Perceptions of clinical clerks and interns of the University of the Philippines College of Medicine towards physical and rehabilitation medicine as a medical specialty

Objectives@#Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients. @*Methods@#This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis. @*Results@#Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited. @*Conclusion@#Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.

Continuing care through telerehabilitation for patients in a COVID-19 referral center in the Philippines: A case series

@#In April 2020, the Department of Rehabilitation Medicine (DRM) of the University of the Philippines - Philippine General Hospital (UP-PGH) transitioned to a telerehabilitation program called ITAWAG, an acronym for Introducing Telerehab As a Way to Access General rehabilitation medicine services. This was in response to the designation of UP-PGH as a COVID-19 referral center and the abrupt closure of all its in-patient and out-patient rehabilitation services. Eleven previous in-patients and out-patients with musculoskeletal and neurologic impairments continued their rehabilitation programs remotely, either through a phone call or video call. Their clinical outcomes and the implementation of the ITAWAG program were monitored to determine the effectiveness of an offsite continuing care program. Using the Clinical Global Impressions-Severity (CGI-S) scale, eight patients had a reduction in the severity of their illness, while the remaining three clients had no change. Feedback surveys showed that most clients and caregivers (68%) and health providers (77%) were satisfied with the program's implementation and its outcome. A frequent complaint was the poor phone reception and internet connection. As threats of a COVID-19 outbreak continue, telerehabilitation gives patients a safe, affordable, and convenient alternative for follow-up and continuity of care in medical rehabilitation. Integrating the ITAWAG program into the initial facility-based rehabilitation management can enhance its value in optimizing functional gains and resolving its shortcomings.

Knowledge, skills, and attitudes of faculty members and residents-in-training of the Department of Rehabilitation Medicine of the Philippine General Hospital towards virtual learning: A cross-sectional study

Background and Objectives@#Virtual learning has been utilized in residency programs to continue training amid the COVID-19 pandemic. This study aimed to determine the knowledge, skills, and attitudes of faculty members and residents of the Department of Rehabilitation Medicine of the Philippine General Hospital towards virtual learning. @*Method@#This is a descriptive cross-sectional study. Respectively, residents and faculty members answered the Online Learning Readiness Scale (OLRS) and Faculty Readiness to Teach Online (FRTO) through Google Forms. @*Results@#Twenty (20) residents and 19 faculty members participated in the study. The majority of the residents preferred asynchronous learning (50%), while faculty members preferred the hybrid mode (74%). Residents’ readiness for online learning was generally high, though problems with easy distractibility (60%) and time management (40%) were revealed. Female residents had higher online communication self-efficacy compared to males (p = 0.0367). Faculty members’ perceived attitude was significantly higher than ability in course design (p = 0.00102), time management (p = 0.00159), and technical competence (p < 0.0001). Males had higher perceived ability in course design (p = 0.0320). Older age groups had lower perceived abilities in course design (p = 0.0301) and technical competence (p = 0.0371). @*Conclusion@#This study revealed the levels of readiness of residents and faculty for virtual learning. Finding indicate the need to address both issues by developing programs to enhance faculty’s online teaching abilities and observing best practices to minimize problems such as distractibility. Large-scale studies with longer time frames are also recommended.

Evaluating the usability of the expanded telerehabilitation program implemented by Philippine General Hospital during the COVID-19 pandemic: A cross-sectional study

Background@#The Department of Rehabilitation Medicine of the University of the Philippines-Philippine General Hospital (UP-PGH) established its telerehabilitation service program in 2017. The program previously catered to patients in a partner rural community by providing teleconsultation and teletherapy over a distance. With the unprecedented coronavirus disease 2019 (COVID-19) pandemic, the program has expanded its service to outpatients previously managed face-to-face by the department, regardless of location. @*Objectives@#This study aimed to evaluate the usability of the telerehabilitation service program at UP-PGH when it was expanded during the pandemic and to associate telerehabilitation usability ratings with the participant groups, demographic characteristics, and prior telemedicine knowledge and experience. @*Methods@#This cross-sectional study involved the doctors, physical therapists, occupational therapists, psychologists, patients, and patients’ carers, who participated in at least one telerehabilitation session and consented to respond to a digital survey thereafter. Total enumeration sampling of all telerehabilitation participants was employed. The study outcome was the usability of the expanded telerehabilitation program based on the System Usability Scale (SUS) benchmarked at 68. Descriptive and inferential statistics were done at a 95% confidence interval. The participants’ responses to open-ended questions regarding telerehabilitation experience and recommendations were also presented. @*Results@#The participants consisted of 19 doctors, 11 therapists, 37 patients, and 74 caregivers. The majority of the participants were female and lived in urban areas. The primary online telerehabilitation platforms used were Viber™ and Zoom™. The mean of overall SUS scores was below average for health providers [doctors (mean = 61.71), therapists (mean = 67.73)]; and above average for end-users [patients (mean 74.56), and carers (mean = 71.89)]. There was a significant difference in the overall SUS scores between doctors (mean: 61.7) and patients (mean: 74.6), p<0.05. In terms of videoconferencing platform, participants reported significantly higher system usability for those who used either Zoom™ (mean: 75.0) or Viber™ (mean: 69.3), as compared to Google Meet™ (mean: 53.1), p<0.05. There was no significant difference in the overall SUS scores across sexes, places of residence, primary telerehabilitation techniques used, prior telemedicine knowledge, and experience. The majority viewed telerehabilitation as a valuable method to provide service during the pandemic, but they were mostly concerned with technical problems, particularly an unstable Internet connection. @*Conclusion@#The expanded telerehabilitation service program of the PGH was perceived as useful by patients and caregivers but not by the health providers. While the program succeeded in providing continued outpatient rehabilitation services during the pandemic, the challenges experienced by its telehealth providers must be investigated and addressed.

Readiness and acceptance of Philippine General Hospital Medical Staff for Telemedicine as alternative method of patient consultation during the COVID-19 pandemic and post-enhanced community quarantine period

Introduction@#The coronavirus disease 2019 (COVID-19) pandemic prompted a shift from standard in-person consultation to non-patient contact methods such as telemedicine. To our knowledge, there was no published a priori evaluation of the telemedicine readiness and acceptance among the medical staff of the Philippine General Hospital (PGH) before implementing the institution’s telemedicine program. The lack of this vital pre-implementation step is understandable given the unprecedented crisis. However, if telemedicine programs will continue in the post-quarantine period, it is crucial to determine the facilitators and barriers to the use of telemedicine. @*Objective@#This study determined the level of readiness and acceptance for telemedicine as an alternative method for patient consultation during the COVID-19 pandemic and post-enhanced community quarantine period among PGH medical staff (consultants, residents, fellows). @*Methods@#The cross-sectional study was conducted from October 2020 to July 2021. Medical staff from the 16 clinical departments of the PGH were selected by systematic random sampling. Inclusion criteria included appointment as medical staff in PGH or University of the Philippines College of Medicine (UPCM), voluntary informed consent, internet access, and technical capacity to access e-mail and SurveyMonkey™. The online survey consisted of two questionnaires. It collected data on the demographic profile and outcomes of interest (e.g., telemedicine readiness and acceptance). Technological readiness was determined through the 16-item modified version of Technological Readiness Index (TRI) version 2.0, while telemedicine acceptance was determined through the modified version of the 19-item Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Descriptive and analytical statistics were performed at a 95% confidence interval. @*Results@#The study had an 87% response rate with 205 respondents, 62% of whom were physicians in training (resident physicians and fellows). The respondents had a median age of 33 years and were mostly males. Only 19% had telemedicine experience before the pandemic. The majority (51%) learned telemedicine on their own. The most common devices used for telemedicine were mobile or smartphones (53%) and laptops (38%). The primary source of internet for telemedicine was mobile broadband (e.g., cellular data) (40%). The majority practiced telemedicine at their home or residence (51%), followed closely by the hospital or clinic (47%). The mean score of the respondents on TRI was 3.56 (very good technological readiness), and 4.00 (very good telemedicine acceptance) on UTAUT (behavioral intention to use the system). Performance expectancy (p = 0.02), effort expectancy (p = 0.03), and self-efficacy (p = 0.02) were significantly directly related to telemedicine adoption, while anxiety (p = 0.03) was significantly inversely related. @*Conclusion@#The PGH medical staff were found to have very good telemedicine readiness and acceptance. This suggests a willingness to use telemedicine during the pandemic. Further studies on the organization and technical support system of the telemedicine program in the PGH are strongly recommended. The quality and efficiency of the program will strongly influence the continued use of telemedicine by the medical staff even after the pandemic.

Rehabilitation for COVID-19 Early Functional Return (RECOVER): Ensuring delivery of Inpatient rehabilitation services for patients with COVID-19 in a low resource setting

@#Early into the pandemic, medical attention centered on the immediate need for intensive medical care of patients diagnosed to have coronavirus 2019 (COVID-19). As more data emerged on the best medical care possible, attention was also given to the complications and long-term sequelae of COVID-19.

Predictors of poor academic performance among the medical students of the University of the Philippines College of Medicine

Background@#Despite the rigorous and extremely competitive selection process of medical students at the University of the Philippines College of Medicine (UPCM), a few still performed poorly in academics that resulted in delayed graduation or failure to graduate at all. @*Methodology@#Factors potentially associated with delayed graduation and failure to graduate among UPCM medical students were analyzed using univariate and multivariable logistic regression with their demographic and pre-admission academic profiles, namely, Pre-medical General Weighted Average Grade (PGWAG), National Medical Admission Test Scores (NMATs), interview scores, pre-med courses, the school graduated from, and admissions categories as predictors. @*Objective@#The objective of this study was to identify the factors that predict the likelihood of not graduating and delayed graduation among the medical students of 24 classes of the UPCM. @*Results@#The odds of delayed graduation and failure to graduate were increased by lower PMGWAG, NMAT score, interview score, admission through the special categories, being a non-UP graduate, and with BS Psychology as pre-med course. @*Conclusion@#The predictors of poor academic performance based on delayed graduation and failure to graduate were the PMGWAG, NMAT, interview scores, admissions category, pre-med course, and the school graduated from. It is recommended that the minimum admissions requirements for PMGWAG be increased particularly among the candidates in the special categories. The selection process in the special categories must put some bearing on the PMGWAGs and NMATs of their applicants.

Sexual functioning after stroke among rehabilitation medicine out-patients and their sexual partners: A cross-sectional study

Background@#Sexuality remains to be a sensitive issue in the Philippines, but it encompasses real problems that stroke patients and their partners continue to face. Sexual dysfunction, an under-recognized complication post-stroke, is caused by an interplay of physical, emotional, cognitive, and language impairments, in combination with psychosocial factors. @*Objectives@#This study aimed to determine changes in sexual functioning (libido, coital frequency, sexual arousal, and sexual satisfaction) among stroke out-patients at the Philippine General Hospital and their sexual partners.@*Methods@#This cross-sectional study involved patients (≥30 years old with 1 stroke episode), and their partners. Through individual interviews and questionnaires, data were gathered on general attitude toward sex, ability to address sexual issues with partner, fear of recurrence of stroke, unwillingness to participate in coitus, risk of depression, and level of happiness. @*Results@#Twenty-nine patients and 23 partners participated. There was a statistically significant decrease in coital frequency post-stroke among patients (p<0.001) and partners (p<0.05). Majority reported lower level of libido, sexual arousal, and sexual satisfaction post-stroke. Participants unable to discuss sexual issues with partner were more likely to report sexual dissatisfaction (p<0.05). Those with higher scores on Zung’s depression scale were likely to be sexually dissatisfied (p<0.05). Level of happiness was moderately correlated with sexual satisfaction (r=0.51).@*Conclusion@#Sexual life of couples affected by stroke is commonly overlooked. There was a decline in libido, coital frequency, arousal, and sexual satisfaction among stroke patients and partners at the Philippine General Hospital.

The comparison of the different adjustment factors for admission to the University of the Philippines College of Medicine

Background@#Among the different criteria, the General Weighted Average Grade (PMGWAG) holds the biggest bearing on admission for the UP College of Medicine. However, GWAs are not comparable across different courses, different batches, different UP units and different schools. An Adjustment Factor is necessary to make PMGWAGs comparable and to level the playing field. @*Objectives@#This study covering a 24-year period aimed to compare various proposed Admission Adjusted Factors of %PMGWAG (Pre-Med GWAG) in terms of Pearson's Correlation, Linear Regression Models and Mean Differences with %MGWAG (Medical GWAG), Class Rank and Board Rating as Outcome variables. @*Methodology@#Various proposed Adjustment Factors were applied to %PMGWAG of medical students from Class 1990 to Class 2014 and Pearson's Correlation, Linear Regression Models and Mean Differences with %MGWAG, Class Rank and Board Rating were derived and analyzed. @*Results@#Adjustment Factor A3 as applied to %PMGWAG correlates best with Board Rating and Class Rank while Adjustment Factor A6 with %MGWAG. On Linear Regression, A3 likewise bested other Adjustment Factors in predicting %MGWAG and %Board Rating while A6 on predicting Class Ranking. Among the various adjustments, A3 exerted the most impact on the outcome variables, based on mean differences. @*Conclusion@#The A3 Adjustment Factor is the preferred and most ideal among the various proposed adjustment factors. Its application on %PMGWAG, correlated best with, most predictive of and most influential to %MGWAG, Board Rating and Class Rating.

Perceptions of clinical clerks and interns of the University of the Philippines College of Medicine towards physical and rehabilitation medicine as a medical specialty

Objectives@# Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients. @*Methods@#This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis. @*Results@#Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited. @*Conclusion@#Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.

The predictors of academic performance of the medical students of upcm: class1990 to class 2013 lateral entrants

Background: The criteria for admission at the University of the Philippine College of Medicine (UPCM) are sixtypercent premed general weighted average grade (PMGWAG), thirty percent National Medical Admission Test(NMAT) scores and ten percent Interview Scores. Through the years, because of the highly competitive natureof the selection process, the admissions cut-offs in PMGWAG and average NMAT has continuously risen.Objectives: This study that covered a twenty four year period, aimed to determine the correlation andpredictive value between the admissions criteria (%Pre-med GWAG, NMAT and Interview Score) withacademic performance parameters (%Med GWAG and Class Ranking) and Board Rating.Methods: The pre-admission and academic records of accepted lateral entrants from Class 1990 to Class 2013were retrieved, reviewed and analyzed. These included the pre-med GWAG (%PMGWAG), NMAT andInterview Scores, Med GWAG (%MGWAG), Class Ranking and Board Rating. Pearsons Correlation and MultipleLinear regression analysis were done.Results: All criteria (%PMGWAG, NMAT, Interview Score) for admissions were correlated with the academicperformance parameters (%MGWAG, Class Rank) and Board Rating. The strongest correlation was observed in%PMGWAG with %MGWAG and Class Rank. Interview score correlated weakly with the academicperformance. Strong correlations between %MGWAG, Class Rank and Board Rating were likewise observed.Rank upon admission also correlated strongly with Class Rank upon graduation. On linear regression analysis,%PMGWAG and NMAT were more predictive of %MGWAG, Class Rank and Board Rating.Conclusion: The weight distribution of the different admissions criteria should be adjusted accordingly.Interview score, a weak predictor of academic performance and a measure of non-cognitive traits, should betreated separately and independently as an admission criteria.