PERCEPTION OF FIRST YEAR MBBS STUDENTS TOWARDS ECE (EARLY CLINICAL EXPOSURE) IN PHYSIOLOGY.

Introduction : Early Clinical Exposure is a teaching learning method which enables student to learn basic sciences effectively and retain the information which bene?ts patient and promotes better patient care. Hundred students selected after applying inclusion exclusion criteria divided into 2 groups A and B taught Methodology : basal ganglia and thyroid physiology in conventional method and other in ECE integrated method respectively and after interchanging groups, demonstrating the clinical features of parkinsonism and hypothyroidism for ECE group. A pretest and post-test were conducted preceding and following lecture in both settings. The results obtained were interpreted using Results : excel. The mean of pre-test marks for Traditional teaching and ECE integrated teaching are 5.62±2.42 and 4.58±2.33 respectively and the post-test scores of Traditional and ECE teaching are 10.62±2.52 and 12.8±2.46 respectively. Discussion : Majority considered that the synchronisation of classroom learning with clinical experiences was bene?cial, and the majority believed that integrated teaching improved understanding of the practical applications of physiology. Through Conclusion : this study we conclude that ECE integrated teaching is more effective in imparting knowledge in ?rst MBBS students as the gap of imagination was bridged by live demonstration with help of patient which is re?ected in the Likert scale and in the scores. Though the ECE integration is a tough job for the teacher, it is a great learning tool for students.

Effectiveness of self-directed learning in physiology-students’ perspective

Background: Self-directed learning (SDL) is an important adult learning educational approach where the learner makes all the effort to study on his own with or without the help of a facilitator. SDL gives the learner greater autonomy and freedom over his own learning process. Aim and Objectives: (1) To compare lecture-based and SDL methodologies using pre-test and post-test on 1st year MBBS students in physiology. (2) To know the effectiveness of SDL methodology sessions from a student’s perspective using questionnaires. Materials and Methods: The present study was conducted among 1st year MBBS students in the Department of Physiology. After taking ethical clearance from the institutional ethical committee, total of 150 students were divided into two groups comprising 75 each. Each group attended two sessions of SDL and lecture where pre-test and post-test was given in the form of MCQs. Pre-test and post-test scores of each session were compared. Student’s perspectives about SDL were assessed via questionnaires. Data entry and analysis were carried out using Microsoft excel datasheet and SPSS software (Ver. 22). The test of significance for paired data was done using Wilcoxon Signed rank test. Results: In our study, it was found that the mean value of the post-test scores of SDL group were greater than that of the lecture session. Majority of students perceived the SDL sessions to be more effective. It helped them know their objectives and proactively establish their learning goal. Conclusion: SDL sessions are more effective than lecture sessions in teaching physiology to 1st year MBBS students. It ensures that the learner becomes more independent, which is a highly desirable trait for a medical graduate.

Efectividad de intervención de enfermería en conocimientos sobre prevención de caídas en ancianos que la experimentaron / Effectiveness of a Nursing Intervention regarding Knowledge about Falls Prevention in Elderly Affected by Such Events

Introducción: El conocimiento sobre prevención de caídas resulta indispensable en la reducción de su incidencia en ancianos, la intervención de enfermería puede ser la vía para lograrlo. Objetivo: Evaluar la efectividad de una intervención de enfermería sustentada en el modelo de Jean Watson en el nivel de conocimientos sobre prevención de caídas en ancianos que la han experimentado. Métodos: Investigación cuantitativa, pre-experimental con pre-test y post-test, contextualizada en 37 consultorios del Policlínico "Dr. Rudesindo Antonio García del Rijo", provincia Sancti Spíritus, Cuba, del 2018 a 2019. Universo conformado por 42 ancianos que presentaron caídas en el último año. El conocimiento se midió con encuestas validadas por expertos y pilotaje con alfa de Cronbach > 0,5. Para los ejes temáticos y metodológicos de la intervención (sustentada en los 10 factores asistenciales de la teoría de Jean Watson), se revisó bibliografía sobre el tema, se tuvieron en cuenta las necesidades de conocimiento identificadas. Se procesó la información con frecuencias absolutas, porcentajes, media, desviación típica, valor mínimo y máximo. Para contrastar la hipótesis se utilizó la Prueba no paramétrica de rangos con signo de Wilcoxon. Resultados: Previo a la intervención, el nivel cuatro de conocimiento lo presentó el 9,52 por ciento de los ancianos, aplicada la intervención ascendió al 90,47 por ciento, con significación z = -5,249, p < 0,05. Conclusiones: La intervención de enfermería sustentada en el modelo de Jean Watson resultó efectiva en el incremento del nivel de conocimientos sobre prevención de caídas en ancianos que la han experimentado(AU)

Introduction: Knowledge about falls prevention is essential in reducing incidence in the elderly; nursing intervention may be the way for achieving it. Objective: To assess a Jean Watson's model-based nursing intervention's effectiveness in the level of knowledge about falls prevention in the elderly who have experienced it. Methods: Quantitative and pre-experimental research with pre-test and post-test, contextualized in 37 family medical offices belonging to Dr. Rudesindo Antonio García del Rijo Polyclinic (Sancti Spíritus Province, Cuba), and carried out from 2018 to 2019. The universe was made up of 42 elderly people who had falls in the last year. Knowledge was measured with surveys validated by experts and piloting with Cronbach's alpha higher than 0.5. For the thematic and methodological axes of the intervention (based on the ten care factors of Jean Watson's theory), the bibliography on the subject was reviewed, as well as the identified knowledge needs were taken into account. The information was processed with absolute frequencies, percentages, mean, standard deviation, as well as with minimum and maximum value. The Wilcoxon's signed rank test was used to test the hypothesis. Results: Prior to the intervention, level four of knowledge was shown by 9.52 percent of the elderly. Once the intervention was applied, it amounted to 90.47 percent, with significance of -5.249 and P < 0.05. Conclusions: A nursing intervention based on Jean Watson's model was effective in increasing the level of knowledge about falls prevention in the elderly who have experienced it(AU)

Mental Health First Aid Training: A Study of Community Members’ Pre and Post-training Responses to a 17-Item Questionnaire

Background:Mental Health First Aid, an important component of metal health educational programs, targets naive community members, public, allied mental health personnel, and mental health experts with specific reference as to how these trained aiders should help people in crisis or with mental health conditions in the community.Objective:This study aimed to describe pre-to-post-test assessment of those who were trained in MHFA program.Setting: National Center for Mental Health Promotion, Riyadh, Saudi Arabia.Methods:Trained mental health professionals organized MHFA courses (n=35) for training self-selected, nonrandomized community members (n=862) who were assessed pre-to-post training by using an adapted 17-item questionnaire for measuring the impact of MHFA course on their mental health knowledge, perception, attitude and practice.Results: The participants’ responses to questionnaire were varied at pre-and post-test evaluation and 65% of them showed mild to significant positive changes in their responses, and the rest were not affected positively after this course, possibly attributed to multiple factors related tonaïve community trainees, advanced questionnaire, short timeline and dissimilar instructors.Conclusion: Although all participants well received the MHFA courses, 65% of participants’ pre-to-post-test responses improved positively. The preliminary results of this studyarenot generalizable to the whole community,need to be cautiously interpreted and this research is calling for more studies especially randomized controlledtrials in future.

Assessment of training need and training efficacy for national program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke among medical officers of West Bengal, India

Background: The national program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS) has been rolled out in West Bengal, with its implementation initiated through state-wide training of Medical Officers (M.O). For attaining requisite competency for meeting NPCDCS objectives, MOs have been trained at their respective district levels. Present study aimed to assess the training need, training efficacy and need for further training.Methods: A repeat cross-sectional study was conducted from May-July 2018 for M.Os of six randomly chosen districts of West Bengal, out of those whereat NPCDCS was launched in first phase. 40-45 M.Os were randomly selected from each district in liaison with district level health authorities. The total sample size was 352 with Finite population correction. On the days of training, pre and post training surveys were conducted with an identical semi-structured, pre-tested and validated questionnaire (Cronbach’s alpha >0.8) covering different levels of cognitive domain, with a maximum possible score of 100 marks. No negative marking was done for incorrect responses. Training was imparted by the Principal Investigator (accredited trainer). Ethical clearance was granted by the State Health Directorate. Informed consent from each participant was obtained.Results: Dependent sample t-test revealed significant increment (p<0.0001) in post-test scores (t=63.134) & one-way repeated measure general linear model (GLM) also revealed F=29.617 (p<.0001). The “Effect Size” was classified as “Huge” (Cohen’s D=63.134/√(352)= 3.365), as was noted between pre-test and post-test scores, based on Cohen’s convention and Sawilowsky’s addition. It was further noted that even after six hour training sessions there was 27.44% knowledge gap (p<0.0001) after adjusting for Bonferroni.Conclusions: Imperativeness of training coupled with periodic refresher training has been established as a pre-requisite for successful implementation of NPCDCS.

A study to assess the effectiveness of training on first aid among students of industrial training institute in tribal area of Thane district, Maharashtra

Background: Sudden illness, injury or animal bites can often be serious unless proper care is administered promptly. First aid is immediate attention to one suffering from illness or injury. Everyone should be able to give effective assistance until an injured person can receive professional medical care. This study was undertaken with objectives of assessing the baseline knowledge among students of industrial training institute (ITI) about common health emergencies, their appropriate first aid measures and to conduct training on first aid through lecture and demonstration as well as to assess effectiveness of training on their knowledge about first aid.Methods: An Interventional study. Baseline and post-test assessment of knowledge scores was carried out after a week and 16 weeks of training sessions on first aid of all students in the institute. Data analyzed by SPSS software using descriptive statistics and appropriate statistical tests of significance.Results: Baseline knowledge about first aid in injuries and bites was higher among students than their knowledge about burns and other emergencies. Rural students and students of scheduled caste and tribe had low baseline knowledge (p=0.015 and p=0.025 respectively). Training on first aid significantly improved knowledge about all health emergencies among all students as evident from post-test scores at first week and 16 weeks (p<0.05). Gain in knowledge was significantly higher among rural students.Conclusions: Students had low baseline knowledge about first aid measures. Sessions combining knowledge and skills have brought about significant improvement in the knowledge of participants irrespective of their age, caste or urban-rural background.

Importancia del cálculo de la sensibilidad, la especificidad y otros parámetros estadísticos en el uso de las pruebas de diagnóstico clínico y de laboratorio / Importance of calculation of sensitivity, specificity, and other statistical parameters in the use of clinical and laboratory diagnostic tests

Resumen: la elección de una prueba a realizar para un paciente, así como su interpretación, es un escenario diario al cual el médico se debe enfrentar y para el cual debe aplicar su juicio crítico basado en las evidencias informadas. Es común que cuando se habla de una prueba de diagnóstico clínico o de laboratorio se describan parámetros como la sensibilidad, la especificidad y los valores predictivos positivos y negativos. Estos reflejan las características de una prueba diagnóstica y sirven para decidir en qué momento se deben utilizar (sensibilidad y especificidad de una prueba) o qué significado tiene el resultado de una prueba en un paciente en particular. Cuando se trata de comparar estos parámetros en diferentes pruebas y optar por la que es de mayor utilidad en el diagnóstico de una enfermedad determinada, es indispensable que el médico conozca y aprenda cómo se obtienen estas medidas y cuál es su interpretación para decidir la conducta más apropiada para el paciente. El objetivo de la presente revisión es ofrecer los conceptos estadísticos básicos y simples para la comprensión y aplicación de las pruebas de diagnóstico clínico y de laboratorio. (AU)

Abstract: The selection of a test to request a patient as well as their interpretation is a daily scenario in which the physician must deal and apply his critical judgment based on the reported evidences. It is common that when talking about a clinical or laboratory diagnostic test, parameters such as sensitivity, specificity and positive and negative predictive values are described. These parameters reflect the characteristics of a diagnostic test and serve to decide when should be used (sensitivity and specificity of a test) or what is the meaning of a test result in a particular patient. When it is necessary to compare these parameters in different tests and opting for the most useful for the diagnosis of a particular disease, it is essential that the physician knows and learns how these measures are obtained and their interpretation to decide the most appropriate behavior for the patient. The objective of the present review is to provide basic and simple statistical concepts for the understanding and application of clinical and laboratory diagnostic tests. (AU)

Effectiveness of Manikin Demonstration over Conventional Lectures for Teaching Shoulder Dystocia.

Background: Shoulder dystocia management necessitates a sound knowledge in diagnosis and applications of appropriate maneuvers. Conventionally this topic is taught with lectures in our institution. Objectives: 1. To compare the effectiveness of manikin demonstration to didactic lecture in teaching shoulder dystocia to undergraduate students. 2. To assess the attitude of students regarding inclusion of demonstrations sessions with manikin to their teaching schedule. Methods: This comparative study was conducted on 60 students attending their 8th semester posting in OBG in Kannur Medical College. Students were divided in to two batches, one receiving a didactic lecture class and the other a manikin demonstration on shoulder dystocia, following which a posttest evaluation was carried out with MCQs. The next day students were crossed over and classes taken using the two methods following which feedback from students were obtained and analyzed. Results: The posttest scores revealed that the group taught by manikin demonstration scored better when compared to the batch taught by lecture which was statistically significant. Feedback analysis showed that all students found manikin demonstration a more interesting method and majority felt this was the better method and helped in understanding the maneuvers. Peer opinion was that though manikin demonstration was more interesting, theoretical aspects could be better covered by a lecture and hence should be used as a complementary method to lecture. Conclusion: Manikin demonstration was more effective in teaching shoulder dystocia when compared to conventional lectures and was also associated with better learner satisfaction.

Case Based Learning in Undergraduate Pathology A Study to Assess its Efficacy and Acceptability as Teaching-Learning Tool

Background: An innovative paradigm, of teaching-learning (TL) method, like Case Based Learning (CBL) in a paraclinical subject like Pathology is considered essential, which would bring about learning of pathological and clinical features of diseases in an integrated easy manner, resulting in growing of interest in undergraduate medical students to learn pathology with better retention of knowledge. Aim: To evaluate the efficacy of CBL as a TL method in Pathology and to assess perception of students and teachers to CBL. Materials and methods: Study involved 86 students from 2 nd professional MBBS course. Two common diseases viz. microcytic hypochromic anemia and pulmonary tuberculosis were taught in two phases respectively. Students were equally divided into two large groups of 43 each – Didactic lecture (DL) and CBL groups. DL group was taught with conventional DL by Pathology-faculties and CBL group was taught with CBL tool jointly by pathology and relevant clinical faculties. Teaching method was interchanged between large groups for two diseases. Pretest and post-test were conducted before and after intervention (DL/CBL) respectively. In addition, to test for knowledge retention one late post-test was also conducted in 2nd phase. Lastly, students’ and teachers’ feedbacks on perception to CBL were obtained

Questionnaire based assessment of teaching effectiveness during a lecture series on pharmacotherapeutics.

Background: Lecture is a widely accepted method of teaching & learning. It provides more of surface learning and covers larger text in specified time. However it has a disadvantage that there is no assessment about the extent of knowledge learner receives. Hence, we designed a daily questionnaire based evaluation technique. Methods: Without disclosing the topic, second year MBBS students (mean n=23) after learning from lecture series in Pharmacology, participated voluntarily to a questionnaire based task on eight therapeutic lecture topics. They wrote answers separately in 5-10 minutes before, and after delivery of text without referring to notes i. e. pre-test & post-test. Papers were valued on score basis, data recorded, interpreted and analyzed. Results: Mean acceptability (81.4%), mean improvement (94%), mean collective maximum score (96%), mean individual maximum score (92%) were observed. 85-100% participants out of total 184 in eight therapeutic lecture topics passed in post-test (None passing in Pre-test) reflected good improvement in cognitive structure. Conclusion: Performance in such tests provides feedback on teaching effectiveness, specificity & adequacy of knowledge gained by learners.

On the path of continual improvement: An evaluation of biomedical waste management training.

Microbiologists play a pivotal role in the prevention of infection both at hospital and community level. Biomedical waste management (BMWM) is one of the aspects of infection control. For the effective implementation of this, various training programmes have been conducted at our regional training centre. This study evaluates the impact of the BMWM training programme. Knowledge on all parameters was signifi cantly better at post-course evaluation for all the participants (P value 0.001). Evaluation of training is recommended to improve the effectiveness of training method.

Pretest scores rather than posttest scores correlate with term-end examination scores in medical education / 医学教育

  Pretests and posttests in the field of preventive medicine and public health were administered to third–year medical students of Shinshu University School of Medicine. This study aimed to determine whether pretest scores or posttest scores correlated with the term–end examination scores.<br>1）Pretests and posttests were administered 7 times to 112 third–year medical students, and the term–end examination was given in the first semester of the 2010 academic year.<br>2）Correlations were determined between pretest scores, posttest scores, the difference between pretest and posttest scores, and term–end examination scores. In addition, students were divided into quartiles in accordance with the pretest scores, and the posttest and term–end examination scores were compared among these quartiles.<br>3）The pretest scores significantly correlated with the posttest and term–end examination scores. The posttest and term–end examination scores were significantly higher in the fourth quartile（the highest pretest score quartile）than in the first quartile（the lowest pretest score quartile）.<br>4）The posttest scores did not correlate with the term–end examination scores.<br>5）Thus, we concluded that the pretest score rather than the posttest score is a useful predictor of the term–end examination score.

Evaluation of “Palliative care workshop for physicians engaged in clinical practice for cancer treatment held in Kyoto”

In Kyoto, we held the first “Palliative care workshop for physicians engaged in clinical practice for cancer treatment” in Japan on June 7-8, 2008 under the directive of the Ministry of Health, Labor and Welfare. There were 163 participants in the workshop, including 56 physicians and 107 voluntarily participating healthcare professionals (77 nurses, 23 pharmacists and 7 other medical professionals). We analyzed the results of tests consisting of 25 questions classified into 7 categories based on their contents. Tests were administered before and after the workshop (pre-test and post-test), and the educational effects of our conference were evaluated by examining changes in test scores. Participants other than physicians, nurses and pharmacists were excluded from analysis of the test scores because comprehensive medical knowledge was required to solve the questions. The mean rates of correct answers on pre- and post-test were 87.9% for physicians (total 78.9%) and 94.6% for physicians (total 89.1%), respectively. The scores were markedly increased after the workshop, showing practical significance of our attempt. However, the percentage of correct answers regarding psychological symptoms was lowest for physicians as well as for other healthcare professionals on both pre- and post-test. These findings strongly suggest that the workshops produced a sufficient educational effect, but improvement in individual training systems is considered necessary, especially in fields related to psychological manifestations. Palliat Care Res 2010; 5(2): 152-161

Impacto de curso de posgrado en la atención primaria de salud / Postgraduate course impact on primary health care

La certificación de las causas de muerte forma parte de los procedimientos médico-legales. Lograr una secuencia lógica de este proceso constituye un ejercicio legal, científico y administrativo de gran trascendencia. El presente estudio se realizó en el área de salud Boyeros en el mes de mayo de 2004. Se trató de una investigación transversal y experimental que tuvo como objetivo valorar la influencia de un programa de posgrado sobre la calidad de la confección del certificado de defunción en médicos de la atención primaria de la salud. La muestra quedó formada por 36 médicos, los que se dividieron en dos grupos, uno control y otro estudio o experimental con 18 médicos cada uno. A ambos se les aplicó una preprueba relacionada con las tres primeras causas de muerte en Cuba, donde se debía establecer la secuencia lógica. Al grupo estudio se le aplicó una posprueba luego de haber concluido el curso con cuadros clínicos similares y con igual nivel de complejidad. Se manifestó a través de medidas de tendencia central que ambos grupos tenían dificultades al aplicárseles la preprueba con similares porcentajes. En el grupo estudio se obtuvo un 72,2 por ciento de respuestas correctas en la posprueba, equivalente a una proporción de 6:1 con una ganancia de respuestas correctas de 22. Se demostró que el curso de superación y capacitación impartido elevó la calidad en lo referente a la certificación de las causas de muerte y procedimientos médico-legales

The certification of death causes is a part of the medicolegal procedures. To achieve a logical sequence of this process is a legal, scientific, and managerial exercise of transcendental importance. This study was undertaken in a health area of Boyeros municipality, in May 2004. It was a cross-sectional and experimental research aimed at evaluating the influence of a postgraduate program on the quality of the death certificate making among physicians at the primary health care level. The sample included 36 physicians, which were divided into two groups, a control group and a study or experimental group, with 18 physicians each. In both, a pretest was applied related to the three first causes of death in Cuba, where a logical sequence should be established. In the study group, a posttest was applied after the culmination of the course with similar clinical pictures, and the same level of complexity. Through measurements of central trend, it was demonstrated that both groups had difficulties with the pretest, and that percentages were similar. In the study group, 72.2 % of the answers were correct in the posttest, equivalent to a 6:1 ratio with a gain of right answers of 22. It was demonstrated that the upgrading and training course conducted increased the quality of the certification of the death causes and of the medicolegal procedures.

Effects of Nutrition Education on Nutrition Knowledge, Dietary Attitudes, and Food Behavior of College Students / 대한지역사회영양학회지

The purpose of this study was to investigate the effects of nutrition education on nutrition knowledge, dietary attitudes, and food behavior of college students. The subjects of this study were 350 college students attending a university. The education group students received nutrition education three hours per week during a 4-week period offered in a 'Home Economics' course. A total of 150 students in the education group and 200 students in the non-education group completed pre-test questionaires examining nutrition knowledge, dietary attitudes, and food behaviors. Major findings were as follows : nutrition knowledge, and food behavior of the education group were improved compared to the non-education group. But significant changes were not observed in dietary attitudes in the education group. There were higher correlations between nutrition knowledge and dietary attitudes score, and between dietary attitudes and food behavior score at the posttest than those at the pretest. These results suggest that nutrition education for college students can effectively improve their nutrition knowledge and food behaviors.