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Perceptions of teachers and students about curriculum viability inhibitors are equally important yet may differ. Divergence can lead to destructive friction and adversely affect curriculum viability. Our team aimed to find the perceptions of teachers and students on inhibitors affecting the viability of an implemented medical curriculum, report their convergence or divergence, and explore approaches to reduce divergence. Through a mixed-method approach, using valid and reliable questionnaires, we found the curriculum under review had no clear inhibitors. Whereas teachers exhibited complete agreement that no educational programme inhibitors existed, students did not fully agree. Upon qualitative inquiry, using focus group discussion with students and teachers, we found that 'improving the communication gap', 'enhancing the role of faculty and students in curriculum', and 'improving the assessment process' can reduce the friction between teachers and students. This study provides an approach that identifies the curriculum viability inhibitors and solutions to address them.

Objective: To determine the effectiveness of video-based teaching in surgery residents by comparing it to the routine operating room traditional teaching. Methodology: The randomized control trial was done at four institutions from September 2022 to March 2023. Interventional group underwent video-based instruction of basic surgical skills whereas the control group was taught through traditional operating room teaching. Pre and post-test mean scores were analyzed on SPSS version 20 through paired t-test. Learning gain was calculated. Supervisors' perceptions were recorded on survey form regarding direct observations and recorded video evaluations of resident skills on post-test. Results: Out of sixty (n=60), fifty-five newly inducted surgical residents completed the study including both females (n=13) and male residents (n=42). Video intervention Group (27.93±3.72) and control group (23.07±4.62) both showed improvements in their post-test scores as compared to pretest scores of 13.68±3.25 and 13.52±3.60 respectively. Mean score difference improvement was more in video intervention group (13.9±3.8) in comparison to control group (9.5±4.3) provided both groups exhibits improvements in all seven domains of the global rating system (reflected by the p <0.0001). However, learning gain of 65% was observed in intervention group as compared to learning gain (41%) of control group. Evaluators(n=5) observed that recorded video evaluations helped to provide integrated feedback, despite being time (40%) and resource intensive (60%). Conclusion: Video-based teaching has higher learning gain irrespective of the fact that both groups exhibit statistically significant results in all seven domains of the global rating system. Recorded video evaluation was found feasible and reliable tool for formative assessment. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of compassion fatigue, compassion satisfaction and burnout and identify the socio-demographic and work-related factors associated with compassion fatigue among FCPS Part-II trainees in Pakistan. Method: A cross-sectional study of FCPS-Ⅱ trainees was conducted using stratified sampling at multiple centers over six months. Data was collected through an online, self-administered survey, which consisted of the 30-item ProQOL-V and a socio-demographic and work-related characteristics questionnaire. Informed consent was obtained from all participants. Data was analysed using SPSS 26 for descriptive stats, one-sample t-test, Pearson correlation, and multivariate linear regression at a 95% significance level. Results: Out of 460, only 392 trainees completely filled the online survey (completion rate: 90.74%). The study found that 78.80% of postgraduate trainees experienced moderate levels of compassion fatigue (CF) (Mean = 27.6, SD = 6.3), with moderate burnout (BO) (75.50%, Mean = 26.6, SD = 5.9), while moderately high Compassion satisfaction (CS) (90.60%, Mean = 33.3, SD = 5.5). Compared to normative data, compassion fatigue levels were significantly elevated among post-graduate trainees (p < 0.001). Significant correlations were observed between CF and BO (r =0.59), CF and CS (r = -0.20), and BO and CS (r = -0.63). Factors associated with higher CF included family dependents (p = 0.029), longer working hours (p < 0.001), and inadequate sleep (p < 0.001). Trainees in “Poor” work environments reported higher CF levels than those in “Excellent” environments (p < 0.001). Additionally, engaging in self-care activities such as exercise, prayer, and socialising were associated with lower CF levels (p < 0.05). Conclusion: The study revealed that many postgraduate trainees experience moderate compassion fatigue and burnout, with a strong positive correlation between CF and BO. Compassion satisfaction inversely related to both CF and BO, highlighting the need to boost CS. Factors like longer work hours, poor sleep, family dependents and unfavorable work conditions were linked to higher Compassion Fatigue. Conversely, engaging in self-care practices like prayer, meditation, exercise, and socialising is associated with decreased compassion fatigue levels. These results stress the importance of tailored interventions to enhance trainees’ well-being and ultimately improve patient care quality. [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]

Objective: To compare the trainees' perception of the Educational Environment (EE) of the two parallel post-graduate training programs (MD & FCPS) in Pediatric Medicine. Methods: This quantitative cross-sectional study was carried out by Department of Medical Education UOL and Department of Pediatric Medicine KEMU from February to December 2021. Data about the perception of EE was collected from the Pediatric Medicine trainees by purposive sampling using the 40 items PHEEM inventory. The inventory has three perception domains: role autonomy, teaching, and social support. In addition, to mean scores, the inventory also gives interpretation according to the score ranges. The FCPS and MD trainees of both genders and all years of training across the institutions of Punjab were approached using Google Forms. SPSS (v 23.0) was used for descriptive and analytic statistics. Results: A total of 327 trainees' responses were included-188 (57.5%) FCPS and 139 (42.5%) MD trainees. The mean overall score was 92±19.7 for FCSP and 93.88±21.5 for MD trainees (p-value 0.41). The interpretation of the overall score was "more positive than negative but room for improvement" in 67.3%. For the subscales of role autonomy, teaching, and social support, the perception was positive by 71%, 80%, and 45% of trainees, respectively. Except for three individual items, the mean scores of the subscales and the individual items were not statistically different between the two groups. Conclusion: The Pediatric Medicine trainees' perception of the educational environment in the FCPS and MD groups was comparable overall and in all three domains. Individual item analysis showed almost similar areas for improvement in both programs. [ABSTRACT FROM AUTHOR]

Our study aimed to explore the factors affecting the trustful relationship between teachers and students in a medical school, which is a subject that has attracted very little attention in literature. This study, conducted at the University College of Medicine and Dentistry in Pakistan, identified ways to increase the trustful relationship between teachers and students. Through a qualitative research design utilising an exploratory study method, one-to-one interviews were carried out with 10 medical students and 10 medical teachers. Data were recorded and transcribed verbatim, and codes and themes were applied using ATLAS.ti. Students revealed that a trustful relationship can be improved by enhancing teachers’ professionalism, accessibility, mentorship, empathy, and dedication, whereas students should possess emotional intelligence and conformist, fairness, affiliative, and achiever qualities to build trust with teachers. This study found that by working on these qualities, a trustful relationship can be improved between teachers and students. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences of struggling undergraduate medical students (mentees) with formal mentoring program at a private medical college in Rawalpindi. Methods: A qualitative exploratory study was carried out from March to August 2019. Data was collected from a purposive sample of sixteen struggling undergraduate students. Validated interview guide was utilized to conduct semi-structured one-to-one interviews. Interviews were audio recorded and transcribed accurately. Confidentiality and anonymity were ensured to the participants due to the sensitive nature of the data. Various measures were taken to achieve trustworthiness in the study. Manual thematic analysis was performed and consensus among all authors was built regarding themes and subthemes. Results: Four themes and twelve subthemes emerged from the data. Participants were satisfied with the psychosocial outcomes of the mentoring program such as emotional, moral, and psychological support, and personal and professional development. Mentees told that mentors were their best guides who shared their life experiences. Moreover, mentors provided guidance on Islam, research methods, and case-based learning. Further, mentees said that mentors provide solutions to their problems. Useful suggestions were provided by the mentees regarding betterment in the present mentoring program such as recruitment of committed staff, the need for verbal feedback from mentees about their mentors, need for career counselling and one-to-one mentoring sessions. Conclusions: Majority of the mentees were satisfied with the formal mentoring program. Mentoring focuses on personal and professional development of all medical students. In addition to the useful suggestions provided by the mentees, there is a need for the addition of specific strategies to deal with students struggling with personal or professional problems. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the students' perception of the educational environment in the pediatric unit of Khyber teaching hospital using Dundee Ready Educational Environment Measures (DREEM). Material and Methods: This cross-sectional, questionnaire-based study was conducted at the Department of Child Health Khyber Teaching Hospital Peshawar, Pakistan, from May to November 2019. The sample size included 220 students fourth-year students. The study instrument was the DREEM questionnaire, which has 50 items that assess five domains. There are 50 items with 5 subscales and the maximum score is 200. Descriptive statistics were used to calculate the mean and standard deviation of the DREEM and the five domains Results: Of the 220 Students, 100 completed the questionnaire, resulting in a response rate of 45%. The total DREEM score was 113.14/200 (56.57%). The results showed that student's perception of their learning environment was 27.31/48 (56.89%), the perception of teachers was 25.45/44 (57.84%), self-perception of their academics was 18.97/32 (59.28%), their perception of the atmosphere was 27.7/48 (57.7%), and social self-perception was 13.7/28 (48.96%). Conclusion: The study found that the atmosphere in the pediatric ward of Khyber Teaching Hospital was perceived positively by the students. However, the total DREEM score and points in the subdomains did not fall in the excellent category and remained one step below the highest rank. Therefore, there is room for improvement in the educational climate at the pediatric ward of Khyber Teaching Hospital. [ABSTRACT FROM AUTHOR]

Role modelling is considered an essential component of teaching in various educational settings and impact students' professional development. Most studies found in the literature have explored the influence of positive role models and limited data is available about the negative role modelling. This study explores the effects of negative role modelling of teachers on the professional development of future doctors. A qualitative exploratory study was done in three medical colleges of Lahore, Pakistan. Fifteen, telephonic, semi-structured interviews were done with fifth-year MBBS students. A thematic analysis was done through manual coding of transcribed interviews. A total of 374 codes were generated in the first cycle of coding, that was merged to 42 in the second cycle. These codes led to 4 subthemes that finally emerged as two themes. The first theme was "Students & patients: In the same boat" highlighting the damaging effects of negative role modelling. The second theme was "Taking the bad with the good" focusing on the ambivalent response of students towards the unprofessional behaviours of their role models. Negative role modelling exponentially affects the attitude and behaviour of medical students especially in informal settings and have detrimental effects on patient care. Students lose some degree of humanism while unconsciously observing the unethical behaviours, to become a part of hospital culture whereas some students show determination to channelize their resentment to reforms. [ABSTRACT FROM AUTHOR]

Objective: To explore the problems faced by recent medical graduates in communication with their patients due to language barriers and the influence of these language barriers on the doctor-patient relationship. Methods: A basic qualitative study was conducted at Allama Iqbal Memorial Teaching Hospital Sialkot, Services Hospital Lahore and Mayo Hospital Lahore over eight months after receiving approval from the Ethical Review Board of the University of Lahore. Twelve recent medical graduates from different departments were selected via a purposive sampling technique. Data was collected through semi-structured interviews conducted over the phone with prior appointments. Manual qualitative thematic analysis was done by transcribing the interview and then codes, subthemes, and themes were generated. Results: Six themes and thirteen subthemes were identified depicting the influence of language barriers on the doctor-patient relationship, namely: frustration (due to repetition, feeling of inadequacy & disappointment), lack of rapport (difficulty in communication, effective counseling & failure in establishment of comfort level), trust Issues (predilection towards the native speaker & difficulty in getting consent) patient dissatisfaction, compliance issues (difficulty in comprehending medication & nature of disease), and threat to patient safety (misdiagnosis & consequent treatment plan & misinterpretation of treatment) Conclusion: This study establishes the detrimental effects of language barriers on the relationship between physician and patient which can help medical educationists and policymakers in devising a curriculum in such a way that it can minimize the impact of language barriers on the doctor-patient relationship. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effect of Team-based learning (TBL) on the critical thinking of health professions students. Methods: This quasi-experimental study, was done in paramedical and nursing sciences institutes using the convenience sampling technique. Students included were enrolled in the haematology course of paramedic institute from January to December 2020 and adult health course of the nursing institute of Khyber Medical University. Six dimensions of critical thinking (CT) of the students before and after TBL were determined using the critical thinking disposition inventory. Results: The study participants included 89 students, comprising 58 students from the paramedic’s institute and 31 from the nursing institute; 67 (75.28%) males and 22 (24.71%) females. The overall pre-test score of CT was 257.46 ± 21.73, and the post-test score was 274.55 ± 19.36, which was statistically significant (p-value = 0.000). The pre-test score of six dimensions, namely, analyticity, inquisitiveness, systematicity, truth-seeking, self-confidence, and open-mindedness was 41.35 ± 5.15, 44.73 ± 4.77, 41.12±6.87, 43.17± 5.19, 44.94±6.03, 42.38 ± 5.32 respectively, whereas the post-test scores were 44.57± 5.28, 47.11 ± 4.69, 46.12± 5.54, 45.77 ± 5.05, 47.58 ± 5.65, 43.56 ± 4.56 correspondingly. Analyticity (p=.000), inquisitiveness (p=.000), systematicity (p=.000), truth-seeking (p=.000) and self-confidence (p=.000) were statistically significant. However, open-mindedness was statistically insignificant (p=.074). Conclusion: TBL improves five out of six dimensions of students’ critical thinking. Besides its established evidence to increase knowledge, TBL can also be used as a teaching methodology for enhancing students’ critical thinking. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives: To gain insights into the e-mentoring experience, needs of the stakeholders (mentors and mentees) challenges and strategies to overcome the challenges. Methods: Qualitative exploratory study was conducted in Islamic International Medical College, from February 2021 to July 2021. The study duration was six months. Six ‘Semi-structured interviews’ of mentors and two ‘focus group discussions’ with mentees were conducted. A purposeful sampling technique was employed to select the respondents. Data were audio taped and transcribed verbatim. After that analysis of data was done by inductive content analysis. Data were coded line by line. Open codes were combined to form categories, which were combined to form themes through abstraction. Results: Data was analyzed by using Atlas.ti. After analyzing data from mentors and mentees, 21 open codes sorted into 15 categories and abstracted to from five major themes. Participants talked about the problems of online sessions like; connectivity issues, impaired interaction, nonspecific goals, unaware of MS Teams use. They suggested strategies to make these sessions more practical; like workshops for training, face to face sessions before online mode, blended approach, careful selection of mentors and mentees. All were satisfied with security and witnessed anonymity and privacy. Conclusion: Online mentoring can help students feel less lonely through social contact. E-mentoring provides flexibility to those who would usually deal with discrimination to being mentored because of their gender, ethnicity, disability or geographical location. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to evaluate: (1) The association between level of training (expertise) and rate of diagnostic errors. (2) The effect of time taken to reach a diagnosis on the frequency of diagnostic errors. (3) The effect of utilization of differential diagnosis checklists in reducing the frequency of diagnostic errors. Methods: The study was carried out from November 2020 till April 2021 in Peshawar. The participants included FCPS Part-II trainees of Maxillofacial Surgery undergoing training in five centres. Thirty written case scenarios were prepared and validated, ten scenarios for each of the three objectives. To evaluate the association between training level (expertise) and the rate of diagnostic errors, two groups of trainees (1st year group and 4th year group) were formed and given ten same case scenarios for diagnosis. To evaluate the effect of time taken to reach diagnosis on the frequency of diagnostic errors, two groups of 4th year trainees (fast group and slow group) were formed by random allocation of participants to groups and given ten similar case scenarios for diagnosis. Fast group was given 15-minutes whereas slow group was given 30-minutes to respond. To evaluate the effect of utilization of differential diagnosis checklists in reducing diagnostic errors, again two groups of 4th year trainees were formed by random allocation of participants to groups and given ten similar case scenarios for diagnosis. One group was given differential diagnosis checklists for the scenarios and the other none. Results: In this study, participants included were 1st year (n=36) and 4th year (n=36) trainees of Maxillofacial Surgery. The results showed that training level or expertise was significantly associated with the rate of diagnostic errors (p = 0.002). Time taken to reach diagnosis and differential diagnosis checklists have no significant effect on the frequency of diagnostic errors (p = 0.74 and 0.56 respectively). Conclusions: Training level (expertise) has significant effect on the frequency of diagnostic errors whereas no significant effect was recorded for time (time taken to reach diagnosis) and differential diagnosis checklists on the rate of diagnostic errors. [ABSTRACT FROM AUTHOR]

Objectives: To explore the challenges faced by medical colleges and coping strategies used in implementing accreditation standards by Pakistan Medical Commission during accreditation inspection 2019. Methods: In this qualitative case study, four medical colleges and their affiliated hospitals from three cities in Khyber Pakhtunkhwa province of Pakistan were selected through purposive sampling. Data was collected through focus group discussions (FGD) through Open-ended questions, based on CIPP (context, input, process, and product) model. Each focus group comprised of Dean, the Director Department of Medical Education (DME) and the Medical Director of the hospital. Data were thematically analyzed and results were based on the CIPP model. Results: Three themes identified were administrative challenges, accreditation challenges and resource challenges. The administrative challenges theme was further explained under subthemes of rules and regulation challenges, documentation and record challenges, and DME-related challenges. The accreditation-related challenges theme was explored in-depth with subthemes of accreditation process-related challenges, accreditation standards-related challenges and curriculum-related challenges. The resource challenges theme was described under sub-themes of infrastructure-related challenges, human resources and financial challenges. The commonest coping strategies adopted by medical colleges were establishing DME, emergency preparatory meetings of staff, and hiring staff on an emergency basis, to overcome administrative, accreditation and resource challenges respectively. Future suggestions for improving the accreditation process in the local context were highlighted. Conclusion: Main challenges identified were administrative challenges, accreditation challenges and resource challenges. Coping strategies by the medical colleges for these challenges are highlighted. The accreditation body should harmonize the process of accreditation with medical colleges and other stakeholders. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the impact of the COVID-19 pandemic on research in health professions. METHODS: It was a qualitative case study. Semi-structured interviews were done with researchers who were selected through purposive sampling. After thirteen interviews, data saturation was achieved. The interviews were recorded on zoom, transcribed verbatim, and analyzed manually for codes, categories, and themes. RESULTS: This study explored the impact of the COVID-19 pandemic on health research through interviews with researchers, revealing three major themes and thirteen subthemes. The themes encompass the challenges encountered by researchers, the research opportunities provided by the pandemic, and modifications in ongoing and planned projects. All participants expressed that the pandemic brought numerous hurdles, including reduced research opportunities, challenges in data collection, small sample sizes, quality assurance concerns, and delays in project completion. However, it also offered silver linings such as the development of new competencies, a shift in research priorities, and increased reliance on virtual platforms for collaboration and data collection. These findings highlight both the obstacles and innovations prompted by the pandemic in health research. CONCLUSION: The COVID-19 pandemic significantly impacted health research, acting as a catalyst for innovation, particularly through the increased use of digital tools and virtual platforms. While researchers faced substantial challenges like disruptions in methodologies and project timelines, these adaptations may persist as integral elements of the research paradigm in health professions, guiding future policy and practice beyond the pandemic. [ABSTRACT FROM AUTHOR]

Background: Efficient communication with patients is an indispensable necessity for physicians of the 21st century. Over the past decades, much work has been done nationally and internationally to instill this essential skill in undergraduate students and medical graduates arc now formally trained to become better communicators. However, deficiencies persist and medical students of today still observe various issues when they observe physician-patient communication interactions in their training. Objective: To understand perceptions of undergraduate medical students about the difficulties in Physician-Patient communication (PPG) & take suggestions on how to overcome them. Methods: A qualitative study design was employed, with data collection through three focus group discussions with medical students studying in Wah medical college, Pakistan in October 2019. Thematic data analysis was done using Adas-ti 8 software. A pragmatic approach was used to understand student perceptions about difficulties in PPG. Results: After open and selective ccxling of data, six major themes were identified. Five of these were in relation to students' perceptions about major difficulties with PPC. These included gap between teaching & practice; doctor patient ratio; lack of counselling; lack of empathy and no informational care. The last theme. Effective teaching of behavioral sciences was related to student suggestions for overcoming problems in PPG. Conclusion: 'Hie various issues regarding the problems in physician patient communication portray a realistic picture of our current communication practices. Various factors have been identified in this study and, the most practical solution to these problems lies in the effective teaching of behavioral sciences. [ABSTRACT FROM AUTHOR]

Self-awareness is measured previously in the higher education however not specifically in relation to 'effectiveness of teaching' thus leaving a gap in the literature. To develop and validate an instrument for medical teachers to measure the self-awareness of their teaching. This was an instrument development multiphase mixed-method study design, based on Brookfield's four lenses theory. The instrument was validated after administering content validity, cognitive pretesting, confirmatory factor analysis and reliability analysis. Contrasting groups' method of standard setting was used to determine the cut-off scores for the levels of self-awareness of medical teachers. A 26-item preliminary draft instrument was reduced to a 19-item final instrument having four themes, that is; self-reflection, communication with students, student feedback, and peer review. Content Validity Scale was 0.92. Confirmatory factor analysis yielded a model with a good-to-excellent fit and an internal consistency of 0.85. The cut-off values were calculated to be 79%, 70%, 59%, and 53% for excellent, good, average and poor self-awareness of teaching skills respectively. The Self-awareness of the teaching skills instrument has excellent validity and good reliability in measuring the self-awareness of teaching skills of medical teachers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Present study was conducted to assess the perceived academic sources of stress among undergraduate dental students and determine its association with gender, year of study, pre-university education and accommodation. This study was conducted in dental section, Islamabad Medical and Dental college, Islamabad from July to November 2016. METHODOLOGY: BDS students were asked to rate their perceived stress on four point Likert scale of modified version of Dental Environment Stress (DES) questionnaire. Descriptive statistics were applied to find the mean scores and SD on all items. Using SPSS v.21, Kruskal Wallis test was used to compare stress levels among different undergraduate professional years and Mann-Whitney U test was applied to determine the association and stress sources and demographic variables. RESULTS: A total of 172/200 participants responded (86%) to the survey. Overall stress in undergraduate dental students was in moderate range. Majority of students (93%) reported that syllabus load was either stressful or very stressful (3.53±0.64), 85% students reported lack of relaxation time as stressful or very stressful (3.42±0.86) and fear of failing was reported as stressful or very stressful by 82.5% (3.34±0.87). When stress scores of all classes were compared third year reported more mean stress scores than other years (2.50±0.50). Females were more stressed compared to males with mean score of (2.37±0.39), students living at home were more stressed than hosteilites (2.38±0.38) and those with GCE A-levels had higher stress (2.40±0.38) compared to HSC background students. Academic performance was the most stressful of the five stress domains (3.07±0.74). CONCLUSION: Syllabus load followed by lack of time for relaxation and fear of failing were the most perceived sources of stress. Academic performance was the most stressful of the five stress domains and third year BDS was the most stressed class. [ABSTRACT FROM AUTHOR]

Curriculum evaluation is typically done by using quality standards defined by accrediting bodies. This does not include inhibitors that hinder the achievement of standards. Hence, to address both standards and inhibitors, we have coined the new concept of "curriculum viability." This study establishes consensus among experts on curriculum viability indicators, i.e. standards and inhibitors, and aims to provide a framework for evaluating the curriculum viability. The study was done in two phases. In the first phase, a consensus was established on the curriculum viability indicators using the Modified Delphi Technique using two rounds. In the first round of the Delphi process, 25 experts participated, which were reduced to 19 in the second round. After two rounds, experts developed a consensus on 40 out of 44 items. These included 27 standards and 13 inhibitors. In the second phase, 18 experts rank-ordered the indicators according to their relative importance in the areas of educational content and strategies, faculty, leadership, assessment, students, educational/working environment, communication, and technology. The list of indicators provides a framework for evaluating the curriculum viability, and their ordering enables curriculum managers to prioritize them during curriculum evaluation. [ABSTRACT FROM AUTHOR]

Objective: To measure the strength of professional identity across five years of MBBS course at Foundation University Medical College. Methodology: This cross-sectional study was conducted at Foundation University Medical College (FUMC) from January 2015 to September 2019. The study included medical students from first to final year MBBS through survey sampling. The questionnaire consisted of two components; PIS score measured the strength of Professional identity and PSIQ score measured the strength of PI as it is reflected in different professional activities. SPSS 20 was used for data analysis. Results: Study included 613 medical students whose mean age was 20.54±1.70 years and 26.4% were males. Professional identity starts forming right from the beginning of MBBS program and there was an overall increase in professional identity scores from first to final year; with mean PIS of 3.68 (i.e. close to "neutral") in first year and 4.03 (i.e. into "agree" range) in final year. The increase in PIS score was statistically significant at two transitions; from 1st to 2nd and then from 3rd to 4th year. Clinical years (fourth and final year) were mainly responsible for most of the increase in PI and PSIQ scores. Conclusion: The professional identity scores increase over the five years of MBBS program. Clinical years significantly increase PI scores hence clinical clerkships should be introduced early through vertical integration. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To prioritize the factors required for the implementation of the centralized, Objective Structured Clinical Examination (OSCE) and Objective Structured Practical Examination (OSPE) to standardize the clinical examination across the province of Khyber Pakhtunkhwa, Pakistan. METHODS: This cross-sectional descriptive survey following quantitative study design was conducted at four medical colleges from Peshawar, Pakistan, from October 2019 to January 2020. All study participants were practically involved in planning and executing OSCE/OSPE. A 20-item survey questionnaire was developed based on the protocol given in AMEE guide-87. All the validation steps, including pilot testing, were followed. Responses were analysed using SPSS-22. RESULTS: Out of 100 faculty members where 72 participants responded. Thirty-eight (52.7%) participants belonged to private sector, 35 (48.6%) were working as demonstrators and 30 (41.7%) as assistant professors. Overall, 44 (61.1%) & 54 (75%) faculty members had some training in OSCE and OSPE respectively. The factors which were highly prioritized included central administration and management (65%), adequate human resource (64%), recruitment of examiners by the implementing body (61%), development of central OSCE/OSPE bank (60%), trained staff (57%), trained standardized patients (53%), the consensus for appropriate marking (50%), coordinated meetings before start of assessment (47%), closed-circuit television surveillance (26%), equipment provision by the examining body (21%), single venue for OSCE/OSPE conduction (19%), and traveling of students to the desired locations (10%). CONCLUSION: The survey revealed that the central administrative body, training of faculty and staff, development of central OSCE/OSPE bank, and provision of equipment are integral to the implementation of centralized OSCE/OSPE. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to teach postgraduate radiology resident physics by both conventional methods and by using the cognitive theory of multimedia, comparing the results and see if there was any improvement in their learning and performance. Study Design: Comparative Experimental study. Materials and Methods: Two groups of PG FCPS students of the first year and second year comprising of 10 students each were formed. Two groups had similar attributes. Results: Statistically these two groups were similar. At the end of the first-round mean pretest score in the conventionally taught group I was 4.1 and the mean post-test score was 8.8. In group II taught by cognitive theory of multimedia, the mean pretest score was 4.2 and the mean post-test score was 13.3. After cross-over in group II taught conventionally the mean test score was 4.0 and the post-test score was 8.9. In group I now taught by cognitive theory of multimedia teaching group mean pretest score was 4.1 and mean post-test score was 13.6. Conclusion: Postgraduate, first and second-year Diagnostic Radiology residents performed better in assessment once they were taught Physics by use of the cognitive theory of multimedia as compared to when taught by the conventional method of teaching. [ABSTRACT FROM AUTHOR]

Objective: To identify the learning strategies used by the medical students with high Grit for design and implementation of a three months course, to assist the medical students having low Grit. Methods: A mixed-method study with explanatory sequential design was followed by an intervention to improve Grit amongst first year students at Foundation University Medical College from March to August 2019. Non-probability convenience sampling was used in the Phase-I. In Phase-II, through purposive sampling, students with high score on GRIT were interviewed. The interview questions were validated and piloted for clarity. All interviews were recorded, transcribed verbatim, and thematic analysis was done. The themes generated were used to design an intervention, which was implemented as a part of the curriculum for less Gritty students to see whether it can enhance Grit in them. Results: A total of 133 students participated out of which, 23(17%) had a high, whereas 10(7.5%) had a low level of Grit. Five themes generated from the transcripts, namely Planning, Metacognitive skills, Mastery learning, Cognitive strategies, and Self-regulation, that led the development of an intervention abbreviated as "RESET-P-GOALS". A Wilcoxon signed-rank test showed that the intervention did elicit a statistically significant change in the Grit score in students having low Grit (Z = -2.8, p= 0.005). Conclusion: Good planning, Mastery learning and self-regulation are the reasons for success of Gritty students. The learning strategies with the name "RESET-P- GOALS" are effective in enhancing Grit in students with less score on Grit. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the clinical teaching activities in pediatric department of Khyber teaching hospital by finding the prevailing and preferred teaching methods for year 05 MBBS students. Material and methods: This cross-sectional survey about teaching methods using a validated questionnaire was conducted in the Department of Child Health Khyber Teaching Hospital Peshawar, Pakistan. The survey was conducted including all the year 05 MBBS medical students who completed their pediatric rotation. Descriptive statistical analysis was applied using SPSS 20. Results: In pediatric department of Khyber Teaching Hospital 200 students of year 05 MBBS completed their 4 weeks of clinical rotation. Bed side teaching was reported to be most frequently used for psychomotor domain i.e. history taking (43.1%), systemic examinations (47.4%) and procedural skill (35%) while 95% of the students preferred direct observation of their skill performance followed by a debriefing session. Regarding affective domain counselling (66.4%) and breaking bad news (3.5%) was taught by didactic method (48.9%) while students preferred role modelling (21.9%) along with lectures (27%). Conclusion: Considering the responses given by students they preferred to be actively involved during patient encounters and given feed-back during their year 05 MBBS. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a survey to be used for determining the impact of pandemics on residents working in Surgical and allied disciplines in a teaching hospital. Material and Methods: A survey tool was developed and reviewed according to AMEE guide 87, Khyber Medical College, Peshawar. After face, content and construct validation, internal consistency and test-retest reliability were calculated by Cronbach alpha on standardized items and Pearson “r” respectively with the help of SPSS-25. Results: During the process, a 28-item survey tool was reduced to 16 items. The items were grouped under 5 sections namely: preliminary data, skills, academic activities, impact over research activities and impact over examination preparations and schedules. The responses of all sections were recorded in the Likert scale (with options from 4-6) while one sections response was either “yes/no/unsure. The results of the pilot study revealed Cronbach’s alpha of 0.7 and Pearson “r” for test-retest reliability on all items as 0.7 to 1. Conclusion: IP-SRP survey is a new validated tool with good validity and reliability that can be used by healthcare professionals in times of pandemics, calamities and natural disasters that occur locally, regionally or globally. [ABSTRACT FROM AUTHOR]

Objectives: To determine the role of structured reflection in teaching basic surgical skills in undergraduate students. Methods: A randomized control trial was done in two medical colleges of Punjab, from January to December 2017 in which participants were divided into two groups through stratified random sampling. Structured reflection was done by interventional group after training. Post-test was taken to assess their surgical skills. Independent t-test compared the mean of two groups. One-way ANOVA was calculated to measure the difference within the different sub-categories of experimental group. Results: Out of 140 students that participated in the study, 138 students stayed till the end (retention rate 98.5%, attrition rate 1.5%). Independent t-test (p-value = 0.01) showed statistically significant difference in both control and interventional groups. One-way ANOVA with robust test of equality of Means showed a positive relationship of reflective capacity and acquisition of surgical skills. Conclusion: The novices who demonstrates better reflective capacity exhibit better acquisition of surgical skills. [ABSTRACT FROM AUTHOR]

Objective: To explore problems faced by struggling undergraduate medical students and their impact on student's academics. Methods: A qualitative case study was carried out from March to August 2019. Semi-structured interviews were conducted with a purposive sample of sixteen struggling students. The interview questions were validated and then piloted to ensure clarity. All interviews were audio recorded and transcribed verbatim. Due to sensitive nature of the data, confidentiality and anonymity was ensured. Thematic analysis was employed to get meaning with in the data set. All authors ensured analytical triangulation by independently analyzing the data before developing consensus on the codes and themes. Results: Eleven sub-themes under four major themes emerged from the transcripts. Participants were found to be struggling with emotional, academics and family related problems. Psychological distress was caused by factors such as fight with friends, one-sided love, and hard financial times. Time management, lack of attention and commitments at home were few of the other problems. Problems had an impact on students as they were demotivated, lost focus in their studies, could not perform good and few participants even failed in examinations. Conclusions: Students were struggling more with emotional and family related problems and less with academics related problems. They were impacting student's academics. The study site had a robust mentoring program however, struggling students need timely identification and more dedicated time to help them manage their problems. Stress relieving activities and counselling sessions may frequently be added, and academically underachieved students should also be given extra care, support, and guidance. [ABSTRACT FROM AUTHOR]

Objective: To explore the trend of medical call writing by doctors working in tertiary care hospitals. Methods: A quantitative descriptive cross-sectional study was carried out to evaluate the quality of medical calls written by the doctors at three tertiary care hospitals of Peshawar, Khyber Pakhtunkhwa between June 2016 to June 2017. An instrument was developed following AMEE Guide 87. Its content validity and reliability were established by 33 consultants from twenty specialties. A total of 198 medical calls (66 each) were collected from medicine, surgery and allied specialties and evaluated on the basis of validated instrument. Results: During instrument development, six items with content Validity Ratio of 0.78 & Kappa value of 0.70 were deemed most significant in every medical call written. Among all the calls, the great majority (96% and 84.34%) mentioned the reason for referral (item 1) and history of presenting problem (item 2), respectively, while item 6 (explicit mention of the doctor who will receive the call) was addressed the least (17.6%). Item 3 (Result of physical examination) and 4 (what tests have been done/arranged by the referring doctor and a summary of the main findings) were stated in < 30% of the calls whereas item 5 (diagnosis/provisional diagnosis) was specified in less than half of the calls. Conclusion: In this study, the written medical calls of different specialties were evaluated using specifically designed six items instrument. Unfortunately, the content of medical calls assessed was found to be inadequate probably because medical call writing is not explicitly taught at under and postgraduate levels. [ABSTRACT FROM AUTHOR]

Objective: To study the perspective of faculty members about the use of social media in medical education. Material and Methods: Across sectional descriptive study was conducted among the faculty of three medical colleges from Sialkot. After ethical approval and informed consent, a structured, pretested questionnaire was used for data collection. Data was entered in IBM SPSS version 23 and analyzed by the use of statistical tools. Results: Out of the total of 123 participants of this study, 65 (52.8%) were males and 58 (47.2%) were females. Mean age of the males was 41.43±10.91years and females were of 32.84±7.83years. Faculty members' use of Social Media in teaching was more in private colleges than public college (P-value 0.018). Benefits score was higher in private institution (p-value 0.300). Barriers score was higher in public institutions but difference was not statistically significant (p-value 0.638).Use of social media score was higher in females but the difference was not statistically significant (p-value 0.965). Conclusion: Majority of the medical faculty in private sector use social media for education whereas the public-sector faculty is also engaged in the process of education through social media tools. [ABSTRACT FROM AUTHOR]

The article provides information on introducing precision medicine (PM) education for medical residents in Rwanda. Topics discussed include purpose of suggesting educating physicians about PM, lessons included in the blended learning curriculum, and lessons learned from PM-based education.