The one-year incidence of stroke in patients with atrial fibrillation in Jordan and its associated factors.

Background: An elevated risk of stroke is linked to atrial fibrillation (AF). Effective care and prevention measures for individuals with AF require an understanding of the factors impacting the incidence of stroke in this population. Evidence regarding the incidence of stroke among patients with AF is insufficient in Jordan. This study aimed to determine the incidence of stroke and its associated factors among patients with AF in Jordan. Methods: The Jordan Atrial Fibrillation Registry JoFib was used to identify a total of 2020 AF patients meeting the study inclusion and exclusion criteria. Demographics, clinical characteristics, and the CHA2DS2-VASc score-based evaluation of stroke risk were extracted from the registry. Results: This study encompassed 2020 participants diagnosed with AF, with 925 (45.8%) being men and 1,095 (54.2%) women. The one-year stroke incidence among the 2020 AF patients was 3.4%. Notably, stroke incidence significantly increased with age (p = 0.04) and was associated with the history of stroke (7.4% vs. 2.7%), hypertension (3.9% vs. 1.9%), and diabetes (5.1% vs. 2.1%). In the multivariate analysis, diabetes (OR = 2.6, 95% CI: 1.5-4.4, p = 0.001) and history of stroke (OR = 2.6, 95% CI: 1.5-4.6, p = 0.001) were significantly associated with stroke incidence. Conclusion: This study emphasizes Jordan's high stroke rate among AF patients. Diabetes and prior stroke history are associated with increased odds of stroke, like all stroke patients. These results highlight the necessity for specialized management strategies among AF patients and highlight the significance of thorough risk assessment and focused interventions to reduce stroke risk in AF patients.

Attitude of Jordanians towards a new enactment for an opt-out organ donation system: a cross-sectional study.

BACKGROUND: Organ donation entails saving or transforming lives through the provision of organs, either from living donors or deceased individuals. In Jordan, low donation rates are attributed to religious misconceptions, limited education and insufficient awareness of the burden on patients with organ failure. OBJECTIVES: To investigate the attitudes of the Jordanian population towards the practicality and effectiveness of introducing an opt-out organ donation system through legislative measures, with the aim of increasing donation rates. DESIGN: This cross-sectional study used a designed self-administered questionnaire. Data were subsequently analysed using IBM SPSS software. SETTING: The study encompassed all 12 cities located in Jordan. PARTICIPANTS: Data were collected from 1146 Jordanian participants, excluding individuals under the age of 18. RESULTS: Approximately 36.6% reported organ or blood donation while 18.9% participated in awareness campaigns. Many (75.7%) perceived insufficient awareness about the importance of organ donation, and 67.1% noted a scarcity of online donor registration platforms. Only 12.0% of participants discussed organ donation with healthcare providers. As anticipated, only 9.0% were registered donors while 67.7% expressed acceptance of organ donation, with 55.3% willing to enrol in donor programmes. Religion influenced 54.2% of organ donation decisions. There are associations between agreement for a new enactment and prior organ or blood donation or discussions with healthcare providers. However, religion affected willingness to donate organs. Most importantly, refusal to be a donor after death was associated with religion, occupation and awareness levels. CONCLUSION: Despite the population's understanding and support for the concept of organ donation, the willingness towards donating their own organs is limited. To boost organ donation rates and acceptance of the new enactment, we recommend conducting educational campaigns, improving online registration platforms, enhancing healthcare provider engagement, collaborating with religious communities and advocating for supportive policies.

Distance Electronic Learning Strategy in Medical Teaching During the COVID-19 Pandemic: Cross-Sectional Survey Study.

BACKGROUND: Teaching hospitals have been regarded as the primary settings where doctors teach and practice high-quality medicine, as well as where medical students learn the profession and acquire their initial clinical skills. A percentage of instruction is now done over the internet or via electronic techniques. The present COVID-19 epidemic has pushed distance electronic learning (DEL) to the forefront of education at all levels, including medical institutions. OBJECTIVE: This study aimed to observe how late-stage medical students felt about DEL, which was put in place during the recent COVID-19 shutdown in Jordan. METHODS: We conducted a prospective, cross-sectional, web-based, questionnaire-based research study during the COVID-19 pandemic lockdown between March 15 and May 1, 2020. During this period, all medical schools in Jordan shifted to DEL. RESULTS: A total of 380 students responded to a request to fill out the questionnaire, of which 256 completed the questionnaire. The data analysis showed that 43.6% (n=112) of respondents had no DEL experience, and 53.1% (n=136)of respondents perceived the DEL method as user-friendly. On the other hand, 64.1% (n=164) of students strongly believed that DEL cannot substitute traditional clinical teaching. There was a significant positive correlation between the perception of user-friendliness and the clarity of the images and texts used. Moreover, there was a strong positive correlation between the perception of sound audibility and confidence in applying knowledge gained through DEL to clinical practice. CONCLUSIONS: DEL is a necessary and important tool in modern medical education, but it should be used as an auxiliary approach in the clinical setting since it cannot replace conventional personal instruction.

Disparities in Obstetric, Neonatal, and Birth Outcomes Among Syrian Women Refugees and Jordanian Women.

Objectives: To compare obstetric and neonatal characteristics and birth outcomes between Syrian refugees and native women in Jordan. Methods: We used the Jordan Stillbirths and Neonatal Deaths Surveillance System to extract sociodemographic and obstetric characteristics of the mothers and birth characteristics of newborns. Multivariate analysis was used to compare the characteristics of 26,139 Jordanian women (27,468 births) and 3,453 Syrian women refugees (3,638 births) who gave birth in five referral hospitals (May 2019 and December 2020). Results: The proportions of low birthweight (14.1% vs. 11.8%, p < 0.001) and small for gestational age (12.0% vs. 10.0%, p < 0.001) newborns were significantly higher for those born to Syrian women compared to those born to Jordanian women. The stillbirth rate (15.1 vs. 9.9 per 1,000 births, p = 0.003), the neonatal death rate (21.2 vs. 13.2 per 1,000 live births, p < 0.001), and perinatal death rate (21.2 vs. 13.2 per 1,000 births, p < 0.001) were significantly higher for the Syrian births. After adjusting for sociodemographic and obstetric characteristics of women, only perinatal death was statistically significantly higher among Syrian babies compared to Jordanian babies (OR = 1.3, 95% CI: 1.1-1.7, p = 0.035). Conclusion: Syrian refugee mothers had a significantly higher risk of adverse obstetric and neonatal outcomes including higher rate of perinatal death compared to Jordanian women.

The Health Literacy of Retinol Cream Usage Among Female Students in the Faculty of Artificial Intelligence at Al-Balqa Applied University.

INTRODUCTION: Considering people's tendency to self-treatment, efforts to address the broad aspects of health literacy are extremely important. The study aimed to find out the level of health literacy related to the use of retinol creams among female undergraduate students of the Faculty of Artificial Intelligence at Al-Balqa Applied University. METHODS: This study adopted an analytical descriptive research methodology by designing and applying a questionnaire tool. The questionnaire consisted, after arbitration and testing its validity and stability, of 15 items. Each item represents one of the indicators for measuring the level of health literacy about the use of retinol creams. The sample of the study was a random sample of female students in the Faculty of Artificial Intelligence at Al-Balqa Applied University. RESULTS: A total of 221 undergraduate female students were enrolled in the study. The most important results were that the arithmetic mean for estimating the level of health culture among female students in the study on the use of retinol creams was 3.117 out of 5, with a relative weight percentage of 62.3% and an average total score on the general level of indicators of total health culture. CONCLUSION: This study provided insights into the health literacy related to the use of retinol creams among female students. While the students demonstrated a high level of health education in some aspects, there were areas where their knowledge and practices could be improved. These findings can contribute to the development of educational programs and interventions aimed at promoting the safe and informed use of retinol creams among university students.

Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan.

Background: Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan. Methods: Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke. Results: The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance. Conclusion: Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.

Knowledge, attitude, practice and perceived barriers towards smoking cessation services among community pharmacists.

Introduction: With more than one billion current smokers, 80% of them living in low and middle-income countries, tobacco smoking is considered a global public health problem. Jordan has one of the highest estimate rates of tobacco use in the region and world. Still, tobacco use interventions, that could significantly reduce the number of smoking-related diseases and reduce health care costs, are scarce. While such interventions could be carried out by community pharmacists, given their unique position to counsel patients and provide effective cessation interventions, the role of community pharmacists in tobacco control services in Jordan has never been fully investigated. Objective: This study aimed at assessing the community pharmacists' knowledge, attitudes, and practice towards smoking cessation and identifying their perceived barriers for smoking cessation counselling utilizing a sample of community pharmacists in Northern Jordan. Method: A cross-sectional study was conducted among community pharmacies in Irbid city, North of Jordan, between April and August 2018. A random sample of 95 pharmacies was selected using the multistage random sampling technique. A structured English questionnaire, consisting of 5 parts, was used. The Survey assessed pharmacists' socio-demographics, knowledge, attitude, practice and perceived barriers related to tobacco use cessation services. Results: One hundred and fifty pharmacists completed the survey. Their mean age was 30.71±10.10 years. The mean of pharmacists' knowledge score was 3.74±0.38, while their positive and negative attitude were 3.87±0.43 and 3.18±0.66 respectively. Pharmacists' mean smoking cessation practice was 2.01+0.64. Barriers to providing cessation interventions included the lack of training on nicotine replacement therapy products (86%), the lack of smoking cessation programs (84%) and low demands from smokers (83.3%). Conclusion: While knowledge related to tobacco use cessation services among the community pharmacists was sub-optimal, a good positive attitude and a low practice levels were observed. The lack of educational materials, low patients' demand, knowledge deficits, low training and the lack of cessation programs have been identified as barriers hindering the provision of smoking cessation services. Furthermore, the study identified factors that will increase community pharmacists' participation in smoking cessation, help in raising pharmacists' awareness of smoking as a public health problem and the importance of their role.

Parental Willingness to Vaccinate Their Children Against SARS-CoV-2 in Jordan: An Explanatory Cross-Sectional Study.

Background: Successful control of the COVID-19 pandemic is largely dependent on vaccine administration to epidemiologically influential groups, including children. Considering that pediatric population comprises a significant portion on the population in developing countries, and their risk of infection and spreading the disease has been underestimated, it is crucial to investigate parental willingness to administer SARS-CoV-2 vaccine to their children between 5 and 11 years old. This study investigates the prevalence and determinants of parental willingness towards vaccinating their children (5-12 years old) against COVID-19 in a developing country setting, Jordan. Methods: A cross-sectional study, conducted between October and November 2021, utilized online Google Forms to collect data on parents' background characteristics, willingness to vaccinate their children, SARS-CoV-2, infection and vaccine, risk perception, and factors affecting decision to vaccinate. Results: A total of 564 parents completed the questionnaire; 82.8% were mothers, 85.3% were 30 years of age or older, and 75.9% had bachelor's degrees or higher. Only 25.4% of parents reported willingness to vaccinate their 5-12 years old children against SARS-CoV-2. Lower parental age, higher income, and having health insurance coverage increased parental willingness. Among participants vaccinated against COVID-19, only 29.0% were willing to vaccinate their children. Healthcare providers' trust and vaccine recommendations by pediatricians increased parental willingness. COVID-19 risk perception seems to have negative effects on parental willingness. Conclusion: A significant proportion of parents in Jordan indicated hesitancy towards administering COVID-19 vaccine for their children. Concerns about vaccine safety and trust in the healthcare system appear to be the most important predictors of parents' hesitancy. Effective vaccine campaigns should focus on risk perception and communication and should consider parental socio-demographic characteristics.

Increased incidence of musculoskeletal pain in medical students during distance learning necessitated by the COVID-19 pandemic.

As a consequence of lockdown during the COVID-19 pandemic, the education system has changed globally. Face to face education has been replaced by distance learning. The aim of the present study was to find the prevalence of musculoskeletal pain and syndromes among medical students during distance learning and to investigate the correlations of musculoskeletal pain with different causal factors. A total of 282 students completed an online questionnaire that measured time spent on digital devices, type of physical activity, time spent sitting, number of walking days/week, ergonomics, and postural habits. Some of these measurements were compared between periods before and during the pandemic. Because of distance learning, time spent on digital devices and total time spent sitting increased significantly from before to during the pandemic (p < 0.001); students' daily physical activities and the number of days per week with at least 10 min of walking decreased significantly (p < 0.001). Most of the students (75.9%) experienced at least one type of musculoskeletal pain, predominately shoulder and neck pain (65%). There was a very significant positive correlation between musculoskeletal pain and postural habits (p < 0.0001). This study suggested that postural habits while sitting have a profoundly negative effect on the musculoskeletal system and are factors in the causation of musculoskeletal pain.

Live in Front of Students Teaching Sessions (LISTS): a Novel Learning Experience from Jordan During the COVID-19 Pandemic.

Objective: The COVID-19 pandemic uncovered innovative approaches in medical education. Modifications are needed to overcome the drawbacks of pure online teaching. Our study aimed at testing a hybrid method of live online practical anatomy sessions in which an element of face-to-face teacher-student interaction is maintained. Methods: We performed an experiment with a one-group design in which medical and medical laboratory sciences students were taught different practical anatomy topics using either purely online or live in front of students teaching sessions (LISTS). Students' performance and perceptions were quantitatively assessed. Results: For 108 medical laboratory sciences students, the mean quiz scores were significantly higher for the topics taught by the LISTS approach (p = 0.025). For two groups of 13 and 17 medical students, the performance in exams was significantly higher for the topics taught using the LISTS method (p = 0.000 and 0.011, respectively) with large effect sizes. Students' perceptions of preference, enjoyment, and satisfaction were all in favor of LISTS. Conclusions: Our results confirmed that keeping at least a minimum of interaction between the teacher and students can have a significant improvement in the performance and engagement in practical anatomy sessions for health professionals. The results indicate that the extra effort of LISTS was worth it.

Knowledge, attitude, practice and perceived barriers towards smoking cessation services among community pharmacists

Introduction: With more than one billion current smokers, 80% of them living in low and middle-income countries, tobacco smoking is considered a global public health problem. Jordan has one of the highest estimate rates of tobacco use in the region and world. Still, tobacco use interventions, that could significantly reduce the number of smoking-related diseases and reduce health care costs, are scarce. While such interventions could be carried out by community pharmacists, given their unique position to counsel patients and provide effective cessation interventions, the role of community pharmacists in tobacco control services in Jordan has never been fully investigated. Objective: This study aimed at assessing the community pharmacists’ knowledge, attitudes, and practice towards smoking cessation and identifying their perceived barriers for smoking cessation counselling utilizing a sample of community pharmacists in Northern Jordan. Method: A cross-sectional study was conducted among community pharmacies in Irbid city, North of Jordan, between April and August 2018. A random sample of 95 pharmacies was selected using the multistage random sampling technique. A structured English questionnaire, consisting of 5 parts, was used. The Survey assessed pharmacists’ socio-demographics, knowledge, attitude, practice and perceived barriers related to tobacco use cessation services. Results: One hundred and fifty pharmacists completed the survey. Their mean age was 30.71±10.10 years. The mean of pharmacists’ knowledge score was 3.74±0.38, while their positive and negative attitude were 3.87±0.43 and 3.18±0.66 respectively. Pharmacists’ mean smoking cessation practice was 2.01+0.64. Barriers to providing cessation interventions included the lack of training on nicotine replacement therapy products (86%), the lack of smoking cessation programs (84%) and low demands from smokers (83.3%). (AU)

Self-Reported Obsession Toward COVID-19 Preventive Measures Among Undergraduate Medical Students During the Early Phase of Pandemic in Jordan.

Background: Coronavirus disease 2019 (COVID-19) pandemic and its associated precautionary measures have substantial impacts not only on the medical, economic, and social context but also on psychological health. This study aimed to assess the obsession toward COVID-19 preventive measures among undergraduate medical students during the early phase of the pandemic in Jordan. Methods: Online questionnaires were distributed between March 16, 2020 and March 19, 2020. Socio-demographic characteristics were collected, and self-reported obsession toward COVID-19 preventive measures was assessed using a single question.COVID-19 knowledge, risk perception, and precautionary measures were evaluated using scales. Using the chi-square test, Student t-test, and one-way ANOVA, we assessed the differences in the obsession of students with socio-demographic characteristics and scores of the scales. Results: A total of 1,404 participants (60% were female participants) completed the survey with a participation rate of 15.6%. Obsession with preventive measures was reported by 6.8%. Obsession was significantly more common among women (9.2%) than men (3.3%) and students who attended COVID-19 lectures (9.5%) than those who did not attend such lectures (5.8%) (p < 0.001 and p = 0.015, respectively). Obsessed participants reported significantly higher levels of COVID-19 knowledge (p = 0.012) and precautionary measures (p < 0.001). COVID-19 risk perception had a mild effect size difference but with no statistical significance (p = 0.075). There were no significant differences in the academic levels of participants (p = 0.791) and universities (p = 0.807) between students who were obsessed and those who were not. Conclusions: Obsession is one of the significant but unspoken psychological effects of COVID-19 precautionary measures among undergraduate medical students. Medical schools should be equipped with means to handle pandemic psychological effects.

Medical students' relative immunity, or lack thereof, against COVID-19 emotional distress and psychological challenges; a descriptive study from Jordan.

Background: Emotional distress is a major impact of COVID-19 among not only the general public but also healthcare workers including medical students. This study aimed at describing self-reported changes in emotional reactions associated with COVID-19 among medical students in Jordan and to assessing the potential effect of social media utilization on emotional distress among this group. Methods: A cross-sectional design was utilized to collect data early on during the outbreak in Jordan. All medical students in Jordan were eligible to complete an online questionnaire assessing self-reported emotional reactions to COVID-19 that covered four main domains: negative emotion (anxiety, worry, depression, panic, loneliness, and nervousness), positive emotion (happiness, joy, and excitement), sleep disorders (insomnia, shallow sleep, nightmares, and insufficient sleep), and aggression (verbal argument and physical fighting). The frequency of social media utilization as a main source of COVID-19 information was also assessed. Results: 59.9% of participants were females, 64.9% were enrolled at the two major medical schools in Jordan, and 59.6% were in the pre-clinical stage (years). A significant proportion of participants self-reported increased negative emotional levels of anxiety (49.2%), worry (72.4%), depression (23.1%), panic (22.6%), and nervousness (38.2%) and decreased positive emotional levels of happiness (44.8%), joy (47.3%), and feelings of excitement (45.1%). Self-reported sleep disorders were not as common (less than 15% for any of the four items), while arguing with others was at 26.7%. Significant differences by gender and academic year were detected. Almost half of participants reported using social media as a main source of COVID-19 information "most/all-the-times" with a significant effect of such on reducing emotional distress. Conclusion: The results suggest a potential effect of COVID-19 on the emotional distress of medical students. Addressing and mitigating such effects is crucial. The potential buffering effect of social media should be further investigated.

6th year medical students' future specialty preferences: A cross-sectional study.

BACKGROUND: Studying career preferences can help in designing and improving health service systems. Determining the preferred specialty and understanding the compulsion affecting specialty choice will provide clues to influence such choice in the future to shift the balance of specialties among practitioners. The current study aimed to determine medical students' preferable specialty choices and the factors influencing their choices and their attitude towards postgraduate medical education in Jordan and abroad. MATERIALS AND METHODS: The descriptive cross-sectional study design included 6th-year medical students in medical faculties in Jordan. An online questionnaire was created on Google Forms and posted on platforms accessible by medical students at level six. Numbers and percentages were presented for all variables. Frequency distributions were also presented. Chi-square distribution was used to measure the association between categorical data. Alpha level of 0.05 was used. RESULTS: Most students 188 (74.3%) preferred to continue their post-graduate training abroad, while only 65 (25.7%) favored Jordan. 150 (59.3%) of the respondents are interested in the medical - non-surgical - specialties. The most important factor that encouraged the students to choose a specialty was Job opportunity (32.5%) followed by the number of years required to complete the training and the expected income (27.7%) each. CONCLUSION: Supportive steps should be undertaken to motivate medical graduates toward the needed specialties. Moreover, local Specialty training programs need to be -reevaluated to ensure proper post graduate medical learning.

Effect of hookah (water pipe) smoking on semen parameters.

Hookah (water pipe) smoking, an old method of tobacco smoking, is regaining widespread popularity all over the world. Although the research in this field is still deficient, it has been proven for its harmful effect on human's health by increasing the risk of cardiovascular disease, infection and lung, oral and bladder cancer (Al-Numair et al., J Food Agric Environ, 5: 17, 2007; Bou Fakhreddine et al., Respir Med, 108: 1241-1253, 2014; Chaouachi, J Negat Results Biomed, 5: 17, 2006). However, no research was found to address its effect on human fertility or reproductive outcome. In this cross-sectional study, we aim to explore the effect of smoking hookah on human semen parameters among men attending In Vitro Fertilization LABs for seminal fluid analysis testing. 104 patients aged between 25 and 45, who are noncigarette smokers and have no chronic medical illness, were enrolled in the study: 50 hookah nonsmokers and 54 hookah smokers. Their semen parameters were compared. Semen volume, normal morphology and progressive motility were slightly lower in the hookah smoker (3.21 ml; 10.2%; 29.56%) versus (3.45 ml; 11.5%; 33.20%), respectively, in nonhookah smokers; however, the difference was not statistically significant. The effect of hookah smoking on semen observed in our study was not statistically significant. Further studies are needed to explore more and confirm any unfavourable effect.

Medical Students and COVID-19: Knowledge, Attitudes, and Precautionary Measures. A Descriptive Study From Jordan.

The recent coronavirus disease (COVID-19) pandemic is associated with increasing morbidity and mortality and has impacted the lives of the global populations. Human behavior and knowledge assessment during the crisis are critical in the overall efforts to contain the outbreak. To assess knowledge, attitude, perceptions, and precautionary measures toward COVID-19 among a sample of medical students in Jordan. This is a cross-sectional descriptive study conducted between the 16th and 19th of March 2020. Participants were students enrolled in different levels of study at the six medical schools in Jordan. An online questionnaire which was posted on online platforms was used. The questionnaire consisted of four main sections: socio-demographics, sources of information, knowledge attitudes, and precautionary measures regarding COVID-19. Medical students used mostly social media (83.4%) and online search engines (84.8%) as their preferred source of information on COVID-19 and relied less on medical search engines (64.1%). Most students believed that hand shaking (93.7%), kissing (94.7%), exposure to contaminated surfaces (97.4%), and droplet inhalation (91.0%) are the primary mode of transmission but were indecisive regarding airborne transmission with only 41.8% in support. Participants also reported that elderly with chronic illnesses are the most susceptible group for the coronavirus infection (95.0%). As a response to the COVID-19 pandemic more than 80.0% of study participants adopted social isolation strategies, regular hand washing, and enhanced personal hygiene measures as their first line of defense against the virus. In conclusion, Jordanian medical students showed expected level of knowledge about the COVID-19 virus and implemented proper strategies to prevent its spread.

Medical students' perceptions of pathology and a proposed curricular integration with histology: a future vision of curricular change / Percepciones de los estudiantes de medicina sobre patología y una propuesta de integración curricular con histología: una visión futura de cambio curricular

Students' perceptions and feedback have a significant impact on academic progress. The aim of this study was to determine the perceptions of medical students regarding the cumulative effects of the first year general histology course and the sophomore pathology introductory course, in addition to their perceptions regarding the curricular integration of histology and pathology. In this cross-sectional study, a questionnaire was given to second-year and third-year medical students in the middle of second semester. The questionnaire comprised several items on students' attitudes toward anatomic pathology, their feedback on the first year general histology and the sophomore pathology courses, and their perceptions regarding the integration of histology and pathology courses. A five-point Likert scale was used. Data were analyzed using Statistical Package for the Social Science (SPSS) v 20 software. Two hundreds and fourteen of the 236 questionnaires distributed were analyzed (response rate = 90.7 %). More than 51 % of the respondents reported that they couldn't identify the normal tissue counterpart of most practical pathology cases. Only 31.3 % thought their practical histology knowledge was beneficial for them in practical pathology. More than 87 % agreed or strongly agreed that pathology cases need to be copresented with normal tissue examples. A significant proportion of the respondents (60.7 %) were with merging histology and pathology in integrated courses. Pathology was of career choices for only 15.4 % of the participants. The curricular integration of histology and pathology in the first year needs to be tested, and much effort is needed to increase students' affinity for anatomic pathology.

Las percepciones y comentarios de los estudiantes tienen un impacto significativo en el progreso académico. El objetivo de este estudio fue determinar las percepciones de los estudiantes de medicina con respecto a los efectos acumulativos del curso de Histología general de primer año y del curso introductorio de Patología de segundo año, además de sus percepciones con respecto a la integración curricular de Histología y Patología. En este estudio transversal, se entregó un cuestionario a estudiantes de medicina de segundo y tercer año, a mediados del segundo semestre. Asimismo, el cuestionario comprendió varios aspectos referente a la actitud de los estudiantes hacia Patología Anatómica, sus comentarios sobre la Histología general en el primer año y los cursos de Patología de segundo año. Además se incorporaron las percepciones de los estudiantes con respecto a la integración de los cursos de Histología y Patología. Se utilizó una escala de Likert de cinco puntos. Los datos se analizaron utilizando el paquete Statistical Package for Social Science (SPSS) v 20. Se analizaron 214 de los 236 cuestionarios distribuidos (tasa de respuesta = 90,7 %). Más del 51 % de los encuestados indicaron estar de acuerdo o totalmente de acuerdo, en que no lograron identificar el tejido normal, en la mayoría de los casos de Patología práctica. Solo el 31,3 % observó que su conocimiento de Histología práctica era beneficioso para ellos durante la Patología práctica. Más del 87 % estuvo de acuerdo o muy de acuerdo en que los casos de Patología deben ser analizados con muestras de tejido normal. Un grupo importante de los encuestados (60,7 %) consideraba incorporar la Histología y la Patología en cursos integrados. Patología fue de elección en la carrera para el 15,4 % de los participantes. La integración curricular de Histología y Patología en el primer año, debe ser evaluada con el propósito de incrementar la afinidad de los estudiantes con la Patología Anatómica.