Needs analysis for an undergraduate dental curriculum in KPK, Pakistan: Gap identification and general needs assessment.

Objective: Dental institutes continue to face challenges in making the transition from a discipline-based to an integrated curriculum. The need analysis is often the first step in the development and implementation of any curriculum. This study intends to carry out a needs analysis for a contemporary dental curriculum in private and public sector dental colleges of Peshawar, KPK, Pakistan. Methods: The mixed method study was carried out at public and private dental institutes in Peshawar from April to July 2022. To guarantee triangulation, data were gathered from three sources. The first source was an analysis of the Pakistan Medical and Dental Council's dental curriculum accreditation standards. The second source was gathering the experts' perspectives, and the final source was a systematic literature search to explore the necessity for an integrated undergraduate dental curriculum from the experiences and expertise of contemporary curricula. Results: Thematic analysis identified the need for the dental curriculum to be a five-year BDS program, involvement of students, and inclusion of digital dentistry and environmental sustainability in the dental curriculum. PMDC accreditation standards focus on alignment in mission, vision, curricular outcomes, an integrated curriculum, and a quality assurance system for assessment. Experts identified the need for a patient-centered curriculum focusing on integrated patient care. They also identified that the current educational environment should be improved to sustain a contemporary dental curriculum in Pakistan. For the literature review, nine articles were included in the final review. Conclusion: The current dental curriculum is not accommodating to the needs of the students in Peshawar. The current dental education environment lacks the infrastructure, logistics, and teacher training to sustain the standards set by PMDC.

Effectiveness of empathy portfolios in developing professional identity formation in medical students: a randomized controlled trial.

BACKGROUND: Medical education requires innovative strategies to enhance empathic skills and the formation of professional identities among students. However, evidence-based teaching of empathy and professional identity formation is inadequately represented, particularly in medical curricula. This study investigated the effectiveness of empathy portfolios in developing Professional Identity Formation (PIF) among medical students and the correlation between empathy and PIF. The objectives of this study were to determine the effectiveness of empathy portfolios for teaching and nurturing PIF in medical students and to investigate the correlation between empathy and PIF. METHODS: A randomized controlled trial was conducted at Peshawar Medical College, Pakistan. The protocol adhered to CONSORT guidelines. A total of 120 students participated in the study. Empathy and PIF were assessed using two validated questionnaires JSPE-S and PIQ before randomization. The participants were randomized in a stratified fashion into the experimental (n = 60) and control (n = 60) groups. The Participants in the intervention group attended a training workshop on portfolio use. Students maintained their portfolios and wrote reflections on incidents that evoked empathy. Independent t-tests were performed to determine whether the control and experimental groups differed in terms of mean empathy and PIF scores, and Pearson's correlation analyses were used to investigate the relationships between pre- and post-empathy, and pre-post-PIF. RESULTS: The mean post-test scores on the Empathy and PIF showed a statistically insignificant difference of 0.75 +-17.6 for empathy and 0.45 ± 8.36 for PIF. The intervention had little influence on empathy and PIF scores, as evidenced by nonsignificant effect sizes of 0.32 and 0.36 for empathy and PIF respectively.A strong positive correlation was found between Pre-Empathy and the PIF-Total score (0.519), and between Post- empathy and the PIF-Total score (0.395) (p < 0.001). CONCLUSIONS: Empathy had a positive linear correlation with PIF; however, the use of empathy portfolios as a three-week single-point intervention was ineffective at nurturing PIF.

Effect of academic stress, educational environment on academic performance & quality of life of medical & dental students; gauging the understanding of health care professionals on factors affecting stress: A mixed method study.

INTRODUCTION: Throughout their academic careers, medical and dental students face challenges that cause varying levels of stress, affecting their academic performance and quality of life (QoL). Our study aims to ascertain the effect of academic stress and the educational environment on the QoL and academic performance of medical and dental students, encompassing the perspectives of both students and healthcare professionals. METHODS: A mixed-method research was conducted from February to May 2022, comprising students from a medical and dental college in Pakistan. During Phase 1, the students participated in the cross-sectional survey and completed the WHO Quality of Life Scale (WHOQOL-BREF), Academic Stress Scale, and Dundee Ready Educational Environment Measure (DREEM) Inventory questionnaires. Academic performance was evaluated through last year's annual assessment results of the students. During Phase 2 of the study, interviews with healthcare professionals who had experience as the students' counsellors were conducted. RESULTS: The mean age of the sample (n = 440) was 22.24 ±1.4 years. The Cronbach Alpha reliability of the DREEM inventory was 0.877, that of the Academic Stress Scale was 0.939 and the WHOQOL scale was 0.895. More than half of the students (n = 230, 52.3%) reported better QoL and the majority perceived a positive educational environment (n = 323, 73.4%) and higher academic stress (n = 225, 51.1%). Males had significantly more academic stress (p<0.05). Those who perceived a positive educational environment and better QoL had better academic performance (p<0.05). Academic performance was positively and significantly correlated with QoL and academic stress (p = 0.000). In qualitative analysis, 112 codes were generated which converged into 5 themes: challenging educational environment, psychological need and support, individual differences, relationship and family life, and adjustment issues. CONCLUSION: Medical and dental students encounter a myriad of challenges, along with significant academic stress, which detrimentally affects their academic performance, despite perceiving a positive educational environment. Conversely, a better QoL is associated with improved academic performance.

Effect of team-based learning on critical thinking: A quasi-experimental study.

Objectives: To determine the effect of Team-based learning (TBL) on the critical thinking of health professions students. Methods: This quasi-experimental study, was done in paramedical and nursing sciences institutes using the convenience sampling technique. Students included were enrolled in the haematology course of paramedic institute from January to December 2020 and adult health course of the nursing institute of Khyber Medical University. Six dimensions of critical thinking (CT) of the students before and after TBL were determined using the critical thinking disposition inventory. Results: The study participants included 89 students, comprising 58 students from the paramedic's institute and 31 from the nursing institute; 67 (75.28%) males and 22 (24.71%) females. The overall pre-test score of CT was 257.46 ± 21.73, and the post-test score was 274.55 ± 19.36, which was statistically significant (p-value = 0.000). The pre-test score of six dimensions, namely, analyticity, inquisitiveness, systematicity, truth-seeking, self-confidence, and open-mindedness was 41.35 ± 5.15, 44.73 ± 4.77, 41.12±6.87, 43.17± 5.19, 44.94±6.03, 42.38 ± 5.32 respectively, whereas the post-test scores were 44.57± 5.28, 47.11 ± 4.69, 46.12± 5.54, 45.77 ± 5.05, 47.58 ± 5.65, 43.56 ± 4.56 correspondingly. Analyticity (p=.000), inquisitiveness (p=.000), systematicity (p=.000), truth-seeking (p=.000) and self-confidence (p=.000) were statistically significant. However, open-mindedness was statistically insignificant (p=.074). Conclusion: TBL improves five out of six dimensions of students' critical thinking. Besides its established evidence to increase knowledge, TBL can also be used as a teaching methodology for enhancing students' critical thinking.

Probing in the complexities of the integrated undergraduate medical curriculum: A qualitative exploratory study.

OBJECTIVE: To explore the perceptions of the faculty regarding the level of curriculum integration and their interpretation of the integration ladder in achieving the complex process. Methods: The qualitative exploratory study was conducted at Islamic International Medical College Islamabad, University College of Medicine and Dentistry Lahore and Rehman Medical College Peshawar, from March to August 2018. The participants were the faculty members involved in the designing and implementation of the integrated curriculum in these institutes. The semi-structured interviews were audio-recorded, transcribed and analysed using Braun and Clarke's thematic content analysis. RESULTS: Of the 18 faculty members, 6 (33.3%) belonged to each of the three institutions. Four themes identified were: curriculum planning, an uphill task; dream versus ground reality; moving up and down the ladder; and teamwork in the paradigm shift. There were different perceptions of the level of integration among faculty members within the same institute. The level of integration ranged from 5-9 in different phases of the curriculum. The processes included all the teamwork steered by the departments of medical education. Conclusion: Although Harden's integration ladder is a useful tool, curriculum integration is an inherently inconsistent and complex process that does not follow a simple hierarchical continuum of integration and requires a teamwork. Identifying the patterns of integration in different phases of the curriculum might be more practical than just determining a single level of integration in the whole curriculum.

Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers.

OBJECTIVE: To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). STUDY DESIGN: Randomized control trial. PLACE AND DURATION OF STUDY: Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. METHODOLOGY: The study consisted of 278 patients, with 139 patients each in Group 'A' and 'B', who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. RESULTS: Mean age of presentation in group A was 55.88 ± 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2 and in group B 15.09 ± 2.81 cm2 (p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p < 0.001). Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A (p < 0.001). CONCLUSION: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers.