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4. Fasting pancreatic polypeptide predicts incident microvascular and macrovascular complications of type 2 diabetes: An observational study

Author

Sam, Amir H., primary, Buckley, Adam J., additional, Lam, Brian Y. H., additional, Bewick, Gavin A., additional, Bech, Paul R., additional, Meeran, Karim, additional, Barakat, Maha T., additional, Bloom, Stephen R., additional, Yeo, Giles S. H., additional, Lessan, Nader G., additional, and Murphy, Kevin G., additional

Published
2024
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5. Development of a Virtual Three-Dimensional Assessment Scenario for Anatomical Education

Author

Bogomolova, Katerina, Sam, Amir H., Misky, Adam T., Gupte, Chinmay M., Strutton, Paul H., Hurkxkens, Thomas J., and Hierck, Beerend P.

Abstract

In anatomical education three-dimensional (3D) visualization technology allows for active and stereoscopic exploration of anatomy and can easily be adopted into medical curricula along with traditional 3D teaching methods. However, most often knowledge is still assessed with two-dimensional (2D) paper-and-pencil tests. To address the growing misalignment between learning and assessment, this viewpoint commentary highlights the development of a virtual 3D assessment scenario and perspectives from students and teachers on the use of this assessment tool: a 10-minute session of anatomical knowledge assessment with real-time interaction between assessor and examinee, both wearing a HoloLens and sharing the same stereoscopic 3D augmented reality model. Additionally, recommendations for future directions, including implementation, validation, logistic challenges, and cost-effectiveness, are provided. Continued collaboration between developers, researchers, teachers, and students is critical to advancing these processes.

Published
2021
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9. Reliability, validity and acceptability of an online clinical reasoning simulator for medical students: An international pilot.

Author

Hornos, Eduardo, Pleguezuelos, Eduardo, Bala, Laksha, Collares, Carlos Fernando, Freeman, Adrian, van der Vleuten, Cees, Murphy, Kevin G., and Sam, Amir H.

Subjects
MEDICAL logic, SELF-evaluation, MEDICAL education, CRONBACH'S alpha, RESEARCH funding, RESEARCH evaluation, PILOT projects, UNDERGRADUATES, EVALUATION of human services programs, DESCRIPTIVE statistics, UNCERTAINTY, DECISION making in clinical medicine, SIMULATION methods in education, SURVEYS, ONLINE education, ABILITY, RESEARCH methodology, RESEARCH, MEDICAL schools, PSYCHOMETRICS, PSYCHOLOGY of medical students, STUDENT attitudes, FACTOR analysis, CONFIDENCE intervals, TRAINING, EVALUATION
Abstract

Introduction: Clinical reasoning skills are essential for decision-making. Current assessment methods are limited when testing clinical reasoning and management of uncertainty. This study evaluates the reliability, validity and acceptability of Practicum Script, an online simulation-based programme, for developing medical students' clinical reasoning skills using real-life cases. Methods: In 2020, we conducted an international, multicentre pilot study using 20 clinical cases with 2457 final-year medical students from 21 schools worldwide. Psychometric analysis was performed (n = 1502 students completing at least 80% of cases). Classical estimates of reliability for three test domains (hypothesis generation, hypothesis argumentation and knowledge application) were calculated using Cronbach's alpha and McDonald's omega coefficients. Validity evidence was obtained by confirmatory factor analysis (CFA) and measurement alignment (MA). Items from the knowledge application domain were analysed using cognitive diagnostic modelling (CDM). Acceptability was evaluated by an anonymous student survey. Results: Reliability estimates were high with narrow confidence intervals. CFA revealed acceptable goodness-of-fit indices for the proposed three-factor model. CDM analysis demonstrated good absolute test fit and high classification accuracy estimates. Student survey responses showed high levels of acceptability. Conclusion: Our findings suggest that Practicum Script is a useful resource for strengthening students' clinical reasoning skills and ability to manage uncertainty. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium

Author

Hamblin, Ross, primary, Fountas, Athanasios, additional, Lithgow, Kirstie, additional, Loughrey, Paul Benjamin, additional, Bonanos, Efstathios, additional, Shinwari, Shah Khalid, additional, Mitchell, Kirsten, additional, Shah, Syed, additional, Grixti, Lydia, additional, Matheou, Mike, additional, Isand, Kristina, additional, McLaren, David S, additional, Surya, Ashutosh, additional, Ullah, Hafiz Zubair, additional, Klaucane, Katarina, additional, Jayasuriya, Anuradha, additional, Bhatti, Sumbal, additional, Mavilakandy, Akash, additional, Ahsan, Masato, additional, Mathew, Susan, additional, Hussein, Ziad, additional, Jansz, Thijs, additional, Wunna, Wunna, additional, MacFarlane, James, additional, Ayuk, John, additional, Abraham, Prakash, additional, Drake, William M, additional, Gurnell, Mark, additional, Brooke, Antonia, additional, Baldeweg, Stephanie E, additional, Sam, Amir H, additional, Martin, Niamh, additional, Higham, Claire, additional, Reddy, Narendra, additional, Levy, Miles J, additional, Ahluwalia, Rupa, additional, Newell-Price, John, additional, Vamvakopoulos, Joannis, additional, Krishnan, Amutha, additional, Lansdown, Andrew, additional, Murray, Robert D, additional, Pal, Aparna, additional, Bradley, Karin, additional, Mamoojee, Yaasir, additional, Purewal, Tejpal, additional, Panicker, Janki, additional, Freel, E Marie, additional, Hasan, Faisal, additional, Kumar, Mohit, additional, Jose, Biju, additional, Hunter, Steven J, additional, and Karavitaki, Niki, additional

Published
2023
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21. UK Prescribing Safety Assessment (PSA): The development, implementation and outcomes of a national online prescribing assessment.

Author

Magavern, Emma F., Hitchings, Andrew, Bollington, Lynne, Wilson, Kurt, Hepburn, David, Westacott, Rachel J., Sam, Amir H., Caulfield, Mark J., and Maxwell, Simon

Subjects
MEDICAL students, BIOMARKERS, PHYSICIANS, GOVERNMENT agencies, MEDICAL schools, MEDICATION safety
Abstract

Aims: The United Kingdom (UK) Prescribing Safety Assessment (PSA) is a 2‐h online assessment of basic competence to prescribe and supervise the use of medicines. It has been undertaken by students and doctors in UK medical and foundation schools for the past decade. This study describes the academic characteristics and performance of the assessment; longitudinal performance of candidates and schools; stakeholder feedback; and surrogate markers of prescribing safety in UK healthcare practice. Methods: We reviewed the performance data generated by over 70 000 medical students and 3700 foundation doctors who have participated in the PSA since its inception in 2013. These data were supplemented by Likert scale and free text feedback from candidates and a variety of stakeholder groups. Further data on medication incidents, collected by national reporting systems and the regulatory body, are reported, with permission. Results: We demonstrate the feasibility, high quality and reliability of an online prescribing assessment, uniquely providing a measure of prescribing competence against a national standard. Over 90% of candidates pass the PSA on their first attempt, while a minority are identified for further training and assessment. The pass rate shows some variation between different institutions and between undergraduate and foundation cohorts. Most responders to a national survey agreed that the PSA is a useful instrument for assessing prescribing competence, and an independent review has recommended adding the PSA to the Medical Licensing Assessment. Surrogate markers suggest there has been improvement in prescribing safety in practice, temporally associated with the introduction of the PSA but other factors could be influential too. Conclusions: The PSA is a practical and cost‐effective way of delivering a reliable national assessment of prescribing competence that has educational impact and is supported by the majority of stakeholders. There is a need to develop national systems to identify and report prescribing errors and the harm they cause, enabling the impact of educational interventions to be measured. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Shock

Author

Ramrakha, Punit S., primary, Moore, Kevin P., additional, and Sam, Amir H., additional

Published
2019
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27. Drug overdoses

Author

Ramrakha, Punit S., primary, Moore, Kevin P., additional, and Sam, Amir H., additional

Published
2019
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38. Natural history of non-functioning pituitary microadenomas - results from the UK NFPA consortium

Author

Hamblin, Ross, Fountas, Athanasios, Lithgow, Kirstie, Loughrey, Paul Benjamin, Bonanos, Efstathios, Shinwari, Shah Khalid, Mitchell, Kirsten, Shah, Syed, Grixti, Lydia, Matheou, Mike, Isand, Kristina, McLaren, David S, Surya, Ashutosh, Ullah, Hafiz Zubair, Klaucane, Katarina, Jayasuriya, Anuradha, Bhatti, Sumbal, Mavilakandy, Akash, Ahsan, Masato, Mathew, Susan, Hussein, Ziad, Jansz, Thijs, Wunna, Wunna, MacFarlane, James, Ayuk, John, Abraham, Prakash, Drake, William M, Gurnell, Mark, Brooke, Antonia, Baldeweg, Stephanie E, Sam, Amir H, Martin, Niamh, Higham, Claire, Reddy, Narendra, Levy, Miles J, Ahluwalia, Rupa, Newell-Price, John, Vamvakopoulos, Joannis, Krishnan, Amutha, Lansdown, Andrew, Murray, Robert D, Pal, Aparna, Bradley, Karin, Mamoojee, Yaasir, Purewal, Tejpal, Panicker, Janki, Freel, E Marie, Hasan, Faisal, Kumar, Mohit, Jose, Biju, Hunter, Steven J, Karavitaki, Niki, Gurnell, Mark [0000-0001-5745-6832], Murray, Robert D [0000-0001-6730-6109], Karavitaki, Niki [0000-0002-4696-0643], and Apollo - University of Cambridge Repository

Subjects
incidentaloma, natural history, Non-functioning, adenoma, pituitary
Abstract

OBJECTIVE: The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care. DESIGN: Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium). METHODS: Clinical, imaging, and hormonal data of micro-NFPA cases between 1/1/2008 and 21/12/2021 were analysed. RESULTS: Data for 459 patients were retrieved [median age at detection 44 years [interquartile range (IQR) 31-57) - 152 males/307 females]. 419 patients had more than two MRIs [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95%CI 4.9%-8.1%) and 14.5% (95%CI 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95%CI 10.4-17.8%) and 21.3% (95%CI 16.4-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2 mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all >5 mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required >3 years after micro-NFPA detection). Sex, age, size at baseline were not predictors of enlargement/reduction. At time of detection, 7.2%, 1.7% and 1.5% patients had secondary hypogonadism, hypothyroidism and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma). CONCLUSIONS: Probability of micro-NFPA growth is low and development of new hypopituitarism is rare. Delaying first follow-up MRI to three years and avoiding hormonal re-evaluation in absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance.

Published
2023

39. Knowledge Attainment and Engagement Among Medical Students: A Comparison of Three Forms of Online Learning

Author

Stackhouse, Ashlyn A, primary, Rafi, Damir, additional, Walls, Risheka, additional, Dodd, Rebecca V, additional, Badger, Kerry, additional, Davies, Daniel J, additional, Brown, Celia A, additional, Cowell, Adrian, additional, Meeran, Karim, additional, Halse, Omid, additional, Kinross, James, additional, Lupton, Martin, additional, Hughes, Elizabeth A, additional, and Sam, Amir H, additional

Published
2023
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40. Knowledge Attainment and Engagement Among Medical Students: A Comparison of Three Forms of Online Learning

Author

Stackhouse,Ashlyn A, Rafi,Damir, Walls,Risheka, Dodd,Rebecca V, Badger,Kerry, Davies,Daniel J, Brown,Celia A, Cowell,Adrian, Meeran,Karim, Halse,Omid, Kinross,James, Lupton,Martin, Hughes,Elizabeth A, Sam,Amir H, Stackhouse,Ashlyn A, Rafi,Damir, Walls,Risheka, Dodd,Rebecca V, Badger,Kerry, Davies,Daniel J, Brown,Celia A, Cowell,Adrian, Meeran,Karim, Halse,Omid, Kinross,James, Lupton,Martin, Hughes,Elizabeth A, and Sam,Amir H

Abstract

Ashlyn A Stackhouse,1,* Damir Rafi,1,* Risheka Walls,1,2 Rebecca V Dodd,1 Kerry Badger,1 Daniel J Davies,1 Celia A Brown,3 Adrian Cowell,1 Karim Meeran,1 Omid Halse,1 James Kinross,4 Martin Lupton,1 Elizabeth A Hughes,5 Amir H Sam1 1Imperial College School of Medicine, Imperial College London, London, UK; 2Imperial College Healthcare NHS Trust, London, UK; 3Warwick Medical School, Department of Medicine, Warwick, UK; 4Department of Surgery and Cancer, Imperial College London, London, UK; 5Health Education England, London, UK*These authors contributed equally to this workCorrespondence: Amir H Sam, Imperial College London, Charing Cross Campus, Reynolds Building, St Dunstan’s Road, London, W6 8RP, UK, Tel +442075895111, Email a.sam@imperial.ac.ukObjective: This study compared knowledge attainment and student enjoyment and engagement between clinical case vignette, patient-testimony videos and mixed reality (MR) teaching via the Microsoft HoloLens 2, all delivered remotely to third year medical students. The feasibility of conducting MR teaching on a large scale was also assessed.Setting & Participants: Medical students in Year 3 at Imperial College London participated in three online teaching sessions, one in each format. All students were expected to attend these scheduled teaching sessions and to complete the formative assessment. Inclusion of their data used as part of the research trial was optional.Primary and Secondary Outcome Measures: The primary outcome measure was performance on a formative assessment, which served to compare knowledge attainment between three forms of online learning. Moreover, we aimed to explore student engagement with each form of learning via a questionnaire, and also feasibility of applying MR as a teaching tool on a large scale. Comparisons between performances on the formative assessment between the three groups were investigated using a repeated measures two-way ANOVA. Engagement and enjoyment were als

Published
2023

47. Natural history of non-functioning pituitary microadenomas - results from the UK NFA consortium

Author

Hamblin, Ross, primary, Fountas, Athanasios, additional, Lithgow, Kirstie, additional, Loughrey, Paul Benjamin, additional, Bonanos, Efstathios, additional, Khalid, Shinwari Shah, additional, Mitchell, Kirsten, additional, Shah, Syed, additional, Grixti, Lydia, additional, Matheou, Mike, additional, Isand, Kristina, additional, McLaren, David, additional, Surya, Ashutosh, additional, Zubair, Ullah Hafiz, additional, Klaucane, Katarina, additional, Jayasuriya, Anuradha, additional, Bhatti, Sumbal, additional, Mavilakandy, Akash, additional, Ahsan, Masato, additional, Mathew, Susan, additional, Hussein, Ziad, additional, Jansz, Thijs, additional, Wunna, Wunna, additional, Ayuk, John, additional, Abraham, Prakash, additional, Drake, William, additional, Brooke, Antonia, additional, Baldeweg, Stephanie E., additional, Sam, Amir H., additional, Martin, Niamh, additional, Higham, Claire, additional, Reddy, Narendra, additional, Ahluwalia, Rupa, additional, Newell-Price, John, additional, Vamvakopoulos, Joannis, additional, Krishnan, Amutha, additional, Lansdown, Andrew, additional, Murray, Robert D, additional, Pal, Aparna, additional, Bradley, Karin, additional, Mamoojee, Yaasir, additional, Purewal, Tejpal, additional, Panicker, Janki, additional, Marie, Freel E, additional, Hasan, Faisal, additional, Kumar, Mohit, additional, Jose, Biju, additional, Hunter, Steven, additional, and Karavitaki, Niki, additional

Published
2022
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50. The impact of the COVID-19 pandemic on UK medical education. A nationwide student survey

Author

Tekkis, Nicholas Pari, Rafi, Damir, Brown, Sam, Courtney, Alona, Kawka, Michal, Howell, Ann-Marie, McLean, Kenneth, Gardiner, Matthew, Mavroveli, Stella, Hutchinson, Peter, Tekkis, Paris, Wilkinson, Paul, Sam, Amir H, Savva, N, Kontovounisios, Christos, Tekkis, N, Rafi, D, Brown, S, Courtney, A, Kawka, M, Howell, A, McLean, K, Gardiner, M, Mavroveli, S, Hutchinson, P, Tekkis, P, Wilkinson, P, Sam, A H, Kontovounisios, C, Mclean, K, Singal, A, Chia, C, Chia, W, Ganesananthan, S, Ooi, S Z Y, Pengelly, S, Wellington, J, Mak, S, Subbiah Ponniah, H, Heyes, A, Aberman, I, Ahmed, T, Al-Shamaa, S, Appleton, L, Arshad, A, Awan, H, Baig, Q, Benedict, K, Berkes, S, Citeroni, N L, Damani, A, de Sancha, A, Fisayo, T, Gupta, S, Haq, M, Heer, B, Jones, A, Khan, H, Kim, H, Meiyalagan, N, Miller, G, Minta, N, Mirza, L, Mohamed, F, Ramjan, F, Read, P, Soni, L, Tailor, V, Tas, R N, Vorona, M, Walker, M, Winkler, T, Bardon, A, Acquaah, J, Ball, T, Bani, W, Elmasry, A, Hussein, F, Kolluri, M, Lusta, H, Newman, J, Nott, M, Perwaiz, M I, Rayner, R, Shah, A, Shaw, I, Yu, K, Cairns, M, Clough, R, Gaier, S, Hirani, D, Jeyapalan, T, Li, Y, Patel, C R, Shabir, H, Wang, Y A, Weatherhead, A, Dhiran, A, Renney, O, Wells, P, Ferguson, S, Joyce, A, Mergo, A, Adebayo, O, Ahmad, J, Akande, O, Ang, G, Aniereobi, E, Awasthi, S, Banjoko, A, Bates, J, Chibada, C, Clarke, N, Craner, I, Desai, D D, Dixon, K, Duffaydar, H I, Kuti, M, Mughal, A Z, Nair, D, Pham, M C, Preest, G G, Reid, R, Sachdeva, G S, Selvaratnam, K, Sheikh, J, Soran, V, Stoney, N, Wheatle, M, Howarth, K, Knapp-Wilson, A, Lee, K S, Mampitiya, N, Masson, C, McAlinden, J J, McGowan, N, Parmar, S C, Robinson, B, Wahid, S, Willis, L, Risquet, R, Adebayo, A, Dhingra, L, Kathiravelupillai, S, Narayanan, R, Soni, J, Ghafourian, P, Hounat, A, Lennon, K A, Abdi Mohamud, M, Chou, W, Chong, L, Graham, C J, Piya, S, Riad, A M, Vennard, S, Wang, J, Kawar, L, Maseland, C, Myatt, R, Tengku Saifudin, T N S, Yong, S Q, Douglas, F, Ogbechie, C, Sharma, K, Zafar, L, Bajomo, M O, Byrne, M H V, Obi, C, Oluyomi, D I, Patsalides, M A, Rajananthanan, A, Richardson, G, Clarke, A, Roxas, A, Adeboye, W, Argus, L, McSweeney, J, Rahman-Chowdhury, M, Hettiarachchi, D S, Masood, M T, Antypas, A, Thomas, M, de Andres Crespo, M, Zimmerman, M, Dhillon, A, Abraha, S, Burton, O, Jalal, A H B, Bailey, B, Casey, A, Kathiravelupillai, A, Missir, E, Boult, H, Campen, D, Collins, J M, Dulai, S, Elhassan, M, Foster, Z, Horton, E, Jones, E, Mahapatra, S, Nancarrow, T, Nyamapfene, T, Rimmer, A, Robberstad, M, Robson-Brown, S, Saeed, A, Sarwar, Y, Taylor, C, Vetere, G, Whelan, M K, Williams, J, Zahid, D, Chand, C, and Matthews, M

Subjects
Crises, Courses (Education), Medical sciences, United Kingdom
Published
2022

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