Challenges faced by female doctors during fellowship training hindering their professional progress in a conservative cultural context

Objective: To explore the professional challenges faced by female doctors during their fellowship training in semi government hospitals of Pakistan. Study Design: It was a qualitative study using a collective case study approach. Place and Duration of Study: This study was carried out in two semi-government hospitals of Rawalpindi i.e. Fauji Foundation and Pakistan Railways hospital, from Jan to Jul 2016

Material and Methods: Ten female doctors working as a trainee [irrespective of year of training] were interviewed by using semi-structured questionnaire. They were inquired about the challenges and issues faced by them in their training. Thematic analysis of the available data was carried out. Themes identified in the data were compared with themes already explored in literature

Results: Ten in-depth interviews revealed themes related to challenges faced by female trainees. All of them strongly believed that training was very tough and hectic and they came across many, departmental, institutional and personal problems during their training. All of them expressed their intense motivation for the training, but still felt it to be demanding. They believed they had paid a heavy price for this training by sacrificing prime time of their youth and family

Conclusion: It was identified by the participants that female encounter countless barriers when they start their fellowship trainings. They come across institutional as well as personal barriers which affect their career, thus hindering their progress

Strengths, weaknesses, opportunities, and threats analysis of integrating the World Health Organization patient safety curriculum into undergraduate medical education in Pakistan: a qualitative case study / 보건의료교육평가

PURPOSE: The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis of integrating the World Health Organization (WHO) patient safety curriculum into undergraduate medical education in Pakistan. METHODS: A qualitative interpretive case study was conducted at Riphah International University, Islamabad, from October 2016 to June 2017. The study included 9 faculty members and 1 expert on patient safety. The interviews were audiotaped, and a thematic analysis of the transcripts was performed using NVivo software. RESULTS: Four themes were derived based on the need analysis model. The sub-themes derived from the collected data were arranged under the themes of strengths, weaknesses, opportunities, and threats, in accordance with the principles of SWOT analysis. The strengths identified were the need for a formal patient safety curriculum and its early integration into the undergraduate program. The weaknesses were faculty awareness and participation in development programs. The opportunities were an ongoing effort to develop an appropriate curriculum, to improve the current culture of healthcare, and to use the WHO curricular resource guide. The threats were attitudes towards patient safety in Pakistani culture, resistance to implementation from different levels, and the role of regulatory authorities. CONCLUSION: The theme of patient safety needs to be incorporated early into the formal medical education curriculum, with the main goals of striving to do no harm and seeing mistakes as opportunities to learn. Faculty development activities need to be organized, and faculty members should to be encouraged to participate in them. The lack of a patient safety culture was identified as the primary reason for resistance to this initiative at many levels. The WHO curriculum, amended according to local institutional culture, can be implemented appropriately with support from the corresponding regulatory bodies.

Effectiveness of test-enhanced Learning [TEL] in lectures for undergraduate medical students

Objective: To determine the effectiveness of Test-Enhanced learning as a learning tool in lectures for undergraduate medical students

Method: This quantitative, randomized controlled trial included eighty-four students of 4th year MBBS from Yusra Medical and Dental College, Islamabad. The duration of study was from March 2016 to August 2016. After obtaining the informed consent; participants were equally assigned to interventional and noninterventional study groups through stratified randomization. Single best answer MCQs of special pathology were used as data collection instrument after validation. A pre- and post-test was taken from both groups, before and after the intervention, respectively and their results were compared using SPSS version 21

Results: There were 13 male [31%] and 29 female [69%] participants in each study group who showed an equivalent baseline performance on pre-test [p=0.95]. Statistically significant difference was found among mean scores of interventional and non-interventional study groups at exit exam [p=0.00]. Interventional group also showed a significant improvement in their post-test scores [mean: 17.17+/-1.59] as compared to pre-test scores [mean: 6.19+/-1.81]

Conclusions: Test-enhanced learning has significant effect on improving the learning of course content delivered to undergraduate medical students through lectures

Micro-feedback training: Learning the art of effective feedback

Multiple attributes are expected of postgraduate research supervisors. Provision of timely and effective face-to-face feedback is one such skill that carries enormous significance in supervisee's professional development. Feedback allows the supervisees to improve upon their performances. Unfortunately, both supervisors and supervisees have contrasting approaches towards the ongoing feedback practices. This incongruence is attributed, in part, to a lack of structured pedagogic training among the medical professionals. A standardized schema is therefore required to acquire and harmonize this pedagogical skill. One such systemized way is a training method called microteaching. Microteaching has long been used to enhance and incorporate old and new undergraduate teaching skills, respectively. Here we propose a similar structured approach of micro-feedback to inculcate effective feedback skills among postgraduate research supervisors using feedback-based scenarios, simulated students, standardized checklists and audiovisual aids. Thus, micro-feedback exercise may prove to be quite promising in improving feedback practices of postgraduate research supervisors

Impact of a social media group page on undergraduate medical physiology learning

Objective: To investigate the impact of associating classroom learning of medical physiology with a Facebook group page in an all-women medical college of a conservative small city in Pakistan

Study Design: Qualitative interpretivist study using semi-structured interviews

Place and Duration of Study: Women Medical College Abbottabad, Pakistan, from March to December 2014

Methodology: A closed Facebook study group was established at a local medical college in Pakistan. It was used to upload learning resources and initiate discussions, coordinated with classroom lectures of physiology. Thirteen semistructured interviews were conducted with volunteer students according to a standard protocol

Results: Five major themes were identified. Facebook group is something new and exciting; it motivated self-study, research, collaborative learning and improved class attendance. Convenience of easily accessible resources allowed the students to concentrate on the lecture rather than note taking. It was easier to communicate with the instructor through Facebook than face to face. Lurkers were also learning. High achievers who had adapted to the current didactic system of teaching were less receptive of the collaborative learning and favored teaching geared towards exam preparation

Conclusion: Using social media for e-learning in undergraduate medical education can enhance the student learning experience, especially in resource-limited regions where Information and communication technology is not an integrated part of the teaching process

Use of massive online open courses as a potential resource to provide continuing medical education in Pakistan

The Pakistan Medical and Dental Council [PM and DC] has made Continuing Medical Education [CME] mandatory for doctors, from 2015 onwards. A minimum of 15 credit hours of CME per year for general practitioners and 30 credit hours for specialist doctors have been made mandatory for renewal of the PMDC registration. While doctors can attend conferences to earn this CME credit, the opportunities are minimum and limited to major cities across Pakistan. Webbased CME is an attractive alternative to attending conferences. It can make up for 25% of the yearly PMDC requirement. So far, only two web-based CME providers have been launched in Pakistan, which is a shortage. Could Massive Online Open Courses [MOOCs] be used to fill this shortage? The MOOCs are online courses that are easily accessible to all learners irrespective of geographical boundary and resources, and can be used as a tool to provide CME to physicians. The problem as to how credit from PM and DC can be obtained, will need to be explored further

Professionalism; how to match the general medical council recommendations in undergraduate medical curriculum?

This paper describes a practical and valid technique for curriculum audit of professionalism theme of an MBChB programme in a UK medical school. The objective was to match the learning outcomes of professionalism covered in an MBChB course, with the guidelines laid by the GMC in Tomorrows Doctors 2003. The benefit being to determine the issues that needs to be addressed in response to the GMC Tomorrows Doctors 2009. A qualitative study design. 2011. University of Glasgow. To analyse the learning outcomes set out in the curriculum documents. All the statements from the explicit curriculum, and the GMC recommendations in Tomorrow's Doctors [2[nd] and 3[rd] Editions] were noted and the individual statements were entered into the NVivo software. A purposive sampling procedure was undertaken to identify "professionalism" in the Year 1 and 2 MBChB curricula and the Tomorrows Doctors, and a comparative content analysis completed. The coverage of learning outcomes related to professionalism was between 10-20%, scattered throughout the course in different domains of the MBChB, giving a balanced weight to each outcome. The professionalism theme of the MBChB course has covered all the learning outcomes of the Tomorrows Doctors in almost exactly the same frequency as suggested by the GMC according to the course requirements of Year 1 and 2. However, the MBChB course needs to be slightly modified to align it with the new guidelines by the GMC

Improving workplace-based learning for undergraduate medical students

Workplace-based learning is considered as one of the most effective way of translating medical theory into clinical practice. Although employed traditionally at postgraduate level, this strategy can be used in undergraduate students coming for clerkships in clinical departments. There are many challenges to workplace learning such as, unfavorable physical environment, lack of interest by clinical staff and teachers, and lack of student motivation. Clinical teachers can help bridge this gap and improve workplace learning through individual and collaborative team effort. Knowledge of various educational theories and principles and their application at workplace can enhance student learning and motivation, for which faculty development is much needed. Different teaching and learning activities can be used and tailored according to the clinical setting. Active reflection by students and constructive feedback from the clinicians forms the backbone of effective workplace learning

Assessment of professionalism in integrated curriculum: the faculty's perspective

To analyse and interpret the role of faculty members in assessing professionalism in a well-established medical school in the UK. A qualitative study. School of Medicine, University of Glasgow, UK, from February to July 2011. Used a constructivist approach, a purposive sampling technique was applied to interview those faculty members who were associated with the assessment of professionalism. A total of eight faculty members were interviewed, and the data was analysed thematically. The learning outcomes are assessed in both formative and summative examinations but the focus is mainly on formative assessments. Both objective and subjective assessment instruments are used, although qualitative assessment instruments evaluate the topic with greater validity. Some of the assessment instruments are used formatively as well as summatively. The assessment of professionalism is a multidimensional activity. Both formative and summative assessments together with an 'assessment for learning' strategy can be used with great effect. Here the role of formative assessment and 'assessment for learning' are more significant as they are a continuous process and their frequency and feedback will make a profound impression on students.