Assessing Family Medicine Residents' Knowledge, Attitudes, and Confidence in Managing In-Flight Medical Emergencies in Riyadh, Saudi Arabia.

The global increase in air travel has led to a rise in in-flight medical emergencies (IMEs), posing significant challenges to global public health. In a significant number of instances, physicians are often called upon to respond to IMEs during flights. These emergencies are unique due to the cabin environment's constraints, including confined space, ambient noise, and reduced atmospheric pressure. Various proactive measures have been introduced to mitigate IME occurrences, but many healthcare professionals, including family medicine (FM) residents, feel inadequately prepared to respond effectively. This cross-sectional study was conducted among all family medicine (FM) residents in Riyadh, Saudi Arabia, in January 2023. A self-reported questionnaire was used, including questions aimed at evaluating the sociodemographics, travel profiles, knowledge, confidence, and attitudes of FM residents toward IMEs and their ability to respond to such emergencies. A total of 189 FM residents participated in the study, revealing a young and diverse group of participants. Most were male (97 (51.3%)), averaging 27 years old. Nearly all held life support credentials (185 (97.9%)), particularly basic life support (BLS) and advanced cardiovascular life support (ACLS). Despite frequent travel, the majority lacked in-flight emergency training and experience. Allergic reactions (28%), cardiovascular (24%), and respiratory emergencies (24%) were the most common IMEs encountered. While 109 (57.7%) would assist during an IME, 87 (46%) were unsure of their competence, and 109 (57.7%) had medico-legal concerns. Most, i.e., 176 (93.2%) agreed with the need for more IME training, but 138 (73%) lacked clarity about in-flight medical supplies. In conclusion, this research underscores the importance of preparing FM residents and healthcare professionals for IMEs, advocating for specialized training programs that enhance their readiness to respond competently to an IME.

The Predictors of Moral Sensitivity Among Physicians.

PURPOSE: The continually advancing nature of health care has improved the quality of care provided to patients. However, it has also resulted in complex ethical issues healthcare providers face in Saudi Arabia. Literature concerning healthcare workers' moral sensitivity in Saudi Arabia is limited. This study aims to estimate moral sensitivity among physicians and determine the factors that influence it. PARTICIPANTS AND METHODS: A descriptive cross-sectional study was carried out among physicians working at a tertiary hospital. The Moral Sensitivity Questionnaire (MSQ) developed by Kim Lützén was used. The lowest score that can be obtained from the MSQ is 30, and the highest score is 210. Low scores demonstrate high ethical sensitivity, and high scores indicate low ethical sensitivity. RESULTS: A total of 253 physicians participated in the study. The mean score of moral sensitivity was 90.6±19.6. There is a significant difference in the overall moral sensitivity in relation to age (P = 0.049). There are significant differences in the Moral conflict dimension according to age (P = 0.002), parental status (P = 0.011), being a member of an ethical committee (P = 0.025), years of experience (P = 0.002), clinical ranking (P < 0.001), and previous training in bioethics (P = 0.029). There were significant differences in the Relational orientation dimension with the clinical ranking (P = 0.038) and specialty (P = 0.038). Membership of an ethical committee is a significant variable in the Benefit dimension (P = 0.028). Correlation coefficients between the overall moral sensitivity score and its dimensions were Autonomy (r = 0.68), Practice (r = 0.69), and Holistic approach (r = 0.69). Physicians who previously had training in bioethics (ß 2.37, P = 0.022) and physicians who worked with clinical ethics committee (ß 2.66, P = 0.008) were more likely to score better in Moral conflict dimension. CONCLUSION: Implementing ethical training for medical students and physicians will help raise their moral sensitivity levels, thereby enhancing how they deal with ethical dilemmas.

Comparing the use of Arabic decision aid to usual care. A multicenter randomized controlled trial for Arabic speaking metastatic colorectal cancer patients in Saudi Arabia.

OBJECTIVES: To evaluate the effect of decision aids (DAs) for metastatic colorectal cancer (mCRC) patients in the Arabic language. METHODS: A multi-centered randomized control trial was used to evaluate the effect of Arabic DA use with usual care for mCRC patients compared to usual care alone. Patients were recruited from 4 main oncology centers in Saudi Arabia: King Fahad Medical City, Riyadh; King Khalid University Hospital, Riyadh; King Saud Medical City, Riyadh; and King Fahd Specialist Hospital, Dammam, Saudi Arabia, between March 2016 and  October 2018. The final follow up was in April 2019. The study measured patient understanding of prognosis, treatment options, and the level of the patient's anxiety. RESULTS: Ninety-two patients were included in the analysis; 51 in the intervention group. A small proportion of both (DA with usual care and usual care) understood that mCRC was incurable (8% and 5%) of the 2 groups, respectively. There was no significant difference between groups in anxiety level; however, a time effect both initially and after one month was significantly higher than at 6 month. CONCLUSION: The study shows that a higher level of patient's baseline understanding lowered anxiety levels over time.  Decision aids group presented low levels of anxiety over time than those provided the usual care. We recommend  using Arabic DA in the oncology centers dealing with mCRC patients, aiming to empower patients in decision making.

The prevalence extent of Complementary and Alternative Medicine (CAM) use among Saudis.

Introduction: There is worldwide interest in the use of CAM. Studying CAM in Saudi population is important as it will reflect the influence of psychosocial, cultural and religious factors on health beliefs and behaviors. The objective of this study was to present an updated review on the use of CAM practices in Saudi Arabia including commonly used types, common conditions for which it has been used and who uses CAM. Methods: This review used data from national surveys conducted in Saudi Arabia and published between 2000 and 2015. The literature search was performed considering standards adopted such as Moose guidelines for observational studies. Two authors independently reviewed each article. The search yielded 73 articles, and a total of 36 articles were included. Further careful data extraction was carried out by two independents reviewers. Results: Most of the reviewed studies were cross-sectional in design and were published between 2014 and 2015, and mostly in Riyadh region. Substantial difference in the findings for the patterns of CAM use was revealed. The most commonly employed practice was of spiritual type such as prayer and reciting Quran alone or on water. Other types include herbs (8-76%), honey (14-73%) and dietary products (6-82%). Cupping (Alhijamah) was least used (4-45%). Acupuncture was more practiced among professionals. Conclusion: The utilization of CAM is widely practiced in Saudi Arabia. There is need for efforts to promote research in the field of CAM to address each practice individually. Population surveys should be encouraged supported by mass media to raise knowledge and awareness about the practice of different CAM modalities. The national center of CAM should play a major role in these efforts.

Faculty development programs improve the quality of Multiple Choice Questions items' writing.

The aim of this study was to assess the utility of long term faculty development programs (FDPs) in order to improve the quality of multiple choice questions (MCQs) items' writing. This was a quasi-experimental study, conducted with newly joined faculty members. The MCQ items were analyzed for difficulty index, discriminating index, reliability, Bloom's cognitive levels, item writing flaws (IWFs) and MCQs' nonfunctioning distractors (NFDs) based test courses of respiratory, cardiovascular and renal blocks. Significant improvement was found in the difficulty index values of pre- to post-training (p = 0.003). MCQs with moderate difficulty and higher discrimination were found to be more in the post-training tests in all three courses. Easy questions were decreased from 36.7 to 22.5%. Significant improvement was also reported in the discriminating indices from 92.1 to 95.4% after training (p = 0.132). More number of higher cognitive level of Bloom's taxonomy was reported in the post-training test items (p<0.0001). Also, NFDs and IWFs were reported less in the post-training items (p<0.02). The MCQs written by the faculties without participating in FDPs are usually of low quality. This study suggests that newly joined faculties need active participation in FDPs as these programs are supportive in improving the quality of MCQs' items writing.

Cigarette smoking among female students in five medical and nonmedical colleges.

OBJECTIVES: This study was conducted to determine the prevalence of smoking, knowledge about the ill effects of smoking on health, and the influence of family members' smoking habits among Saudi female students. METHODS: This is a type of cross-sectional study. A sample of 1,070 female students was selected by a nonrandom and convenient sampling method from five colleges (Medicine, Business and Administration, Computer Sciences, Education, and Languages and Translation) of King Saud University, Riyadh, Saudi Arabia. A self-administrated questionnaire was used to determine the personal, social, and educational characteristics of the respondents. In addition, questions about their smoking types, status, duration of smoking, knowledge about the ill effects of smoking, daily cigarette consumption, and reasons for quitting smoking were included. RESULTS: The students' response rate was 85%. The prevalence of current smoking was 4.3% and 5.6% for cigarettes and water-pipes, respectively, whereas 3.9% of the participants were ex-smokers. The prevalence of current smoking was highest in the College of Business and Administration (10.81%) and lowest in the College of Medicine (0.86%). The majority (77%) of the smokers' parents (current and ex-smokers) were also smokers. More than half (54%) of the smokers started their smoking habit for entertainment, and 44.4% of the participants did not know that smoking causes serious health problems. The most common factors for quitting smoking were health concerns (54%), religious beliefs (29%), and parent's advice (17%). CONCLUSION: The study concludes that the prevalence of smoking varies in different subject streams and that family and friends have a great influence on individuals starting or stopping smoking. Extensive health education programs are needed to educate young women on the health hazards of smoking and help stop them from smoking.

Sleep disorder among medical students: relationship to their academic performance.

BACKGROUND: Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. OBJECTIVE: To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. METHODS: This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. RESULTS: There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6-10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥ 3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). CONCLUSION: A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.