[Impact of a communication skills audiovisual package on medical students' knowledge]

Over the last decade more emphasis is being put on teaching communication skills [CS]. Use of videos and role-play was suggested to improve CS. This article will present the impact of an audiovisual package on promoting the knowledge of medical students in CS. Seventy-five second year medical students - distributed into eight groups led by four facilitators - critiqued a video clip immediately before and after the introduction of a communication skills audiovisual package. The skills taught included opening the interview, questioning, facilitation, clarification, reflection, confrontation, summarizing, and preparation of the patient for the physical exam. The students, also, role-played the reviewed scenario. The students' pre- and post-intervention responses were analyzed using a standardized grading form. There was a significant improvement in students' knowledge [p < 0.000] after the introduction of the intervention in all the CS taught except closed ended questioning. This improvement was consistent among the four facilitators. Reviewing video scenarios and role-playing improved the knowledge in core communication skills among second-year medical students assessed by a video-based written examination

[Focus groups findings reveal barriers to teach communication skills to medical students]

In December 2002, 74 medical students in the second preclinical years at the American University of Beirut [AUB] attended a workshop on basic communication skills [CS]. The students watched video clips which demonstrated different communication skills and stages of the consultation, and role-played to try out ways they could improve the consultation. Their familiarity with the skills taught was assessed at the beginning of the workshop, immediately afterwards, and again six months later. There was a significant improvement noted immediately after the intervention but this apparent gain was lost at six months. Sixteen students, who attended the workshop, also attended two focus group discussions which were aimed to assess student recall of the communications skills workshop, and explore ways in which the students thought the knowledge gained could be maintained. In general students thought that lack of exposure to patients at the time when the CS course was held, and a lack of consistency in CS coupled with poor faculty CS role modeling hindered their ability to maintain and practice good CS. Teaching CS may be more effective if medical students are taught these skills when they are exposed to patients on a regular basis, and the training is maintained throughout the clinical years. However, more emphasis should be on reminding faculty members of their role as teachers and good communicating role models to students through workshops and seminars

Prevalence of hepatitis B in a presumably healthy Lebanese population

Policy makers need data on the prevalence of infection with HBV in order to determine the cost effectiveness of universal immunization against hepatitis B. This study aims at determining the prevalence rate of infection with HBV in a basically healthy group of Lebanese adults. Sera from 2634 presumably healthy Lebanese individuals, mean age 32.1 years, obtained between 1995-1997, were tested for hepatitis B surface antigen [HBsAg]. The sample was composed of subjects residing in different areas in Lebanon. Detection of HBsAg was performed utilizing the ELISA technique. The analysis took place in the Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Chi-square test was used to examine statistical associations. The prevalence of HBsAg among the samples was 1.6%. Blue-collar employees, smokers and those living in the South of Lebanon were significantly more likely to be infected with hepatitis B virus. The data presented indicates that Lebanon has a low prevalence of HBV infection. Cost-effective studies are needed to justify universal immunization against hepatitis B especially in countries where budgets are tight

List of essential drugs for primary care in Lebanon

In 1966, Lebanon had around 19,000 drug formulations registered in the Ministry of Public Health. The government decreased that number to 5400 in 1992 through numerous interventions. In 1995 and in an effort to rationalize drug prescribing, the Lebanese government organized an ad hoc committee of medical and pharmaceutical experts to review the 1992 list and create a list of essential drugs for primary care [LEDPC]. This report describes the process and the studies used to update the 1992 list by the ad hoc committee

Chest pain evaluation

Chest pain is one of the frequent complaints in patients presenting to emergency rooms and ambulatory care clinics. For the primary care physician evaluating these patients, there are three essential steps in the evaluation of chest pain. The first step is to determine whether the chest pain is cardiac in origin or not. If the pain is suspected to be cardiac, then the next step would be to determine if the chest pain is secondary to an acute coronary syndrome [acute myocardial infarction or unstable angina] that requires immediate referral to an emergency room to initiate therapy and admit to the hospital. If the pain is not considered to be due to an acute coronary syndrome, then we proceed with a systematic approach to try to determine the likelihood that a particular patient has significant coronary artery disease [CAD]. This is determined based on the patient's history, risk factors and electrocardiogram. Once the likelihood is assessed, this will determine what further invasive or non-invasive tests would be required to complete the patient's evaluation