Evaluation of a training programme to induct medical students in delivering public health talks.

INTRODUCTION: It is uncommon for medical students to deliver public health talks as part of their medical education curriculum. This study evaluated the effectiveness of a novel training programme that required medical students to deliver public health talks during their family medicine (FM) clerkship in a Singapore primary care institution. METHODS: The FM faculty staff guided teams of third-year medical students to select appropriate topics for health talks that were to be conducted at designated polyclinics. The talks were video-recorded and appraised for clarity, content and delivery. The appraisal was done by the student's peers and assigned faculty staff. The audience was surveyed to determine their satisfaction level and understanding of the talks. The students also self-rated the effectiveness of this new teaching activity. RESULTS: A total of 120 medical students completed a questionnaire to rate the effectiveness of the new teaching activity. 85.8% of the students felt confident about the delivery of their talks, 95.8% reported having learnt how to deliver talks and 92.5% perceived this new training modality as useful in their medical education. Based on the results of the audience survey, the speakers were perceived as knowledgeable (53.1%), confident (51.3%) and professional (39.0%). Assessment of 15 video-recorded talks showed satisfactory delivery of the talks by the students. CONCLUSION: The majority of the students reported a favourable overall learning experience under this new training programme. This finding is supported by the positive feedback garnered from the audience, peers of the medical students and the faculty staff.

Extending Quadrivalent Human Papilloma Virus (HPV) Vaccination To Males

Introduction: Human papilloma virus (HPV)-related genital warts and cancers can lead to significant morbidity. The ACIP 2011 from the United States recommends routine quadrivalent HPV vaccination for both males and females for primary prevention.1 This study reviews current evidence on vaccinating males routinely, and determines if it can be applied to Singapore. Methods: Relevant articles from PubMed were obtained by searches using the search words “quadrivalent HPV vaccination”, “males”, “cancer” and “prevention”. Three retrieved articles are included in this review and 3 additional articles are included from the references of the selected articles. Results: Quadrivalent HPV vaccination is effective in the primary prevention of HPV-related genital warts and cancers in both genders. Effectiveness in the secondary prevention of HPV-related recurrent high-grade intra-epithelial neoplasia(HGAIN) was suggested in a cohort study among men. The vaccine is safe with minor side effects of localised injection site pain. Conclusion: Given the efficacy and safety of quadrivalent HPV vaccination in both males and females, local studies should be done to confirm the benefits of routine vaccination.

Understanding patients' perspective of statin therapy: can we design a better approach to the management of dyslipidaemia? A literature review.

INTRODUCTION: Dyslipidaemia leads to atherosclerosis and is a major risk factor for cardiovascular diseases. In clinical trials, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been shown to effectively reduce dyslipidaemia. Despite the availability and accessibility of statins, myocardial infarctions and cerebrovascular accidents remain among the top causes of mortality in developed countries, including Singapore. This enigma could be attributed to suboptimal adherence to statin therapy. The present literature review aimed to evaluate patients' perceptions of statin therapy. METHODS: We searched PubMed and other databases for articles published in English from October 1991 to May 2012 containing keywords such as 'patient', 'views', 'perceptions', 'adherence', 'statin' and 'dyslipidaemia'. Of the 122 eligible studies retrieved, 58 were reviewed. The findings were categorised and framed in accordance with the Health Belief Model. RESULTS: Patients with dyslipidaemia appeared to underestimate their susceptibility to dyslipidaemia-related complications, partly due to their demographic profiles. Failure to appreciate the severity of potential complications was a major hindrance toward adherence to statin therapy. Other factors that affected a patient's adherence included lack of perceived benefits, perceived side effects, the cost of statins, poor physician-patient relationship, and overestimation of the effectiveness of diet control as a treatment modality. CONCLUSION: Existing evidence suggests that the cause of poor adherence to statin therapy is multifactorial. The use of the Health Belief Model to present the results of our literature review provides a systematic framework that could be used to design a patient-centric approach for enhancing adherence to statin therapy.

What Approach can Primary Care Physicians Adopt to Manage their Patient who is Upset as a Result of Adverse Effect from their Treatment?

The article explores the various approaches a doctor can use in managing and upset patient. These approaches include BATHE (Background-Affect-Troubles-Handling-Empathy), LEARN (Listen-Explain-Acknowledge-Recommend and Negotiate) and LEAP (Listen-Empathise-Agree-Partnership). We include a case study of a 16 year old patient who presented with a sore throat. She subsequently developed a rash after starting Amoxicillin, which was later changed to Augmentin. The doctor utilised the BATHE approach in managing the patient’s unhappiness.