Bridging knowledge gaps in paediatric chronic urticaria through a video-based educational tool.

BACKGROUND: There is a lack of patient educational resources about chronic urticaria (CU). AIMS: To develop and test the effectiveness of an education tool to help paediatric patients and their families better understand CU and its management. METHODS: From July 2020 to May 2022, paediatric patients with a history of CU who presented to the allergy outpatient clinics at our institution were recruited. Consenting families and patients were asked to complete five questions related to the definition, causes and management of CU at the time of presentation to the clinic. Participants were shown a 5-min animated video addressing the main knowledge gaps about CU. At the end of the video, participants were redirected to the same five questions to respond again. The scores were recorded as a proportion of correct answers (range 0·0-1·0). RESULTS: In total, 53 patients [30 girls (56·6%), 23 boys (43·4%); mean age 9·7 ± 5·1 years, range 1·4-18·5 years] were recruited. The mean baseline pre-video education questionnaire score was 0·67 ± 0·2 (range 0·2-1·0), while the mean post-video score was 0·94 ± 0·1 (range 0·4-1·0), a mean score difference of 0·27, which was statistically significant (P < 0·001). At the 1-year follow-up, 14 (26·4%) patients answered the questionnaire again to assess retention of knowledge; the mean score was 0·83 ± 0·2 (range 0·2-1·0). CONCLUSIONS: Our educational video was successful in educating patients and their families to better understand urticaria. Future studies should aim to optimize patient education through nontraditional tools such as videos, and compare knowledge gain using different methods of education.

Bridging Knowledge Gaps in Anaphylaxis Management Through a Video-Based Educational Tool.

Introduction: We aimed to develop and test the effectiveness of an education tool to help pediatric patients and their families better understand anaphylaxis and its management, and to improve current knowledge and treatment guidelines adherence. Methods: From June 2019 to May 2022, 128 pediatric patients with history of food-triggered anaphylaxis who presented to the allergy outpatient clinics at the study institution were recruited. Consenting families were asked to complete 6 questions related to the triggers, recognition, and management of anaphylaxis at the time of presentation to the clinic. Participants were shown a 5-min animated video on the causes, presentation, and management of anaphylaxis. At the end of the video, the participants were redirected to the same 6 questions to respond again. The scores were recorded in proportion of correct answers (minimum 0.0; maximum 1.0). Results: The mean age of the patients was 5.8 ± 4.5 years (range: 0.5-18.8 years). The majority were males (70 patients; 54.7%). The mean baseline prevideo education questionnaire score was 0.76 ± 0.2 (range: 0.3-1.0), whereas the mean follow-up score was 0.82 ± 0.2 (range: 0.3-1.0). This score difference of 0.06 was statistically significant (P < 0.001). There were no significant associations between change in scores and age or gender of the participants. Conclusion: Our video teaching method was successful in educating patients and their families to better understand anaphylaxis and its management at the moment of the clinical encounter. Retention of knowledge at long-term follow-up should be assessed.

Learning knee arthrocentesis using YouTube videos.

BACKGROUND: This study aims to compare medical students' educational outcomes in performing knee arthrocentesis through searching and using YouTube videos versus traditional supervisor-led sessions. METHOD: Seventy-one medical students were randomly assigned to three groups. Group A had a traditional supervisor-led clinical session, where the supervisor demonstrated the procedure. Students in group B were provided with links to YouTube videos of knee arthrocentesis that were deemed to be of high educational quality, whereas group C searched and learned from any YouTube video that they found themselves based on the learning objectives provided. Student performance was first examined following the learning sessions, and then again after receiving feedback on the performance. RESULTS: Prior to feedback, statistically significant higher mean scores were noted for group A in the identification of an appropriate puncture site (p = 0.015), puncture site sterilization (p = 0.046), wearing sterile gloves (p < 0.001) and direction of needle insertion (p < 0.001). The overall mean scores (maximum possible score is 21) before feedback for groups A, B and C were 17.9 ± 1.9, 14.9 ± 2.0 and 15.4 ± 1.8, respectively (p < 0.001). The overall mean scores after feedback for groups A, B and C were 21.0 ± 0.0, 20.9 ± 0.3 and 21.0 ± 0.0, respectively (p = 0.037). CONCLUSION: Students performed equally whether they were provided with videos or found their own; however, without appropriate learner feedback from an instructor, YouTube videos cannot replace traditional supervisor-led sessions for learning knee arthrocentesis.

Neuroimaging Evaluation for First Attack of Unprovoked Nonfebrile Seizure in Pediatrics: When to Order?

OBJECTIVE: To assess the value of neuroimaging studies in evaluating pediatric patients presenting with a first attack of nonfebrile seizure. METHOD: We reviewed the medical records of pediatric patients aged 28 days to 12 years who were admitted between 1 January and 31 December 2013 with a first attack of unprovoked, afebrile seizure. These patients had undergone neuroimaging studies. The exclusion criterion was patients with known predisposing conditions for seizure. The computed tomography (CT) scan and magnetic resonance imaging (MRI) results were either normal or abnormal, and the abnormal ones were further classified into clinically insignificant or significant. Descriptive analysis was performed to summarize the data. RESULT: Fifty children were identified with a mean age of 5.2 ± 3.8 years. Of the 50 subjects, 29 (58.0%) were males and 21 (42.0%) were females. Sixteen patients (32.0%) had abnormal neuroimaging studies (CT scan, MRI or both); however, only 1 was considered to have a clinically significant abnormality, later diagnosed as Moyamoya disease. CONCLUSION: In this study, the neuroimaging studies were found not to be useful in evaluating pediatric patients presenting with a first attack of unprovoked, nonfebrile seizures.

The educational environment of the undergraduate medical curriculum at Kuwait University.

BACKGROUND: Educational environment of an institution affects the quality of learning. We aim to assess the educational environment of the undergraduate curriculum of Faculty of Medicine, Kuwait University (FOMKU). METHODS: A cross-sectional study was carried out during April 2014. The validated Dundee Ready Education Environment Measure (DREEM) questionnaire was e-mailed to 607 students. Mean scores of the main domains of the questionnaire, and for each item, were calculated, and their association with the students' background information was measured using Student's t-test (P-value of ≤0.05 was considered as the cut-off level of significance). RESULTS: Of 607 students, 117 (19.3%) completed the questionnaire. The total mean score for DREEM was 108.7/200 (54.3%). The mean score for students' perception of teaching, perception of teachers, academic self-perception, perception of atmosphere, and social self-perception were 25.2/48 (52.5%), 24.6/44 (55.9%), 18.4/32 (57.5%), 26.2/48 (54.5%), and 14.3/28 (51.0%), respectively. The highest mean score for an item of DREEM questionnaire was for "my accommodation is pleasant" (3.48±0.75), while the lowest was for "there is a good support system for students who get stressed" (0.88±0.86). The total mean score was not significantly different between the two phases of the curriculum, or among males and females; however, few significant differences among the main domains and items were noted. CONCLUSION: Based on the learners' perspectives, the educational environment of FOMKU, was suboptimal. Medical educators in Kuwait should improve this environment in order to advance the quality of the delivered curriculum.

Medical and surgical ward rounds in teaching hospitals of Kuwait University: students' perceptions.

BACKGROUND: Teaching sessions for medical students during ward rounds are an essential component of bedside teaching, providing students with the opportunity to regard patients as actual people, and to observe their physical conditions directly, allowing a better understanding of illnesses to be developed. We aim to explore medical students' perceptions regarding medical and surgical ward rounds within the Faculty of Medicine at Kuwait University, and to evaluate whether this teaching activity is meeting the expectation of learners. METHODS: A pretested questionnaire was used to collect data from 141 medical students during the 2012-2013 academic year. They were asked to provide their current and expected ratings about competencies that were supposed to be gained during ward rounds, on a scale from 1 (lowest) to 5 (highest). Mean scores were calculated, and the Student t-test was used to compare results. P < 0.05 was the cut-off level for significance. RESULTS: Only 17 students (12.1%) declined to participate in the study. The students' current competency scores (for competencies taught within both disciplines - medical and surgical) were significantly lower than the scores indicating students' expectations (P < 0.001). The best-taught competency was bedside examination, in both medical (mean: 3.45) and surgical (mean: 3.05) ward rounds. However, medical ward rounds were better than surgical rounds in covering some competencies, especially the teaching of professional attitude and approach towards patients (P < 0.001). CONCLUSION: Both medical and surgical ward rounds were deficient in meeting the students' expectations. Medical educators should utilize the available literature to improve the bedside teaching experience for their students.

Self-confidence of medical students in performing clinical skills acquired during their surgical rotation. Assessing clinical skills education in Kuwait.

OBJECTIVE: To assess the self-confidence of clinical years` medical students in performing clinical skills/procedures. METHODS: A cross-sectional study was conducted in April 2011 at the Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Safat, Kuwait. A questionnaire was used to collect data from students who had completed their surgical rotation of their first clinical year. The students reported their level of self-confidence in performing specific skills/procedures related to that rotation. Data were presented using frequencies and percentages. A total score of confidence was calculated for each student. The Mann-Whitney and Kruskal-Wallis tests were used to assess the association between the students` sociodemographic characteristics and confidence score. RESULTS: Of the 122 students invited to participate in the study, only 15 (12.3%) declined to comply. Most students reported high confidence level (more than 75%) in performing 7 of the 13 history taking/physical examination skills, and 2 of the 39 diagnostic/treatment procedure skills. The highest confidence level was in performing abdominal examination, while the lowest level was in care of Jackson-Pratt drain site and emptying the drain bulb. The total confidence score was significantly higher among males (p=0.021), and students with higher monthly income (p=0.002). CONCLUSION: Medical students appeared to have poor self-confidence in performing clinical skills/procedures. Curriculum planners should explore potential reasons, and methods for the improvement of confidence level among medical students in performing skills/procedures they were expected to learn during their surgical rotation.

Are medical students accepted by patients in teaching hospitals?

BACKGROUND: Worldwide, patients are the cornerstone of bedside teaching of medical students. In this study, the authors aimed to assess patients' acceptability toward medical students in teaching hospitals of the Faculty of Medicine of Kuwait University. METHODS: Ninehundred and ninety five patients were approached in 14 teaching hospitals; 932 patients agreed to participate (refusal rate is 6.3%). A self-administered questionnaire was used to collect data. RESULTS: In general, higher acceptance of students by patients was found when there is no direct contact between the patient and the student (e.g., reading patients' files, presenting in outpatient clinic, observing doctors performing examination or procedures) compared to other situations (e.g., performing physical examination or procedures). Pediatrics patients showed higher acceptance of students compared to patients in other specialties, while Obstetrics/Gynecology patients showed the highest refusal of students. Gender of patients (especially females) and students appeared to affect the degree of acceptance of medical students by patients. Majority of the patients (436; 46.8%) believed that the presence of medical students in hospitals improves the quality of health care. CONCLUSION: Patients are an important factor of bedside teaching. Clinical tutors must take advantage of patients who accept medical students. Clinical tutors and medical students should master essential communication skills to convince patients in accepting students, thus improving bedside teaching. Also, using simulation and standardization should be considered to address scenarios that most patients are unwilling to allow students to participate.

Knowledge and self-reported practice of universal precautions among Kuwait University medical students in their clinical years.

OBJECTIVES: This cross-sectional study aimed to assess the knowledge and practice of universal precautions among Faculty of Medicine, Kuwait University, medical students in their clinical years. SUBJECTS AND METHODS: A self-administered questionnaire including 9 knowledge and 9 practice questions of universal precautions was used. A score was calculated for both knowledge and practice. These scores were dichotomized into less than median score (poor) and more than median score (good). 244 students were invited to participate. RESULTS: Of the 244 students, 220 (90.2%) accepted to participate. Of the 9 knowledge questions about universal precautions, 7 were answered correctly by more than 60% (range 64.8-90.4) of the students. All questions regarding the practice of universal precautions were answered correctly by over 60% (range 61.8-96.4) of the students. The prevalence of poor knowledge was 38.2% (84/220) and poor practice was 27.7% (61/220). Grade point average was significantly (p = 0.008) associated with the knowledge status of the respondents; however, it was not significantly associated (p = 0.397) with practice of universal precautions. Furthermore, neither the knowledge status nor any of the sociodemographic variables were significantly associated with the practice of universal precautions. CONCLUSIONS: A substantial number of students of the Faculty of Medicine, Kuwait University, in their clinical years appeared to have poor level of both knowledge and practice of universal precautions. Efforts are needed to optimize the level of knowledge and practice among students to minimize the risk of preventable infections.