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Objective: To assess whether problem-based learning enhances students’ perception of their active learning and critical thinking skills with time, and to validate the self-assessment scale regarding active learning and critical thinking in the local context. Method: The exploratory study was conducted at the Bahria University Dental College, Karachi, from February to September 2020, and comprised dental undergraduates in their first and second years of the academic programme Data was collected using the self-assessment scale on active learning and critical thinking questionnaire which was administered twice after problem-based learning tutorials. Data was analysed using SPSS 23. Results: There was a significant difference in the mean questionnaire scores of modules 1 and 3 of the first-year batch and modules 4 and 6 of the second-year batch (p=0.001). Cronbach’s alpha value was 0.735 in the first-year cohort and 0.802 in the second-year cohort. Conclusion: Dental students’ perception of active learning and critical thinking increased with time using problem-based learning as the tool. The self-assessment scale on active learning and critical thinking was also found validated in the local context. Key Words: Active learning, Critical thinking, Dental undergraduates, Problem-based learning, PBL, Self-assessment.

Objective: To find out the frequency of mental distress among medical students in Pakistani medical colleges. Method: The systematic review comprised a search on PubMed and Google Scholar databases for articles published in English language between 2004 and 2019 having the key words ‘mental distress’, ‘medical undergraduate’, ‘depression’ and ‘anxiety’. After a four-phase scrutiny process, articles were shortlisted for detailed review. Conventional content analysis was utilised for data analysis. Results: Of the 30 articles, 18(60%) were reviewed in detail. Distress among Pakistani medical students was reported up to 90% which is alarmingly high. Study year, financial issues and academic burden were the noteworthy causal factors. Academics and examinations were substantial stress factors and religion was the commonly adopted coping strategy. Conclusions: Multiple studies showed evidence of an increasing rate of mental distress among medical undergraduates having various causative factors, mainly the academic burden. Key Words: Mental stress, Medical undergraduates, Pakistani medical college, Depression and anxiety stress.

Objective To explore students' perceptions regarding self-directed learning, their experience of it, and how it may play a role in life-long learning. Methods The exploratory study was conducted at the Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia, in January and February 2018, and comprised male undergraduate medical students from academic years 2-6. Data was collected through focus group discussions regarding the students' perception of self-directed learning. The sessions were audiotaped, transcribed, and analysed thematically. Validation was done by member-checking and external audit. Results There were 29 male students with a mean age of 22.4±1.9 years. A total of 4 focus group discussion sessions were conducted; 2(50%) with students of preclinical years 2 and 3, and 2(50%) with students of clinical years 4-6. Five major themes generated were: understanding of self-directed learning; views about self-directed learning as a strategy; process of the strategy; effects of self-directed learning; self-directed learning and life-long learning. Subthemes which led to developing major themes included self-study, personal efforts, and objectives and goals formed theme1; good strategy, boredom with lectures, and need guidance theme2; time management, outline of planning, and internet browsing theme3; deep learning and curiosity theme4; life-long learning and future progress theme 5. Conclusions The students were found to have mixed perceptions regarding self-directed learning. Most students perceived that SDL could affect their learning and future progress positively. However, they needed support to effectively use this strategy. The faculty role was found to be crucial in this regard.

Objective To provide an overview of existing literature regarding ethics in undergraduate medical education around the world, and to identify gaps in literature for recommending areas for future research. Methods The scoping review was conducted in March 2016. PubMed and Web of Science search engines were used to identify English language literature on ethics in undergraduate medical education published over the preceding 20 years. Google search was used for grey literature. Two reviewers independently screened eligible studies for final study selection and review. Descriptive analysis of data was performed with mutual consensus. Results Of the 199 items located, 56(28%) were included; 37(33%) of 112 studies, and 19(22%) of 87 pieces of grey literature. Papers covered almost all regions of the world, including North and South America, Europe, Africa, and different Asian regions like Middle East, central, south-east and far east. The analysis identified several curriculum designs and teaching methods used for ethics education. Conclusions The review identified gaps in evidence that required further research. These areas include theoretical underpinning of ethics curriculum, role of educators, standardisation and validation of teaching and learning strategies, and relevance to cultural context in the development and delivery of ethics curriculum, especially in Asian regions.

Objective To find out the most appropriate learning theory for the ethics education of medical undergraduates. Methods Two electronic databases were searched PubMed and Web of Science. We searched for published articles written in English without a time limit using the keywords: ethics education, medical undergraduates and learning theory. In the four-phased retrieval process, six full texts out of 133 citations were included in this review. Data were analyzed done by conventional content analysis. Results This systemic review revealed that reflection is the most effective pathway to develop ethical attributes and values of the physician. Social constructivist and experiential theory seem appropriate to form the basis for developing effective ethics curriculum. Conclusions This review heightens the importance of learning theories for ethics education. It gives prompt evidence that reflection is the most suitable model for ethical education. Therefore, the educational theories and teaching activities that endorse reflective learning should be used for ethics education.