Reforming medical education in pakistan through strengthening departments of medical education

Objective: To review the current status of departments of medical education in all public and private medical colleges located in the city of Lahore, Pakistan

Methods: This was a quantitative, cross sectional descriptive study; conducted from March to October 2015 in Pakistan Medical and Dental Council [PM and DC] recognized medical colleges located in Lahore, Pakistan. Respondents were the heads of departments of medical education or any other well-informed faculty member. A questionnaire was prepared to obtain information about the current status of the departments of medical education [DMEs]. The investigator personally visited all medical colleges for data collection. Both verbal and written consents were obtained and the questionnaire was administered to the resource persons. The data was organized and entered in SPSS for descriptive analysis

Results: Out of the 18 medical colleges in Lahore, six [33.3%] belonged to public sector and 12 [66.7%] were from private sector. All medical colleges reported to have a functional DME. However, eight had established DMEs during the past five years. Only one [5.6%] head of DME was working on full-time basis. Eleven [61.1%] heads of DMEs did not have any formal qualification in medical education. Eight [44.4%] colleges claimed to have adequate human resources for DME. Thirteen [72.2%] colleges mentioned that adequate financial resources were available for running DMEs. It is encouraging to see that DMEs in private sector medical colleges are playing increasingly significant role in managing educational activities. Similarly, the senior management of private sector seems to be relatively more eager to promote educational activities

Conclusion: There is an increasing recognition towards establishing DMEs in the medical colleges, but their infrastructure, proper functioning and availability of human and financial resources are serious impediments requiring immediate attention

Assessment of dental students' psychomotor skills using oral surgery simulation models

Aims: The aim of this study was to determine the validity of using oral surgery simulation models as a tool to assess the psychomotor skills of dental students

Materials and Methods: All students in the 4th year of a 6 years dental program were enrolled in the study. 23 dental students were asked to display their competency in the injection of local anesthesia and dental extraction in two summative testing environments namely; in the simulation and in the outpatient clinic. A panel of four experts assessed the students' performance during the injection of local anesthesia and tooth extraction on patients and simulation using a pre-validated checklist. Students' scores were compared in both settings

Results: The results showed no significant correlation between the scores on patients and simulation in the two settings [P = 0.759]

Conclusions: The study revealed that the real patient remains the gold standard in summative assessment of dental students' psychomotor skills

Perceptions of medical students about educational environment at services institute of medical sciences, Lahore

Objective: the objective of this study was to assess the perceptions of undergraduate medical students of Services Institute of Medical Sciences [SIMS], using DRE EM questionnaire

Material and Methods: all students from the final year MBBS class of the medical college [n=150] were included in the study. The non-parametric chi-square test and Mann Whitney U Test were used to determine the significance of differences [proportion of frequencies] for individual items

Results: the total no of final year students of medical college were 150 with 135 respondents with 43% males and 57% females. DREEM score SIMS medical college in metropolitan city was 118.6 indicating a positive perception

Conclusion: DREEM is a valid instrument for the measurement of students' perceptions worldwide. The students of SIMS have positive perception about educational environment of the institute

Utilization pattern of different health facilities for MCH services in the three areas of district Lahore

A community based study was conducted in two rural and one urban areas of Lahore district. The objective was to assess the utilization of different health facilities for selected MCH services. All the ladies who had delivered a baby in the past one year were asked about the place of delivery, the development of any post delivery complications and the utilization of health facilities for the treatment of post delivery complications. Upto 97.5%, 80% and 63.4% of deliveries were conducted by 'Dais' [Traditional Birth Attendants] in the two rural and one urban areas respectively. As many as 16%, 24% and 30% of the mothers developed post delivery complications in the two rural and one urban areas respectively. In one rural area, 45.9% of complication were treated by 'Dais', while in the second rural area 42.0% of cases got treatment from a medical store. In the city area however, 78% of complications were treated by either a private doctor or at a GHF. There is a need to provide optimum level of all types of health care services, that is, lady doctors and other staff, essential medicines and proper labour room facilities. People need to be educated and motivated for the use of these facilities. Traditional Birth Attendants'and 'Village Health Workers' programmes are expected to provide some break-through in the above mentioned patterns of child delivery

Response and attitude of people towards health care facilities

Traditionally the unavailability of doctors and health care facilities have been blamed as key factors for ill-health of people. This is not true because health care utilization is still very low in many areas where proper health facilities are available. From sociologist's perspective, the attitudes and behaviour of people determine the success or failure of a system. This study has been done in Ali Hussainabad, a village approximately 25 km from Lahore. All the health facilitites are in the village. In a sample of 100 households, chosen systematically, the attitudes and behaviours of people towards health care facilities was assessed. It is observed that a disease is either neglected or a home remedy was tried for the first few days. Non-qualified and qualified dispensers were contacted as first line of treatment outside the home. Even if treatment was initiated, vast majority of patients decided by themselves about stopping treatment. Despite availability, doctors and hospital played a minor role in the whole scenario

Awareness of physicians about the use of metered dose inhaler in teaching hospitals of Lahore, Pakistan

To evaluate awareness of hospital residence about the use of metered dose inhaler. Design: A comparative study of pulmonary and non-pulmonary physicians through demonstration of MDI use, observed by a single investigator. Settings: Four teaching hospitals in Lahore. Subjects: Eighty residents including 8 senior registrars, with minimal hospital experience of one year. 96.3% of all participants have been prescribing inhalers, while 93.8% were actually demonstrating its use to their patients. Majority of the physicians [43.8%] learnt the technique of MDI use from their senior colleagues [95% CL: 32.9%-54.7%] where as 36.3% [95% CL: 25.8%-46.8%] had leant it from more than one source. The most frequent error included, making more than one actuation at a actuation at a time [83.8%] and not giving a gap before next actuation [72.5%]. Breath holding was advised by 49.46%, slow inhalation by 48.1%, shaking of inhaler by 31.3%, approximation of lips by only 28.8% of the doctors. At least 6 out of 10 steps were correctly performed by 25 [31%] participant which included 37.5% of the pulmonary and 23.8% of the non pulmonary group. This difference is however not statistically significant at 5% level [X2 = 8.82, P = NS] Overall knowledge about the use of basic inhalational device [MDI] among pulmonary and non-pulmonary residents from teaching hospitals is same but very poor