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Background: Breast cancer (BC) poses a significant public health concern as it is the most common cancer detected among women worldwide. Early detection and intervention are associated with better prognosis and survival. A primary reason for the rising mortality and morbidity in developing countries is the lack of patient education and practice early detection programs and presentation. Aims and Objectives: The main objective of this study is to evaluate the prevalence of delayed presentation and the factors lead to delay among BC patients in Sri Lanka. Materials and Methods: A descriptive cross-sectional study was conducted from January 01, 2023, to June 30, 2023 among women diagnosed with BC attending two selected state hospitals in Sri Lanka. All women with histological diagnosis of early, locally advanced, or metastatic BC attending for treatment were included and women with recurrent BC and concomitant other cancers were excluded. Presentation delay was defined as ≥3 months. The calculated sample size was 396. Results: About 47.5% of our study population (n=188) had a presentation delay of more than 3 months. The main reasons for the delay in presentation were, being unaware that BC is a major problem in Sri Lanka, difficulty in accessing healthcare, and not being able to find time due to family and social commitments. Women who had not been practicing self-breast examination had a significant association with presentation delay (OR=3.26, 95% CI - 0.090–0.362, P=0.001). The participants who were having a presentation delay were also more likely to be diagnosed with an advanced stage of cancer (OR=2.86, 95% CI - 2.573–3.153, P=0.000). Conclusion: Our study population depicts a good knowledge related to BC symptoms, risk factors, and early detection methods. However, very few are practicing them. There is also a significant delay of presentation due to various factors. Awareness and good practices would lead to early detection and diagnosis and improve overall survival.

Abstract Background The shadowing house officer is an experiential learning activity that usually takes place within the final year clinical rotations of medical undergraduates. An exposure to a surgical intern is especially useful as the work extends to more practical aspects of ward work. Objective We assessed the impact of the shadowing house officer exprience during medical student clinical rotation on the surgical internship and to evaluate the challenges of the shadowing period. Methods A descriptive cross-sectional survey was carried out among 108 surgical intern doctors in Sri Lanka via electronic media in 2023. Results Our study population consisted of 108 interns, with a response rate of 43.2%. This study demonstrates that on average a final year medical student undergoes a 4- day shadowing period in surgery which was considered by a majority to help in smooth transition to internship. 56% had a clear understanding about learning outcomes and less than half has had an induction session prior to commencement of shadowing. Official documentation, routine ward work, team work and communication skills were meaningfully experienced during shadowing. The main criticisms were inadequate breaks leading to exhaustion and missing out on important teaching activities. Another major concern was shadowing close to the final examination. Conclusions Surgical shadowing house officer is an authentic work experience that intern doctors consider as important component in orientating the role of an intern. Introduction of shadowing at an earlier stage would be more beneficial and provide a broader view about the clinical set up to undergraduates.

Objective: The operating room is a unique learning experience that has visual, aural, kinesthetic learning stimuli and provides benefits to the medical students such as development of sound clinical knowledge and skills, and gaining personal insight into ones' career choice. However, this can be a challenging place due to the unfamiliar learning environment. We aimed to study the Sri Lankan Medical students' perception and attitudes on operating theatre learning experience. Design and setting: A descriptive cross-sectional survey was carried out among medical students undergoing surgical clinical training on the perspectives of the teaching and learning experience in the operating theatre in Sri Lanka. Participants: Our study group consisted of 390 medical students from four different medical faculties in Sri Lanka representing all levels of surgical clinical rotations. Results: A majority of the students had actively participated in the operating theater. Despite this, the students' clarity of the learning outcomes and expectations in a theatre varied greatly. Majority of the students felt that the surgeons were willingly to teach but also noted that there was no standardization in teaching. This study clearly shows a significant correlation between positive emotions and surgical teams welcoming attitude towards the medical students. Long standing hours were considered a negative emotion by a majority of students. We also observed that theatre environment can be physically and mentally exhausting. Conclusions: Thus, empathy, feeling welcome and giving breaks to refresh can go a long way in making the learning experience better. Regular feedback to trainers on students' perception of the theatre experience is important to value the students' opinion and improve the quality of the surgical theatre. We strongly recommend initiation of clear induction sessions with introduction of well-structured teaching learning activities in the operating theatre.

Background: The shadowing house officer is an experiential learning activity that usually takes place within the final year clinical rotations of medical undergraduates. An exposure to a surgical intern is especially useful as the work extends to more practical aspects of ward work. Objective: We assessed the impact of the shadowing house officer experience during medical student clinical rotation on the surgical internship and to evaluate the challenges of the shadowing period. Methods: A descriptive cross-sectional survey was carried out among 108 surgical intern doctors in Sri Lanka via electronic media in 2023. Results: Our study population consisted of 108 interns, with a response rate of 43.2%. This study demonstrates that on average a final year medical student undergoes a 4-day shadowing period in surgery which was considered by a majority to help in smooth transition to internship. 56% had a clear understanding about learning outcomes and less than half has had an induction session prior to commencement of shadowing. Official documentation, routine ward work, team work and communication skills were meaningfully experienced during shadowing. The main criticisms were inadequate breaks leading to exhaustion and missing out on important teaching activities. Another major concern was shadowing close to the final examination. Conclusions: Surgical shadowing house officer is an authentic work experience that intern doctors consider as important component in orientating the role of an intern. Introduction of shadowing at an earlier stage would be more beneficial and provide a broader view about the clinical set up to undergraduates.