Comparison of depression, anxiety, and stress between public and private university medical students.

Context: Depression, anxiety, and stress are common among medical students because of hectic and heavy studies. Aim: This study was carried out to determine the magnitude of the Depression, Anxiety, and Stress Scale (DASS) among undergraduate medical students and its relationship with its causative factors in public and private universities. Setting and Design: The study tool was DASS (Depression, Anxiety, Stress Scale-21) which was distributed through the Department of Physiology, College of Medicine, King Saud University, adopting a multistage cluster sampling method for an observational study design. Subjects and Data: Data from undergraduate medical students (N = 337) was collected from public and private medical colleges in Saudi Arabia. Statistical Analysis: Independent t-tests and analysis of covariance were applied to analyze the data. Results: There was a significant difference in depression with a higher mean score in private versus public medical students (8.38±5.93 vs 6.34±5.46, p=0.001), anxiety (9.49±5.12 vs 7.91±5.00, p=0.005), and stress (9.11±5.11 vs 7.93±5.02, p=0.035). There was a significant difference in the level of anxiety between second- and third-years students (p =0.01). Conclusion: Private medical university students have significantly higher depression, anxiety, and stress levels compared to public universities. More studies are needed to explore the causes of this psychological impact.

An insightful estimation of undergraduate medical students' experience about the Flipped Classroom.

BACKGROUND AND OBJECTIVE: The Flipped Classroom (FC) approach has become increasingly predominant and popular in medical education. This study aimed to explore the usefulness and the scope of FC based on medical students' experience, with their adaptation challenges. METHODS: The present study was a mixed-method accomplished during the academic years 2019-20, involving fourth-year students at the College of Medicine in Riyadh, Saudi Arabia. A self-administered questionnaire was used to seek their first experience and opinion of the FC. RESULTS: A total of 234 questionnaires were distributed to the students, and 214 students completed the survey (response rate of 91.45%). Out of this total, 68.2 % were males and 31.8% were females. Most of the students agreed 156 (72.9%) that the flipped classroom was more engaging than the traditional lecture, among them 100 (68.5%) males and 56 (82.3) females agreed. Almost ~79% of students liked FC as it enabled them knowing the material in advance, and the class time was spent clarifying the facts and principles with active interaction, as commented during focus group discussion "More chance for discussing with the doctors, and I got the chance to answer" (St. 6). CONCLUSION: The results showed that the students like the FC more than the conventional classroom. Suggestions were given by students to improve the active learning sessions within the FC modality.

Prevalence of insomnia and related psychological factors with coping strategies among medical students in clinical years during the COVID-19 pandemic.

We explored the prevalence of insomnia, confirm the associated psychological factors and current coping strategies among undergraduate medical during their clinical years. This cross-sectional, quantitative, descriptive study was conducted at the department of medical education, college of medicine, King Saud University (KSU), Riyadh, Saudi Arabia. The participants (n = 463) were the 3rd to 5th year, and intern medical clinical students. We collected responses about sleep, using the Insomnia Severity Index (ISI). We also used Kessler-10 (K10), Psychological Distress and the Patient Health Questionnaire (PHQ-9). Items related to Coping strategies were also used from our previously published study and COVID-19 issues were explored using a self-developed questionnaire. According to the ISI ranking, 162 (34.9 %) of the participants had insomnia, among them 57.4% of females and 42.6% were males. Age groups between 22 and 25 have more sleeping disorder (43.2%) as compared to other age groups. 3rd-year students have more insomnia 36.41% as compared to other years. Individuals with insomnia symptoms were more likely (1.67 times higher) to be female students (OR = 1.67; P = 0.005) as compared to male students. A significantly high prevalence (3.37 times high) of insomnia was noted for those students or interns who have attended their clinical training irregularly as compare to regularly attending participants (OR = 2.32; P = 0.12) during COVID-19. Transition time i.e. year 3 of medical program was more stressful for the students and female students perceived stress and insomnia more than their male counterparts. It is important to address identified disorder early in order to reduce psychological morbidity and its harmful implications for medical students and young physicians.

Evaluation of the isosceles-configured SUN TeethTMtoothbrush in dental plaque removal and gingival health.

Objective: To evaluate the clinical efficacy and safety profile of a novel-designed isosceles-configured (SUN Teeth™) toothbrush in comparison to a standard reference toothbrush with end-rounded bristles (approved by the American Dental Association [ADA]). Methods: The sample size was determined using the G-Power-software, version 3.1.2 and, accordingly, 104 subjects (ages 19 years to 25 years) were recruited and randomized into either the test group (n = 54) or the control group (n = 50). Prior to study commencement, scaling was performed followed by abstinence from oral hygiene for 24 hours. Baseline pre-brushing gingivitis scores (Lobene) and plaque scores (Turesky modification of Quigley Hein) were recorded. Brushing was performed for 3 minutes and post-brushing scores were recorded on days 1, 14, and 28 without refraining from regular brushing. Data were analysed with Statistical Package for Social Sciences (IBM-SPSS, v.25.0). Results: Post-brushing plaque scores showed significant reduction in both groups at all time intervals. However, no significant differences between the test and control brush groups were achieved at any time points. Conclusion: The isosceles-configured SUN TeethTMtoothbrush is equivalent in plaque removal to the conventional flat-bristled ADA reference brush.

Objectif: Évaluer l'efficacité clinique et le profil de sécurité d'une brosse à dents à conception novatrice d'une configuration isocèle (SUN TeethMD) en comparaison à une brosse à dents à référence standard dotée de soies aux pointes arrondies (approuvée par l'Association dentaire américaine [ADA]). Méthodologie: La taille de l'échantillon a été établie à l'aide du logiciel G-Power, version 3.1.2, et 104 sujets (âgés de 19 à 25 ans) ont été recrutés et randomisés dans un groupe d'essai (n = 54) ou un groupe témoin (n = 50). Avant le début de l'étude, un détartrage a été effectué, suivi par l'abstinence de l'hygiène buccodentaire pendant 24 heures. Des cotes de référence de gingivite prébrossage (Lobene) et des cotes de plaque (modification Turesky de Quigley Hein) ont été consignées. Le brossage était effectué pendant 3 minutes et les cotes après-brossage étaient consignées aux jours 1, 14 et 28 sans éviter le brossage régulier. Les données ont été analysées avec l'Ensemble des programmes statistiques relatif aux sciences sociales (IBM-SPSS, v.25.0). Résultats: Les cotes de plaque après-brossage ont été significativement réduites dans chaque groupe à tous les intervalles de temps. Cependant, aucune différence significative n'a été réalisée en aucun temps entre les groupes de brossage d'essai et témoin. Conclusion: La brosse à dents SUN TeethMDà configuration isocèle est équivalente en matière d'enlèvement de la plaque à la brosse de référence conventionnelle à soies plates de l'ADA.

Faculty development program assists the new faculty in constructing high-quality short answer questions; a quasi-experimental study.

Faculty development programs (FD) prepare the faculty for their educational role and career tasks. We aimed to evaluate the effectiveness of FDP in advancing the quality of short-answer questions (SAQs). This was a quasi-experimental study, comprising 37 new faculty. The SAQs were examined on psychometric analysis and Bloom's cognitive levels for the two educational blocks of 1st medical year (i.e. Musculoskeletal (MSK) and Renal blocks). We found substantial improvement in the discrimination index values of SAQs prepared after the workshop (p = 0.04). A higher number of SAQs with moderate difficulty and higher discrimination were also observed. Flaws within the post-workshop questions were reduced (3.0%) when compared with pre-workshop (12.5%). The major incline was also reported within Bloom's cognitive levels when pre-workshop K2 questions (30%) were compared with post-workshop (45.5%) with a p-value = 0.05. The SAQs constructed by the faculty member without participating in FDP are generally of unsatisfactory quality. After the FDP the assessment items of two blocks improved for various parameters of student assessment. The current study advocates that newly joined faculty shall be provided with the FDP to be guided, trained and supported for improving the quality of assessment through SAQs items writing.

Professionalism development of undergraduate medical students: Effect of time and transition.

ABSTRACT: Changeover phases are essential and inevitable times in professional life, which let the learners adapt and grasp emerging opportunities for learning based on the past experiences with the catering of novel creativity as required in the present as well as emerging time. This study was carried out to examine the effectiveness of a professionalism course, during the transition from a non-clinical to clinical setting, within the context of undergraduate medical education.This observational study was conducted during 2019 to 2020, with pre- and post-professionalism course evaluation. We used the Dundee Poly-professionalism inventory-1: Academic Integrity, among the undergraduate medical students.Our results are based on the medical student's professional progress with the transition from 2nd year to 3rd year. During the 1st phase of the study, the participants at their Pre-Professionalism Course (PrPC) level in their 2nd medical year (only attended the introductory lectures for professionalism), showed a good understanding of professionalism. For the 2nd phase, when the same students, at their Post-Professionalism Course (PoPC) level, in their 3rd year (completed professionalism course) filled the same survey and it was found that there was no decline in their understanding of the topic, even after more than a year. They were even more aware of the significance of professionalism in their clinical settings.Despite a year gap, the understanding of professionalism among students was stable. Results helped us infer that time laps did not affect the professionalism concept learned earlier; rather during clinical settings, students become more aware of professionalism.

Association of COVID-19 Pandemic with undergraduate Medical Students' Perceived Stress and Coping.

PURPOSE: The COVID-19 pandemic poses a major challenge for medical students' learning and has become a potential stressor, with a profound influence on their psychological well-being. We aimed to determine the effect of the current pandemic on undergraduate medical students' learning. We also explored the association of their stress level with coping strategies, educational, and psychological variables. MATERIALS AND METHODS: This is a cross-sectional design study, and participants were the 1st to 5th year medical students. A self-administered questionnaire (18 items) and a well-known Kessler 10 Psychological Distress questionnaire (10 items) were used to collect the data related to perceived stress with an association of educational, psychological, and coping variables. RESULTS: The prevalence of overall stress was significantly higher (χ 2= 16.3; P=0.000) in female medical students, ie, (40%) as compared to the male students (16.6%), and was highest (48.8%) during the 3rd medical year. It was also noted that the most effective strategy, embraced by students to cope with the severe stress, was "indulging in religious activities" (OR= 1.08; P=0.81). Furthermore, 22.3% of students had perceived severe stress as they did not prefer online learning. Similarly, those students who have not believed or refused the online learning or disagree in "there is pleasure in the study due to COVID" they have significantly higher stress (χ 2=39.7; P=0.000) 21.5% mild, 17.8% of moderate, and 21.2% severe. CONCLUSION: We found that the COVID-19 pandemic has induced stress and changes in medical students' educational attitudes and strategies. The results exhibited that the predominance of stress is higher in females than males, and also more stress was perceived by the students during their transitional year, ie, 3rd medical year (from pre-clinical to clinical) and also the respondents who regularly did religious meditation were at lower levels of stress. COVID-19's influence on medical education and students' well-being will be felt at an extended level, which necessitates an appropriate plan for preparedness.

Medical professionalism videos on YouTube: Content exploration and appraisal of user engagement.

BACKGROUND: Social media has become the fastest growing platform for sharing and retrieving information and knowledge, and YouTube is one of the most popular and growing sources of health and educational information video-sharing website. But, videos on this open platform are not peer-assessed, therefore, the accessible data should be adequately assessed. Till date, no exploration and analysis for assessing the credibility and usefulness of Medical professionalism videos available on YouTube are conducted. OBJECTIVE: To analyze the video sources, contents and quality of YouTube videos about the topic of medical professionalism. METHODS: A systematic search was accomplished on YouTube videos during the period between March 1, 2020 and March 27, 2020. The phrases as significant words used throughout YouTube web search were 'Professionalism in Medical Education', Professionalism in medicine', 'Professionalism of medical students', 'Professionalism in healthcare'. 'Teaching professionalism', 'Attributes of professionalism'. The basic information collected for each video included author's/publisher's name, total number of watchers, likes, dislikes and positive and undesirable remarks. The videos were categorized into educationally useful and useless established on the content, correctness of the knowledge and the advices. Different variables were measured and correlated for the data analysis.YouTube website was searched the using keywords 'Professionalism in Medical Education', Professionalism in medicine', 'Professionalism of medical students', 'Professionalism in healthcare'. 'Teaching professionalism', and 'Attributes of professionalism'. RESULTS: After 2 rounds of screening by the subject experts and critical analysis of all the 137 YouTube videos, only 41 (29.92%) were identified as pertinent to the subject matter, i.e., educational type. After on expert viewing these 41 videos established upon our pre-set inclusion/exclusion criteria, only 17 (41.46%) videos were found to be academically valuable in nature. CONCLUSION: Medical professionalism multimedia videos uploaded by the healthcare specialists or organizations on YouTube provided reliable information for medical students, healthcare workers and other professional. We conclude that YouTube is a leading and free online source of videos meant for students or other healthcare workers yet the viewers need to be aware of the source prior to using it for training learning.

Integrated undergraduate dental curriculum.

OBJECTIVE: To develop a blueprint for producing an integrated undergraduate curriculum for dental schools in the region. METHODS: The study framework was designed at Islamic International Dental College- Riphah International University, Islamabad during May 2016-January 2017. Integrated curriculum was developed by using themes described as modules, such as organs, science of oral diagnosis, aesthetics and dental rehabilitation. Contents or topics from different disciplines having similar focussed learning outcomes were united in one particular module. Horizontal and vertical homogenisations of various modules were achieved by displaying them in a specific way on Bloom's ladder . RESULTS: All modules were free of boundaries of traditional subjects. For example, dental emergency was a theme (module) which carried assorted contents associated with dental emergency from endodontic, oral surgery, prosthetic disciplines etc. CONCLUSIONS: The framework provided an outline and pattern to develop integrated undergraduate curriculum for dental schools.

Prevalence of Type 2 Diabetes Mellitus Among Men in the Middle East: A Retrospective Study.

The rising prevalence of diabetes mellitus (DM) is a serious global health concern. The world is experiencing type 2 diabetes epidemics and prevalence differs by gender, regions, and level of socioeconomic development. Type 2 diabetes mellitus (T2DM) in men increased at a faster rate and numbers are continuing to rise in some regions of the world. This study aimed to estimate the prevalence of T2DM among men in the Middle East countries. Seventy-four research articles were identified through search engines including Web of Science, Medline, PubMed, EMBASE, Scopus, and Ovid databases by using keywords "epidemiology," "prevalence," "diabetes mellitus," and individual names of the Middle East states. Finally, 17 studies were included for the assessment of prevalence of T2DM among men in the Middle East. In the Middle East, high prevalence of T2DM among men was identified in Bahrain (33.60%), Saudi Arabia (29.10%), United Arab Emirates (UAE; 25.83%), and Kuwait (25.40%), whereas low prevalence was reported in Iran (9.90%) and Yemen (9.80%). The random pooled prevalence in the Gulf Cooperation Council (GCC) states was (24.0%) compared to non-GCC states (16.0%), and in both GCC and non-GCC countries combined, it was 19%. The prevalence was significantly associated with the gross domestic product of these states ( p = .0005). Despite different socioeconomic and cultural settings in the Middle East, the rising T2DM prevalence among men was identified in Bahrain, Saudi Arabia, UAE, and Kuwait. These states must incorporate future diabetes defensive strategies targeting the Middle East population to minimize the burden of DM from the region.

Effect of Obesity on Cognitive Function among School Adolescents: A Cross-Sectional Study.

OBJECTIVES: Childhood obesity contributes to the risk of numerous health problems and has become a major global health concern. This study aimed to establish the association between obesity and cognitive function among healthy school adolescents. METHODS: This study was carried out by taking school adolescents (n = 400) from June 2016 to December 2017. The mean age of the participants was 13.93 ± 0.81 years. The students were divided into group A (obese, n = 223) and B (non-obese, n = 177). Cognitive functions were recorded as per study tool of the Cambridge Neuropsychological Test Automated Battery (CANTAB). RESULTS: Severely obese students showed a significant delay in cognitive functions as compared to students with normal BMI. Attention Switching Task (AST)-Latency among students with normal BMI was 647.88 ± 137.59 compared to the students with high BMI (685.08 ± 115.92, p = 0.05), AST-Incongruent was 680.78 ± 142.07 versus 726.76 ± 122.31 (p = 0.02), AST-Percent correct trials was 84.31 ± 10.45 versus 78.09 ± 14.87 (p = 0.001), and Intra-Extra Dimensional Set Shift (IED) Total errors among students with normal BMI was 33.93 ± 21.53 compared to the students with high BMI (42.86 ± 37.27, p = 0.03). CONCLUSION: Cognitive functions including AST-Latency, AST-Incongruent, AST-Percent correct trials, and IED Total errors were significantly weakened in markedly obese students. Significant impairments in their cognitive functions, especially attention, retention, intelligence, and cognitive flexibility, were observed. The findings of this study emphasize the need to involve school adolescents in physical activities to reduce body weight in order to have cognitive functions within normal range and also to minimize obesity-associated complications.

An approach for developing integrated undergraduate medical curriculum.

BACKGROUND AND OBJECTIVES: Medical schools are to develop integrated medical curricula because the term 'integrated curriculum' has grown up and flourished globally and it has become mandatory to align the medical education with the global concept in Pakistan. This paper aims to present a guideline to design an undergraduate integrated medical curriculum. METHODS: Various themes are used to develop integrated curriculum which are basic medical science, simulation skills, clinical science, personality development, research, entrepreneurship and pre specialization. Each theme is subdivided, termed a module and its contents primarily focus on particular aspect. RESULTS: Knowledge, skill and attitude, embodied in themes or modules, are planted in specific way that they have horizontal as well as vertical integration. There is no boundary of various traditional disciplines in template of five years curriculum. For example, diagnosis is a theme which carries contents from medicine, surgery, orthopedics etc. CONCLUSION: The blueprint introduced in this paper would help medical educators to draft integrated medical curricula for those institutions which intend to switch their medical programs from traditional to integrated one.

Comparison of the learning of two notations: A pilot study.

INTRODUCTION: MICAP is a new notation in which the teeth are indicated by letters (I-incisor, C-canine, P-premolar, M-molar) and numbers [1,2,3] which are written superscript and subscript on the relevant letters. FDI tooth notation is a two digit system where one digit shows quadrant and the second one shows the tooth of the quadrant. This study aimed to compare the short term retention of knowledge of two notation systems (FDI two digit system and MICAP notation) by lecture method. METHODS: Undergraduate students [N=80] of three schools participated in a cross-over study. Two theory-driven classroom based lectures on MICAP notation and FDI notation were delivered separately. Data were collected using eight randomly selected permanent teeth to be written in MICAP format and FDI format at pretest (before the lecture), post-test I (immediately after lecture) and post-test II (one week after the lecture). Analysis was done by SPSS version 20.0 using repeated measures ANCOVA and independent t-test. RESULTS: The results of pre-test and post-test I were similar for FDI education. Similar results were found between post-test I and post-test II for MICAP and FDI notations. CONCLUSION: The study findings indicated that the two notations (FDI and MICAP) were equally mind cognitive. However, the sample size used in this study may not reflect the global scenario. Therefore, we suggest more studies to be performed for prospective adaptation of MICAP in dental curriculum.

Lesson plan on new method of teeth identification introduced at dental schools in Malaysia and Pakistan.

This article describes a new tooth notation system designed to be implemented for educational purposes in dental schools in Malaysia and Pakistan for identification of teeth and subsequently dental communication for wellness of dental patients. Its format is constructed as a lesson plan to present an uncomplicated tooth notation system by first letter of each tooth class (I-incisor, C-canine, P-premolar, and M-molar) to describe and communicate dental information. The new system is a promising and potential educational lesson that is innovative in its contents, easily understandable, and usable in dental charting as indicated by the results of a pilot study. However, further studies are required to investigate the strength of this new system.

An assessment of the prescribing skills of undergraduate dental students in malaysia.

Most dental schools lack a module on prescription writing in pharmacology. This study assessed the prescription writing skills of a group of Malaysian dental students at the end of their undergraduate training program. A quantitative study of a two-group posttest experiment was designed, and thirty-seven fifth-year (final-year) dental students were divided into two groups (A [n=18] and B [n=19]). Group A received a didactic lecture on how to write a complete prescription, while Group B served as a control group. For prescription writing, three standardized dental scenarios with a diagnosis of irreversible pulpitis associated with a child and a pregnant woman and periapical pulpitis for an adult man were administered. Thus, a total of 111 prescriptions (Group A [n=54] and Group B [n=57]) were collected. Twelve elements in each prescription were assessed by frequency and a chi-square test. Improvements in eight out of the twelve elements were observed in prescriptions written by students in Group A. The significantly improved elements were provision of the symbol R(x) (39.8 percent) (p<0.001), inclusion of the prescriber's signature (75.3 percent) (p<0.001), inclusion of the date with the prescriber's signature (54.6 percent) (p<0.001), and inclusion of the prescriber's registration (30.5 percent) (p<0.001). Overall, Group A gained almost a 50 percent improvement in writing complete prescriptions due to the intervening lecture. It appeared a traditional lecture led to the more accurate writing of a complete prescription. It was suggested that a module on prescription writing be added to the school's pharmacology curriculum, so that dental graduates will be competent in prescription writing for the sake of their patients' health.

MICAP--a novel system for identification and communication of dental problems.

AIM: To design a new tooth notation system to record and communicate dental and periodontal problems around the world. METHODOLOGY: The design of a new tooth notification system is based on the first letter of each tooth class, M-molar, I-incisor, C-canine and P-premolar, termed as ANAASEA letters and digits (1, 2, 3), termed as TOT digits, assigned to appropriate tooth types to record the right and left maxillary and mandibular teeth of both permanent and deciduous dentitions for specifically dental and periodontal charting and generally other dental oriented purposes. The letter 'd' is written along with the ANAASEA letters used for deciduous tooth classes. RESULTS: The MICAP system records and communicates dental and periodontal problems manually as well as electronically by using letters I, C, P, M and assigned digits 1, 2, 3. The assigned digits are written as superscript and subscript on right and left sides of letters I, C, P and M not only to identify teeth during oral examination but also in writing referral letters and submitting dental claims for various performed dental procedures. CONCLUSIONS: The identification of and communication about human teeth by the MICAP system is simple, error free and user/computer friendly.