Students' perceptions of and satisfaction with their Orthopaedic posting learning environment by using the Healthcare Education Micro-Learning Environment Measure (HEMLEM) questionnaire.

BACKGROUND: The learning environment in medical education is crucial for student development, encompassing social, psychological, and physical aspects that significantly affect learning. This study aimed to assess undergraduate medical students' perception of the orthopaedic ward's learning environment and examine the factors influencing their overall satisfaction during clinical rotation. METHODS: This cross sectional quantitative study was conducted in a private medical college in Pakistan. Data was collected through a pre-validated questionnaire, "The Healthcare Education Micro-Learning Environment Measure (HEMLEM)." Data analysis was done using SPSS version 23 software. RESULTS: A total of 205/300 students (response rate 68.33%) [103 (50.2%) males and 102(49.85) females] participated in this survey. Notably, 116 (56.6%) appreciated the ward's welcoming, friendly, and open atmosphere, and 114(55.6%) of the respondents appreciated the ward culture where they felt free to ask questions or comment. Additionally, 111(54.7%) appreciated the faculty's enthusiasm for teaching. A comparison between male and female students showed significantly higher satisfaction among males regarding staff attitudes and behaviours (p < .019). CONCLUSION: Undergraduate students held a predominantly positive view of the orthopaedic ward's learning environment, with differences observed based on gender and year of study. The study highlights the importance of both staff attitude and teaching quality in shaping the educational experience. It suggests that medical institutions should focus on enhancing teaching skills among clinicians to improve learning experiences and ultimately benefit patient care and the healthcare system.

Experiences of virtual teaching during COVID-19 in medical institutes of Karachi, Pakistan: teachers' perspective.

Objective: To determine the experiences of faculty members related to virtual teaching. METHODS: The cross-sectional study was conducted from January 15 to March 15, 2021, at undergraduate medical institutions located in Karachi, and comprised all the faculty members. Data was collected using a Google Survey questionnaire, and it was analysed using SPSS 20. RESULTS: Of the 385 subjects, 157(40.78%) were from basic sciences faculty, and 228(59.2%) were from the clinical sciences faculty. The majority had 3-5 years of teaching experience 142(37%). The most common online tool was Zoom 250(65%). The faculty who had prior experience or had received formal training for online teaching was more successful in controlling and engaging students than the rest (p<0.001). Those who had enough computer literacy had a better experience in conducting online teaching sessions (p=0.01). The experienced faculty found the opportunity to focus more on the topic that was to be taught online (p<0.001). CONCLUSIONS: Most of the faculty members used online tool Zoom. Faculty members with computer literacy and proper training for online teaching were more successful in controlling and engaging students and conducting online teaching sessions.

Frequency of and Various Factors Associated with Stress, Anxiety, and Depression among Low Back Pain Patients.

Objective To measure the frequency of depression, anxiety, and stress and its association with other variables i.e., age, gender, and off work hours among low back pain (LBP) patients attending an orthopedic outpatient department (OPD) at a private hospital in Jeddah, Saudi Arabia (SA). Methodology This is the cross-sectional study, which was done in a secondary care hospital of Jeddah, SA. Data was collected between the periods of 2017-2018. All patients who attended orthopaedic OPD with LBP were included in this study and were requested to fill the Depression, Anxiety, Stress Scale-21 (DASS-21) questionnaire. The gathered data were analyzed through the Statistical Package for Social Sciences (SPSS) version 23 (SPSS Inc., Chicago, IL). One-way analysis of variance (ANOVA) was used to compare the mean difference in depression, anxiety, and stress scores between genders, age, and number of leaves from their work. Results Three hundred sixty patients came to the orthopedic OPD with the primary complaint of LBP, 318 (88.3%) were male while 42 (11.7%) were female. The study showed that among these patients 24 (6.7%) subjects were suffering from the depression while 136 (37.8%) from anxiety and 167 (46.4%) from stress. Linear regression analysis showed that depression was negatively associated with age and stress was negatively associated with the off work because of the severity.  Conclusion In conclusion, the findings of this study revealed that LBP and mental distress are related to each other. This finding urges physicians to check and treat the mental distress in patients with LBP for a better outcome.

Misdirected Patients in Orthopedic Outpatient Clinics: A Retrospective Four Years Data Analysis (23435 Patients).

Objective To identify the frequency of misdirected patients in orthopedic outpatient clinics. Methodology This was a retrospective study done in a private hospital of Jeddah. Computer records of patients attending the orthopedic outpatient department (OPD) during the period of 2013-2017 were collected. Data were analysed using IBM SPSS version 23 (IBM Corp, Armonk, NY). Descriptive statistics are presented as frequency and percentages. Results Out of the 23435 cases, 6944 (29.6%) cases should not be seen primarily in orthopedic clinic, 13638 (58.2%) were the cases that may or may not be seen primarily in orthopedic clinic, whereas, there were 2853 (12.2%) who must be seen mainly by orthopedic specialist. Conclusion This study revealed that a huge number of patients who visited orthopedic OPD does not need primarily orthopedic consultation. So, it is recommended to direct the patients to the right specialist in outpatient clinics to avoid the unnecessary burden on orthopedic clinics. The triage of referrals or walk-in patients may help to prevent this issue.

Rapid Assessment of Physical Activity and its Association Among Patients with Low Back Pain.

Objective To evaluate the physical activity levels in individuals with low back pain (LBP) and its relationship with various demographic variables like age, gender, number of days off from work and nature of occupation. Methodology This was a cross-sectional study that was done in a private hospital in Jeddah, Saudi Arabia. Data was collected between the periods of 2017-2018. All patients who attended the orthopedic outpatient department (OPD) with LBP were included in this study and were requested to fill the Rapid Assessment of Physical Activity (RAPA) questionnaire. The gathered data were analyzed through the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL), version 23. One-way analysis of variance (ANOVA) was used to compare the mean difference in RAPA scores between genders, age, occupation and number of leaves from their work.  Results Three hundred sixty patients visited the orthopedic OPD with the primary complaint of LBP, 318 (88.3%) were male whereas 42 (11.7%) were female. The study revealed that among these patients, 117 (32.5%) led sedentary while 176 (48.9%) led an underactive lifestyle. Furthermore, 246 (68.3%) patients did not do any activity that increases their muscle strength and flexibility. Conclusion The findings of this study revealed that low physical activity is prevalent in patients with LBP. Therefore, the importance of physical activity should be highlighted in order to prevent chronic diseases like LBP.

Spontaneous bilateral quadriceps rupture in a patient with ankylosing spondylitis: A case report.

Ankylosing spondylitis is a prototype rheumatoid factor-negative spondyloarthropathy that causes the vertebrae to fuse making the spine less flexible, resulting in a hunched-forward posture. A 47-year-old male who was a known case of ankylosing spondylitis presented with left quadriceps rupture after raising his right foot to lightly hit a football. He was fitted with a knee immobilizer as an emergency measure. The extent of the rupture was not yet established when patient requested leave to go home. The right quadriceps was ruptured as well when he took his immobilizer off to go the bathroom. We report herein an extremely rare case of ankylosing spondylitis with atrophy in the quadriceps to the extent of causing pathological muscle rupture. Prolonged period of immobilization results in muscle wasting which leads to knee joint instability so the muscle should be repaired as soon as possible.