Evaluation of a communication skills training course for medical students using peer role-play.

OBJECTIVE: To evaluate the effect of using peer role-playing in learning the communication skills as a step in the development of the communication skills training course delivered to pre-clinical medical students. METHODS: This study was conducted at the King Abdulaziz University, Jeddah, Saudi Arabia, between September 2014 and February 2015 and comprised medical students. Mixed methods design was used to evaluate the developed communication skills training course. Tests were conducted before and after the communication skills training course to assess the students' self-reported communication. After the course, the students completed a satisfaction survey. Focus groups were conducted to assess the behavioural and organisational changes induced by the course. SPSS 16 was used for data analysis.. RESULTS: Of the293 respondents, 246(84%) were satisfied with the course. Overall, 169(58%) subjects chose the lectures as the most helpful methods for learning the communication skills while 124(42%) considered practical sessions as the most helpful method. Besides, 237(81%) respondents reported that the role-play was beneficial for their learning, while 219(75%) perceived the video-taped role-play as an appropriate method for assessing the communication skills. CONCLUSIONS: Peer role-play was found to be a feasible and well-perceived alternative method in facilitating the acquisition of communication skills..

Is rotavirus still a major cause for diarrheal illness in hospitalized pediatric patients after rotavirus vaccine introduction in the Saudi national immunization program?

Previous studies in Jeddah, western Saudi Arabia, showed rotavirus (RV) prevalence around 40% in pediatric inpatients with gastroenteritis (GE) with a maximum level during cooler months. Currently, there are no data on impact of rotavirus vaccine (RVV) on RV-GE in Saudi Arabia. Therefore, this study was conducted to assess impact of RVV on incidence and severity of RV-GE in hospitalized pediatric patients; 3 years after introduction of RVV in Saudi immunization program (SIP) in January, 2013.This cross-sectional observational study included GE cases under 5 years of age admitted to 2 tertiary hospitals, in Jeddah, from October to December, 2015. All included GE-cases had RV antigen detection in stool by immunochromatographic assay, complete data collection including RVV status and severity assessment (Vesikari score) in initial admission.During study period, a total of 359 GE cases in children under 5 years of age were hospitalized with 14 (3.9%) RV-GE confirmed cases. Mean age of RV-GE patients was 13.10 ±â€Š5.70 months. All RV cases had severe GE and 1 case received RVV. Among other 345 GE cases, 35.7% did not receive RVV and 46.1% had severe GE. Severe GE (Vesikari score > 11) was more significantly identified among RV-GE cases than in other all-cause GE (P < .001). During same period of this study in 2012, 369 RV-GE out of 1193 total GE cases (31%) were hospitalized at 2 hospitals, so, number of hospitalized pediatric patients for all-cause and RV-GE in children under 5 years of age decreased significantly in 2015 RV season (compared to 2015 RV season, odds ratio for RV-GE in 2012: 11.04, 95% CI: 6.38-19.09).Logistic regression analysis of variables of this cross-sectional, hospital-based study in Jeddah, Saudi Arabia, 3 years after introduction of RVV in SIP, showed that among the studied variables, RVV was associated with remarkable reduction of hazard of all-cause and RV-GE in vaccinated and even in unvaccinated children under 5 years of age possibly by RVV herd effect. However, RV was still associated with severe GE-related hospitalizations in unvaccinated children against RV who were younger than 2 years and particularly in the 1st year of life, indicating need for more optimum rate of RVV coverage. Hopefully, further improvement in RVV coverage rate may make RV-GE a disease of the past in Saudi children.

Evaluating the long-term impact of faculty development programs on MCQ item analysis.

PURPOSE: Evaluating the long-term impact of faculty development programs (FDPs) can help monitor the effectiveness of the program and identify areas for development. This study examined long-term differences in confidence, knowledge, behaviors, and policies of faculty members who attended FDPs on multiple choice question (MCQ) item analysis and faculty members who did not attend the FDPs. METHODS: A cross-sectional study design was used, by administering a 24-item survey to a representative sample (simple random selection) of 61 faculty members at King Abdulaziz University Faculty of Medicine. RESULTS: Among respondents, 34% did not attend FDPs; 53% attended 1-3 FDPs; and 13% attended more than 3 FDPs on MCQ item analysis. Results showed that faculty knowledge on elements of MCQ item analysis was significantly greater (p = .01) for members who attended the FDPs. Faculty who attended FDPs on MCQ item analysis were twice more likely to conduct item analysis in general (p = .020) and four times more likely to conduct item analysis for more than 70% of module examinations (p = .005). CONCLUSION: FDPs focused on MCQ item analysis can yield systematic changes on faculty confidence, knowledge, and behaviors. Moreover, FDPs also need support from the department and need sustained strategic support to ensure continued effectiveness.

Risk factors and predictors of uncontrolled hyperglycemia and diabetic ketoacidosis in children and adolescents with type 1 diabetes mellitus in Jeddah, western Saudi Arabia.

BACKGROUND: Little is known about levels of glycemic control and risk factors for uncontrolled hyperglycemia in Saudi children with type 1 diabetes mellitus (T1DM). The aim of the present study was to identify levels of glycemic control, risk factors and predictors of uncontrolled hyperglycemia (HG) and diabetic ketoacidosis (DKA) in children with T1DM. METHODS: A retrospective study was performed on Saudi children and adolescents with confirmed T1DM who were followed at the Pediatric Endocrinology Clinic of the Maternity and Children Hospital, Jeddah, from 2000 to 2014. Data collection included all possible factors that may be associated with uncontrolled T1DM. Patients were classified according to American Diabetes Association guidelines for target HbA1c levels per age group. Comparisons were made between well-controlled (WC) patients, HG patients, and DKA patients. Calculation of odds ratios and logistic regression allowed for estimation of the role of each risk factor in uncontrolled T1DM. RESULTS: Only 31.2 % of children and adolescents with T1DM were well controlled. Better glycemic control was associated with age < 6 years, urban residence, and T1DM duration <5 years. Glycemic control was not affected by gender, insulin therapy, or comorbidities. The most significant independent predictors of hyperglycemia and DKA were poor compliance with a healthy lifestyle (adjusted hazards ratio [AHR] 28.94; 95 % confidence interval [CI] 8.37-100.04) and an excess intake of sweets (AHR 3.31; 95 % CI 1.54-7.11). CONCLUSION: The most significant independent predictor for poor glycemic control (particularly DKA rather than hyperglycemia) in Saudi children and adolescents was poor compliance with a healthy lifestyle with an excessive intake of sweets.

Extracurricular leadership development programme to prepare future Saudi physicians as leaders.

OBJECTIVE: To describe and evaluate an innovative approach for developing leadership skills in a cohort of medical students through an extracurricular programme. METHODS: The study was conducted at King Abdulaziz University, Jeddah, Saudi Arabia, from April to June of the academic year 2014-15, and comprised medical students from all batches. Mixed-method design was used to evaluate the leadership development programme. Pre- and post-tests were conducted to assess students' learning and their satisfaction was evaluated at the end of the programme. Focus groups were conducted to assess the programme's impact on participants' behaviour. Data analysis was done using SPSS 16. RESULTS: Of the 55 participants, 45(82%) responded to the evaluation survey. Of them, 29(65%) reported intended changes in their leadership practices immediately after the programme, with 8(28%) of them reporting more than one change. The mean students' satisfaction with the overall performance of the speakers and programme organisation was high at 4.12±0.91 and 4.54±0.89, respectively. CONCLUSIONS: Early experience of the leadership development programme produced positive results. An intense programme analysis is required to fully understand this significant organisational need.

Impact of maternal breast cancer on school-aged children in Saudi Arabia.

BACKGROUND: We examine whether mothers with breast cancer told their children about the diagnosis, explore mothers' perceptions of the impact of doing so on the mother-child relationship, and assess perceptions of how this affected the children. METHODS: A convenience sample of 28 women with breast cancer ages 35 to 60 was interviewed using a 39-item close-ended questionnaire at the Al-Amoudi Breast Cancer Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia. Inclusion criteria were having a diagnosis of breast cancer and having school-aged children (ages 5 to 16 years). Questions were asked concerning each child (n = 99). RESULTS: The majority of women (75%) told their children about the diagnosis, and explained the treatment (61%). In most cases, telling the children had a positive effect on how the children treated their mothers (84%), on the maternal-child relationship (80%), and on the personality and behavior of the child (90%). The most common negative reaction by children was increased clinging behavior to the mother (15%). Despite the perceived positive impact on the mother-child relationship and on the child's overall behavior towards the mother, school performance suffered as a result (77%). CONCLUSIONS: These preliminary results suggest that when a mother with breast cancer tells a child about the diagnosis and discusses it with them, this often results in an improvement in the maternal-child relationship. However, the knowing the mother's diagnosis may adversely affect the child's school performance, which will need to be anticipated and addressed with formal counseling if it persists.

Unique features and risk factors of Helicobacter pylori infection at the main children's intermediate school in Rabigh, Saudi Arabia.

BACKGROUND: This study was conducted to determine characters and risk factors of Helicobacter pylori infection and its relationship with recurrent abdominal pain and other gastrointestinal symptoms at the main children's intermediate school in Rabigh, Saudi Arabia. METHODS: A cross-sectional study was conducted at a boys' intermediate school. A questionnaire for the gastrointestinal (GI) symptoms and relevant personal and socioeconomic risk factors related to H. pylori infection was distributed followed by H. pylori IgG antibody assay and 14C urea breath test to detect active infection. RESULTS: H. pylori was diagnosed by positive urea breath test in 51.5 % of students. H. pylori infection was symptomatic with at least one upper GI symptom in 89.7 % of infected students which was higher than symptomatic cases reported in any other study. H. pylori-infected students had significantly more association with the presence of any upper GI symptom (p < 0.001), recurrent abdominal pain (p < 0.001), anorexia (p < 0.001), nausea (p < 0.026), family history of peptic disease (p < 0.001), drinking desalinated municipal water (p < 0.001), lower income (p = 0.02), and eating outside home (p = 0.003) than uninfected students. Logistic regression analysis showed that the most significant predictors of H. pylori infection were presence of any upper GI symptom (OR 5.3, 95 % CI 2.32-15.71), family history of peptic disease (OR 2.2, 95 % CI 1.11-3.9), and drinking desalinated municipal water (OR 2.1, 95 % CI 1.09-3.2). CONCLUSIONS: This study presented unique features and risk factors of H. pylori infection in 12-15-year-old Saudi boys in Rabigh, and mainly supported the role of H. pylori in causing recurrent abdominal pain.

Prevalence and characters of Entamoeba histolytica infection in Saudi infants and children admitted with diarrhea at 2 main hospitals at south Jeddah: a re-emerging serious infection with unusual presentation

In this study, Entamoeba histolytica had high prevalence and unusual presentation by affecting high proportion of infants under 1 year; severe clinical manifestations, and laboratory findings that were known to be usually encountered in invasive amebiasis as significant leukocytosis for age, neutrophilic leukocytosis for age, and positive C-reactive protein were found among more than 50% of admitted Saudi infants and children with E. histolytica infection in our locality. E. histolytica can be a re-emerging serious infection when it finds favorable environmental conditions and host factors which are mainly attributed to inadequate breastfeeding in this study. This may occur in any other area of the world with the same risk factors, so we must be ready to tackle it with effective and more powerful preventive measures.

Prevalence and characters of Entamoeba histolytica infection in Saudi infants and children admitted with diarrhea at 2 main hospitals at South Jeddah: a re-emerging serious infection with unusual presentation.

In this study, Entamoeba histolytica had high prevalence and unusual presentation by affecting high proportion of infants under 1 year; severe clinical manifestations, and laboratory findings that were known to be usually encountered in invasive amebiasis as significant leukocytosis for age, neutrophilic leukocytosis for age, and positive C-reactive protein were found among more than 50% of admitted Saudi infants and children with E. histolytica infection in our locality. E. histolytica can be a re-emerging serious infection when it finds favorable environmental conditions and host factors which are mainly attributed to inadequate breastfeeding in this study. This may occur in any other area of the world with the same risk factors, so we must be ready to tackle it with effective and more powerful preventive measures.

Benchmarking the post-accreditation patient safety culture at King Abdulaziz University Hospital.

BACKGROUND AND OBJECTIVES: Accreditation is an internationally recognized evaluation process used to assess, promote, and guarantee efficient and effective patient care and safety. Saudi Arabia is one of the first countries in the eastern Mediterranean region to implement health care accreditation standards. This study provides valuable information pertaining to the impact of accreditation in the unique multicultural, multilingual competitive environment at King Abdulaziz University Hospital in Saudi Arabia. The objective of this study was to perform an unbiased assessment of the impact of accreditation on patient safety culture. DESIGN AND SETTING: Cross-sectional retrospective and prospective study post-accreditation at King Abdulaziz University Hospital in Jeddah, Saudi Arabia from January 1, 2006 to December 31, 2009. PATIENTS AND METHODS: A total of 870 registered nurses from eight different cultural backgrounds working at 22 hospital units were given electronic access to the survey. A 5-point Likert scale was used, ranging from 1 for 'Strongly disagree' to 5 for 'Strongly agree.' The survey results were matched with the international benchmarks from the Hospital Survey on Patient Safety Culture, 2005. RESULTS: A total of 605 nurses answered the survey questionnaire. The comparison between the percentages of nurses at King Abdulaziz University Hospital (KAUH) and those at international hospitals who answered 'Agree' and 'Strongly agree' showed a post-accreditation improved perception of the culture of patient safety. CONCLUSIONS: Accreditation has an overall statistically significant improvement in the perception of the culture of patient safety.