%) were females. The overall mean emotional intelligence score was 81.23±22.8, while the overall mean dental environmental stress score was 109.54±19.5 with a trend of decreasing stress levels from first to final year. A Pearson correlation test was run. Significant negative relationship was found between emotional intelligence and academic stress (p<0.05)., Conclusions: The gradual increase of emotional intelligence from first to final year showed the importance of teaching and learning methods that incorporate certain emotional intelligence trends.

Objective: To compare peer-assisted learning with facilitator-assisted learning in small group format comprising undergraduate medical students., Methods: The interventional study was conducted from March to August 2016 at Peshawar Medical College, Peshawar, Pakistan, and comprised 2nd year medical students who were randomised into two groups; Group 1 was exposed to peer-assisted learning while Group 2 had facilitator-assisted learning. A validated multiple-choice questionnaire was used for data collection both before and after the intervention. SPSS 19 was used for data analysis., Results: Of the 80 subjects, there were 40(50%) in each of the two groups, and the groups had 20(50%) males and as many females each. Mean age of Group 1 was 18.90±0.68 years and in Group 2 it was 18.40±0.72 years. There was no significant difference between academic scores of the two groups (p=0.65). Within the groups, pre- and post-intervention test scores showed significant difference (p<0.05)., Conclusions: Peer-assisted learning was found to be as good as facilitator-assisted learning and it can be introduced as a method of effective teaching.

Objective: To develop an instrument for assessing the ethical sensitivity of freshly graduated dentists.., Methods: This instrument development study was done at Sardar Begum Dental College, Peshawar, Pakistan, from September 2014 to April 2015. The instrument developed was the Dental Ethical Sensitivity Scale in accordance with the guidelines for the development of educational instruments. Data was obtained from freshly graduated dentists through the instrument containing vignettes related to three domains of ethics; beneficence, autonomy and confidentiality. Content validity index and Angoff's method were used to determine the validity and cut-off passing score respectively. Reliability analysis comprised internal consistency and test re-test., Results: Of the 138 house officers approached, 107(77%) responded. Of them, 37(34.5%) were males and 70(65.4%) were females. The overall mean age was 23.7±1. 1 years. Overall, 51(47.6%) subjects were ethically sensitive whereas 50(46.7%) were partially sensitive and 6(5.6%) were insensitive. The CVI for the instrument was 0.8; cutoff score was 83%; internal consistency was 0.63; and test re-test reliability was 0.71. Relation between ethical sensitivity, gender and class attendance of the participants was insignificant (p>0.05 each)., Conclusion: Dental Ethical Sensitivity Scale was found to be effective in providing a valid and reliable assessment instrument for measuring ethical sensitivity of freshly graduated dentists.