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Background: Joining the health care force as a doctor is a dream that flourishes in the minds of majority of youngsters in Pakistan, making the admission process highly competitive. Currently, our admission criteria only caters the knowledge domain of the applicants while research argues that personality of the candidates should also be considered when selecting the cream of the nation for one of the most critical profession of medicine. Objective: The objective of this research was to investigate stakeholders' perspectives on the incorporation of personality assessment as a component of the admission requirements for medical colleges in Pakistan. Methods: An exploratory qualitative study was conducted using a multi-center approach, where participants from three different stakeholder groups involved in medical college admissions in Pakistan (Governing body members, experienced academic staff, and medical scholars) were interviewed. The analysis method used was thematic analysis. Results: The stakeholders reached a consensus that the current admission criteria need to be revised, although opinions were varied regarding the inclusion of personality assessment in the admission process. The stakeholders identified conscientiousness, agreeableness, neuroticism, extraversion, and openness to experience as the key personality features to be evaluated for medical college admissions, in descending order of importance. Conclusion: This study highlighted the need to revise and expand the existing admission criteria, while also revealing a diversified feedback to the proposal of introducing personality appraisal as part of the medical college admission standards as they may pose significant obstacles. [ABSTRACT FROM AUTHOR]

Objective: To measure the level of preparedness of MBBS students to clinical exposure to COVID-19 pandemic. Study Design: Cross-sectional online questionnaire survey. Place and Duration of Study: Physiology department, Islamic International Medical College, Riphah University, from July to July 2020. Methodology: Medical students from first to final year were included. Data was collected through a validated questionnaire measuring knowledge, attitude and practice of medical students regarding COVID-19. Statistical analysis was done on Microsoft Excel. Frequencies, percentages, mean, and standard deviation were calculated. Results: A total of 315 students were included in the final analysis. The mean age of the students was 21 3.2. Social media were the main sources of information for 45.5% of the students. The overall level of knowledge of students about COVID-19 was good in 88% and 12% had poor knowledge. The attitude had a mixed response of 55.5% being confident that the disease would be controlled while 93.3% and 87% of the students wanted to help and educate the society. Regarding practice 91% of the students had good practice and used face masks though poor practice were the application of hand sanitizer and going out of home 68%. Conclusion: The level of preparedness of MBBS students before clinical exposure to the COVID-19 Pandemic was satisfactory. The students had good knowledge, a mixed attitude and good practices regarding COVID-19. Gaps in knowledge and the practice which were highlighted need to be addressed by the educational institutes through awareness programs before interaction with the patients is initiated. [ABSTRACT FROM AUTHOR]

Objective: There are growing concerns towards the quality of medical education in Pakistan. To help strengthen accreditation processes, this study identifies the challenges towards quality assurance of Basic Medical Education in Pakistan. Methods: A qualitative case study was carried out from March to August 2018. Participants included inspectors from various disciplines in both public and private medical colleges, and medical educationists from Pakistan. Semi-structured interviews were conducted with 12 inspectors, while focus group discussion included 10 medical educationists. All the interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted to capture the intricacies of meaning within the data. Results: Data identified 14 sub-themes grouped under three major themes. Challenges towards quality assurance included mounting political influence, commercialism in medical education, weak regulatory capacity of accrediting body, violation of rules, lack of valid accreditation standards and skilled inspectors. Conclusion: Quality assurance of Basic Medical Education in Pakistan involves various systemic, resource and personnel related challenges. The accrediting body needs to bring major reforms in its accreditation system and strengthen its regulatory and technical educational capacity to ensure the quality of medical education in nearly 168 medical and dental colleges of the country. [ABSTRACT FROM AUTHOR]

1: Department of Pathology, PAC Hospital Kamra, Kamra, Pakistan OBJECTIVE: To determine the frequency of attributes of role modelling demonstrated by clinical trainers in teaching hospitals. METHODS: A pre-validated role model apperception tool (RoMAT) was used in this cross-sectional study to collect responses from trainees serving in seven teaching hospitals of Pakistan from January to December 2019. The questionnaire contained items on personal, teaching, and clinical attributes of role models. Responders were asked to recognize and respond to attributes of their identified clinical trainers on four-point Likert scale (strongly disagree to strongly agree). Descriptive statistics was carried out using SPSS 21. RESULTS: Out of the 900 questionnaires distributed; 740 post graduate trainees responded (response rate 82%); 540 (73%) recognized one role model, 185 (25%) identified two role models and the rest 15 (2%) did not identify any clinical trainer as a role model. Common attributes of trainers included: excellent clinical reasoning skills (97%), honesty and integrity (90%), awareness of role model status (86%), professionally competent (80%), communication skills (78%), positive interaction (84%), positive attitude (82%), making learning exciting (81%), understanding learners' needs (73%), demonstrating enthusiasm (86%), easy to work with (85%), leadership qualities (72%). Less common attributes included empathy (38%), patience (36%) and rapport with students (33%). CONCLUSION: Trainers in teaching hospitals has to improve their less common characteristics which include empathy, patience and rapport with students. [ABSTRACT FROM AUTHOR]

Objectives: To develop and validate a tool for the assessment of professionalism in medical students during clerkship., Methods: The mixed-method study was conducted from February to September 2018 at the Islamic International Medical College, Riphah University, Islamabad, Pakistan. A preliminary focus group discussion was followed by two rounds of Delphi technique to validate micro-scenarios for the relevance of each item of the instrument alongside its content validity. For content and construct validation of the tool, content validity, cognitive validity, cognitive pretesting, confirmatory factor analysis and reliability assessment was done. Piloting was done on medical students doing clerkship. Data was analysed using SPSS 21 and AMOS 21., Results: A 35-item preliminary tool from micro-scenarios generated after focus group discussion was developed for the first Delphi round. For the second round, a 29-item tool was resent to the experts for validation. After the second round, the content validity scale was 0.94. Removal of 1 item produced a 28-item tool. Pre-cognitive testing of the 28 items resulted in rephrasing of 4, modification of 2, and deletion of 1 and a tool with 27 items. Piloting was carried out and after CFA resulted in a reduced 21 item tool. Cronbach's alpha value was 0.96. A good to excellent model fit was produced after performing confirmatory factor analysis., Conclusions: A tool comprising of 21 items scored on a 5-point Likert scale that had acceptable construct validity and good content validity was developed. It can be used to evaluate the level of professionalism of local medical students doing clerkship.

Objective: To evaluate the perception of fresh dental graduates regarding professional competences essential for a graduating dentist., Methods: This quantitative, descriptive, cross-sectional study was conducted at four public and four private sector dental colleges in Punjab, Pakistan, from June to December 2014, and comprised dental graduates of the years 2013 and 2014. A comprehensive document containing 32 professionalism competences, divided into 3 sub-domains, was developed based on the competence documents of local and foreign accrediting bodies. Responses were recorded on a five-point Likert scale. The competences were categorised as 'essential' and 'good to have' based on the agreement cut-off of 75%. SPSS 21 was used for data analysis., Results: Of the 386 participants, 152(39.4%) were from public-sector colleges and 234(60.6%) from private ones. The overall mean age was 23.69±1.06 years. Of the 32 competences, the participants marked 18(56.25%) as 'essential' and 15(46.9%) as 'good to have'. In the latter category, 3(20%) competences were from the domain of professional attitude and behaviour, 7(46.6%) from ethics and jurisprudence and 4(26.7%) from the domain of communication and interpersonal skills., Conclusions: Pakistani dental graduates had an overall positive attitude regarding professionalism competences.

Objective: To document safety for use, through recording changes in blood pressure and pulse rate, after administering 3.6 ml of a 2% lignocaine with 1:100,000 epinephrine dental local anaesthetic in a group of hypertensive patients., Methodology: The present study was conducted at Shaikh Zayed Medical Complex, Lahore, from May to December 2008, using a convenience sampling technique. The first 60 walk-in patients in the dental outpatient department planned for tooth extraction were enrolled in the study. Out of these 60 patients, 10 had pre-hypertension (BP = 130/90), 10 had stage 1 hypertension (BP =140-159/90-99) and 10 study subjects were suffering from stage 2 hypertension (BP = 160-179/100-109). Thirty age and sex matched normo-tensive patients requiring tooth extraction acted as the control group. All patients were administered two cartridges each of 1.8 ml of dental local anaesthesia containing 2% Lignocaine with 1:100,000 epinephrine. Blood pressure and pulse rate (PR) were the risk indicators that were measured thrice; pre-injection, 2 minutes and 5 minutes after injection., Results: A decrease in systolic in stage 2 hypertension patients after 2 and 5 minutes of injections was noted. The diastolic BP (DBP) fell in all the groups after injections. Mean pulse rate increased from three to four beats per minute in all groups except in stage 2 hypertension patients where it slightly decreased., Conclusion: Epinephrine containing dental local anaesthesia decreased systolic blood pressure in stage 2 hypertension patients included in this study. There was an observed decrease of 21 mm Hg in systolic blood pressure hypertension patients but with no adverse effects.