Team based learning [TBL] in undergraduate medical education

To determine if modified Team Based Learning [TBL] was more effective than Traditional Didactic Lecture [TDL] in improving knowledge outcomes about Diabetes management in fourth year medical students and to check the students' view about the TBL method in comparison with their earlier experience with TDL. A comparative study. Lahore Medical and Dental College, Lahore, from January to February 2011 in 4 weeks. Modification of the original TBL method as described by Michaelsen was done to accommodate the educational system. A total of 7 sessions were allotted to teach non-communicable diseases to fourth year MBBS students. Session which was scheduled for teaching Diabetes mellitus was conducted first by TDL and three weeks later with the TBL session. MCQ based tests were administered to self paired groups of students first after the TDL session and then after the TBL session. Wilcoxon signed-rank test was used to compare post-TDL and post-TBL test scores of the students. Students' views about the TBL session compared to the TDL session were checked by using pre-tested questionnaire. Seventy two, fourth year MBBS students participated in this TBL session. Majority were females 49 [68.1%]. There was improvement of test scores of students after the TBL session when compared to the test scores after TDL session [p < 0.001]. Majority of the respondents noted that TBL session was a better learning strategy compared to TDL. The 72 students included in the study achieved higher mean test scores on test questions that assessed their knowledge of Diabetes mellitus content learned using the TBL strategy compared with TDL method [p < 0.001]. TBL learning method was favoured by a majority of medical students compared to the TDL session

Medical students' perspective about role-plays as a teaching strategy in community medicine

To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine. A quasi-experimental study. Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010. A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at < 0.05 as significant. Sixty-three students were selected as participants of this study in which 46 belonged to the fourth year MBBS class [73%] and 17 were third year MBBS students [27%]. There were 13 male [20.6%] and 50 female [79.4%] students. Role-plays were identified as most effective method of teaching [n = 25, 37.9%] followed by lectures [n = 17, 25.8%, p = 0.054]. Fifty-two students [78.5%] admitted that role-plays improved their knowledge of the subject, 55 [84.6%] said that it will help them in their clinical performance. Fifty-nine participants [89.4%] found role-plays interesting and 49 [74.2%] wanted to incorporate role-plays as a part of curriculum. Fifty-six of the participants [88.9%] agreed that role-plays improved their communication skills. Twenty-one participants [31.8%] believed that it helped them in making acquaintance with the local situation. Forty-six students [76.7%] identified role-plays as a feasible way of andragogy [p = 0.005] and 48 [76.2%] said that it provoked critical thinking about the subject [p = 0.038]. Fifty-four students [85.7%] admitted that their attention span was better in role-plays as compared to lectures [p = 0.047]. Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine

Factors affecting medical specialty preferences and associated gender differences in fourth year MBBS students

To Identify factors affecting medical specialty preferences and associated gender differences in Fourth Year MBBS students. This was a Cross-sectional survey conducted on fourth year MBBS students of Lahore Medical and Dental College through a Preformed Structured questionnaire by non probability sampling technique. The student were told that the survey was voluntary and were given a choice of refusal but fortunately all the students in the class participated in the survey [n=120]. Data was collected during January 2009. Data was analyzed using SFSS v. 16.0. Descriptive statistics were computed, and the relationship between specialty preference and categorical variables [gender, reasons for choosing a particular specialty] were evaluated using Pearson Chi square test. A calculated p value of

Medical education: views and recommendations by final year MBBS students of a private medical college in Lahore

To obtain the views and recommendations of final year MBBS medical students of Lahore Medical and Dental College, Lahore about various aspects of the current medical education. Cross-sectional survey. Lahore Medical and Dental College, Lahore in October and November 2007. Preformed close ended structured questionnaire regarding medical teaching and evaluation methods and recommendations was used to collect the data from students of final year MBBS [n=120] at Lahore Medical and Dental College. SPSS 15 program was used for analysis. Data was presented as frequency percentages. A majority of the students [79%] thought that multimedia was the most effective teaching tool, [54%] students viewed 45 minutes as ideal lecture duration. Measures suggested to improve the examination results were regular tests [54%], improved lecture content [32%] and regular tutorials [10%]. MCQ's were the mode of examination questions preferred by 62% of students. Recommendations given by students for improving the current medical education were better teaching [26%] followed by increased motivation in students 54 [16%] and more hands-on training/practical field work [12%]. Medical students in this study preferred multimedia, lecture duration less than 45 minutes and MCQ's as their preferred mode of evaluation. Students recommended increased emphasis on better lectures, increasing learning motivation in students and more hands on training/practical field work to improve current medical teaching

Reasons for selection of nursing profession in Pakistan

Nursing is the backbone of health care delivery system. There are various factors which influence the choice of selecting nursing as profession. [1] To find out the socio demographic profile of nurses working at Ghurki Trust Teaching Hospital [GTTH] Lahore. [2] To explore the reasons for selection of this profession. A cross sectional descriptive study. From October 2009 to January 2010. GTTH, Lahore. All the nurses working in Ghurki Trust Teaching Hospital, Lahore are included in this study and their responses are obtained with a self administered questionnaire. A total of 77 nurses participated in our study. The age distribution of these nurses has shown that a large number of nurses, 49 [63.6%] belonged to age group between 20 to 30 years. There were 26 [33.8%] nurses who had done B. Sc nursing. About 72 nurses [93.5%] have monthly income more than Rs.10.000. Majority of them, 48 [62.3%] are unmarried. 41 [53.2%] of the nurses selected this profession due to their own personal interest, 15 nurses [19.5%] selected this profession due to their parental influence. 12 nurses [15.6%] selected this profession for serving humanity. 9[11.7%] selected this profession to support their family. Approximately 25 nurses [32.5%] said that there are other family members working in the same profession. It was noted that out of these 25 nurses, 10 [40%] had their sisters in the same profession. Nursing forms the backbone of health care delivery system of a country. Decision makers in health sector need to understand that human resource development. Particularly nursing requires revolutionary changes. As public health policy makers, it is imperative that we investigate the reasons for selection of nursing profession to attract and retain these important partners in health care provision

Congenital heart disease: knowledge and myths in parents attending cardiology department of children hospital and institute of child health, Lahore

To assess the parental knowledge and myths related to etiology of congenital heart disease. A cross sectional descriptive study. Out patient department, indoor and echocardiography rooms of Children Hospital and Institute of Child Health [CH and ICH] Lahore, in two weeks of October, 2007. Convenient sampling technique was used to recruit 299 children between 1 month and 14 years of age, suffering from congenital heart disease. Cases of rheumatic fever and associated congestive cardiac failure were excluded from the study group. A structured questionnaire was used to interview parents of the study group. Descriptive statistics was determined in terms of percentages. Out of total 299 patients included in this study, 132 were in the age group of 1 -5 years [44%], with the mean age 1.86 years +/- 0.886 SD. 200 were males [67%] and 99 were females [33%]. The respondents included 71% mothers and 27% fathers. Ventricular septal defect [VSD] was the most common disease encountered in 128 children [43%], Regarding the causes of congenital cardiac defects, parents blamed cousin marriage [41%], inheritance [26%], increased maternal age [16%], maternal smoking [16%] and paternal smoking [39%]. Other responses included evil spirits, moon and sun eclipses and bad wishes/evil I eye. 57% of the respondents said that there is no relationship between gender and congenital cardiac malformation and 85% respondents believed that there is no relation with the food taken in pregnancy and subsequent cardiac defects. High Salt intake was considered as an associated factor by 47 [15%] of the respondents. Naming the cause of cardiac malformations, 41% of the parents said drugs taken in pregnancy, 13% of the respondents blamed alcohol, cocaine and opium intake. Among parents, 73% were aware of the fact that maternal health is important for disease causation in neonates but could not name any particular disease. The parents of those children, who have congenital malformation, have different myths and fallacies associated with disease causation. Adequate health education strategies should be adopted towards mass dissemination of information in the community about this important issue

Selection of medical profession by first year medical students

The factors which influence medical students' selection of specific medical specialties have been analyzed by a number of studies in the literature. However, very few studies have been carried out to ascertain the factors which influence students selection of the medical profession itself. The literature review did not identify any such study conducted in Pakistan, therefore this particular venture was undertaken. To establish a baseline of factors that affect student's decision in selecting medical profession and to determine if there was a significant difference in factor by gender. Lahore Medical and Dental College, between January and February 2009. The present study was a cross-sectional survey in which the first year MBBS class of Lahore Medical and Dental College, comprising ninety students were part of the study. Data was collected using a pre-formed structured questionnaire, which was pretested before adoption of the final version. The collected data was analyzed using version 16 of the statistical package for social sciences [SPSS]. Data is presented in the form of tables and figures. It is described in the form of frequencies and percentages. Inferential statistics were done using Fisher Exact test at 5% level, Among 90 respondents, 58 [64%] were females, 74 [82%] were between 18-20 years of age, 81 [90%] had their residence in Pakistan, 57 [63%] of the respondents' fathers and 26 [29%] of their mothers had attained postgraduate education. Of the respondents' parents, 29 [32%] of the fathers and 12 [14%] of the mothers belonged to the medical profession. All students taking two attempts at FSc/A-level/American high examination also took two attempts at the entry test to a medical college [p<0.001]. A large proportion 10 [59%], of students who attempted the entry test twice had fathers who were doctors. The popular reasons for selection of medical profession by the respondents included personal interest [89%], parental wish [58%] and a desire to serve humanity [41%]. Among the respondents 100% males had a personal interest in medical profession in contrast to 83% female respondents [p=0.012], 100% male respondents were influenced by parental wish compared to 34% females [p<0.001], 100% males in contrast to 9% females identified humanitarian concern [p<0.001] as factors influencing selection of medical profession. The prestigious status of the profession, parents being doctors, financial incentives, better career opportunities and a better chance to go abroad were the factors identified by only the male respondents as compared to the female respondents in influencing their choice of medical field [p<0.05]. The overall frequent choices for selection of medical profession included personal interest in the profession, parental wish and a desire to serve humanity. Whereas, parents being in the same profession, financial incentives, better career opportunities and the prestige associated with the profession were identified as motivating factors by only the male respondents

Smoking patterns

To determine the smoking patterns of medical students of 4th year MBBS. A cross-sectional survey. Lahore Medical and Dental College [LMDC], Lahore, Pakistan. From November to December 2006. The 50 medical students of 4th year MBBS, who were current smokers. A structured questionnaire was used to collect the data. Descriptive statistics was determined in terms of percentages. In present study, 48% students started smoking between 14-17 years of age, 34% started to smoke between ages 18-21 years and 18% of them had been smoking for past 4-6 yrs. Main reason to commence smoking included curiosity [27%], need to look glamorous [22%], peer pressure [16%] and stress relieving [10%]. When probed about numbers of cigarettes smoked daily, the response of majority was that 32% of students admitted to smoking 1 -5 cigarettes, similar number admitted to smoking 6-10 cigarettes, and 30% of students smoked more than 20 cigarettes. Among the respondents, 41% had a brother who was a smoker and 37% had a father who was a smoker. More than half the respondents [58%] said that their parents were unaware of their smoking habit. Regarding awareness about the medical hazards of smoking, 31% of students named cancer, 29% mentioned heart disease, 18% were familiar with COPD and only 7% referred to stroke. The main concerns of respondents regarding smoking were fear of being discovered by their parents [22%], psychological dependence [20%] and physical dependence [18%]. Only 50% of students tried to quit smoking, using hypnosis and substitutes like nicotine gum and nicotine patches. Tobacco smoking among medical students is alarming. These findings not only raise concerns for the future health of our medical students but also their credibility and effectiveness as health promoters for population at large

Diabetes mellitus; awareness among individuals attending out patient department of Ghurki trust teaching hospital

To assess the awareness of diabetes in individuals attending Out Patient Department of Ghurki Trust Teaching Hospital. Descriptive study design. Out Patients Department, Ghurki Teaching Hospital, Lahore. The study was conducted among a sample of 50 individuals, recruited by convenience sampling technique. Data was collected, by administering a structured questionnaire, during a two week period in December 2006. Data was presented in the form of tables and graphs. General Awareness of Diabetes Mellitus in the participants of our study was poor. Only 16% recognized it as a disease of the pancreas while 50% considered it to be a disease of other systems. Majority of the respondents [78%] had no idea about the types of the disease. When asked about the communicability of diabetes, 76% considered it to be non-communicable, 10% thought it to be communicable. Among the respondents, 78% thought diabetes is inheritable. When asked about its prevention, 54% considered avoiding sugar as the best way to prevent diabetes, while only 9% believed weight reduction to be important. Regarding the management of diabetes, 40% of respondents considered medication, 27% thought of diet modification as a better way, 18% considered exercise, while only 6% named weight reduction. The participants of the present study lacked awareness of types of diabetes, its mode of inheritance, its prevention and management

Immunization status; assessment of children between 1 - 3 years coming to OPD of children hospital and institute of child health, Lahore

To assess the immunization status of children between 1-3 years of age coming to the Children Hospital and Institute of Child Health, Lahore. Descriptive study. The study was conducted at OPD of Children Hospital and Institute of Child Health, Lahore. The data was collected in two weeks in December, 2006. Information was gathered from parents about the immunization status of 50 children and awareness of parents of these children about the vaccine preventable diseases, using a pre-tested questionnaire comprising of close ended questions. The results were presented in the form of tables and graphs. The data was collected for 28 male children [56%] and 22 female children [44%]. According to parents, 29 children [58%] were delivered at hospitals, whereas, 21 children [42%] were born at home. Maximum immunization was done at Government hospitals [47%]. About 40% of the children had their first immunization at the time of birth. Only 17% of the parents could easily recall vaccination of their children against polio, about 14% of parents could name pertussis, 13% of parents named tuberculosis, about 12% of parents could name hepatitis and measles, diphtheria was known to only 7% of parents and tetanus was named about 5% of parents. Among the parents, 18% could not answer this question. Nearly all the children [98%] had taken polio drops at home. The best source of information about immunization program was declared to be the health care providers [33%], mass media [23%], mother/mother in law [19%], and other family members [17%]. The present study concludes that 99% of children coming to OPD of Children Hospital were immunized for Polio, despite the lack of awareness among parents about vaccination against other communicable diseases. The best source of information about immunization was the health care providers, mass media and family members

Prevention of hepatitis B; knowledge and practice among first year MBBS students

To assess the knowledge and practice of first year MBBS students, for the prevention of Hepatitis B. Descriptive study. The study was conducted at Lahore Medical and Dental College. Lahore. The data was collected in two weeks in December, 2006. A total of 50 students were recruited using a non probability random sampling technique, through the lottery method. A pre-tested structured questionnaire was administered to collect information about the knowledge and practice of students about the prevention of hepatitis B. Data was presented in the form of simple tables and graphs. Out of 50 students, majority [96%] responded that it was a disease of liver. Regarding knowledge about the communicability of Hepatitis B, 78% said it was communicable, 19% assumed that it was water borne. Other responses included spread via blood transfusion [28%], through use of injection [21%], close physical contact [8%] and un-hygienic conditions [18%]. For prevention of Hepatitis B, the more common responses were, provision of clean water [24%], improvement in hygiene [27%], restriction to single sex partner [6%], avoidance of sharing syringes and needles [19%], screening blood before transfusion [9%] and vaccination [15%]. The high risk group was identified as the poor people living in unhygienic conditions [34%], surgeons [32%], barbers [12%], Intravenous drug users [8%], recipient of blood transfusion [6%] and uneducated people [6%]. Only 1 respondent [2%] said that sex workers could be at risk of getting this disease. When inquired about their vaccination status, 66% of students admitted to have been vaccinated against Hepatitis B, while 34% of have not been vaccinated. The present study concludes that there is lack of awareness among the medical students entering into the profession about the hazards of Hepatitis B, its routes of spread and its modes of prevention. Similarly, all the students were not vaccinated against Hepatitis B, which made the m very vulnerable to this disease