Survivability and behavior of probiotic bacteria encapsulated by internal gelation in non-dairy matrix and In Vitro GIT conditions.

The primary objective of this investigation was to assess the viability of free and encapsulated Lactobacillus plantarum probiotics in mango juice and under simulated gastrointestinal conditions. Specifically, the probiotics were encapsulated using sodium alginate and alginate-soy protein isolate through the internal gelation method, and the obtained probiotics were characterized for various attributes. Both free and encapsulated probiotics were exposed to challenging conditions, including thermal stress, low temperature, and simulated gastrointestinal conditions. Additionally, both types of probiotics were incorporated into mango juice, and their survival was monitored over a 28-day storage period. Following viability under simulated gastrointestinal conditions, the count of free and encapsulated probiotic cells decreased from initial levels of 9.57 log CFU/mL, 9.55 log CFU/mL, and 9.53 log CFU/mL, 9.56 log CFU/mL to final levels of 6.14 log CFU/mL, 8.31 log CFU/mL, and 6.24 log CFU/mL, 8.62 log CFU/mL, respectively. Notably, encapsulated probiotics exhibited a decrease of 1.24 log CFU and 0.94 log CFU, while free cells experienced a reduction of 3.43 log CFU and 6.24 log CFU in mango juice over the storage period. Encapsulated probiotics demonstrated higher viability in mango juice compared to free probiotics throughout the 28-day storage period. These findings suggest that mango juice can be enriched with probiotics to create a health-promoting beverage.

Investigating the internal structure of multiple mini interviews-A perspective from Pakistan.

BACKGROUND: Healthcare professionals require many personal attributes in addition to cognitive abilities and psychomotor skills for competent practice. Multiple Mini- Interviews are being employed globally to assess personality attributes of candidates for selection in health professions education at all level of entry; these attributes are namely, communication skills, critical thinking, honesty, responsibility, health advocacy, empathy and sanctity of life. Considering the high stakes involved for students, faculty, institutions and the society, rigorous quality assurance mechanisms similar to those used for student assessment must be employed for student selection, throughout the continuum of medical education. It is a difficult undertaking as these psychological constructs are difficult to define and measure. Though considered to yield reliable and valid scores, studies providing multiple evidences of internal structure especially dimensionality of Multiple Mini-Interviews are sparse giving rise to questions if they are measuring a single or multiple constructs and even if they are measuring what they are purported to be measuring. OBJECTIVE: The main objective is to provide statistical support of the multi-dimensional nature of our Multiple Mini Interviews, hypothesized a-priori, through CFA. Another objective is to provide multiple evidences for the internal structure. Our study highlights the link between content and internal structure evidences of the constructs, thus establishing that our Multiple Mini Interviews measure what they were intended to measure. METHOD: After securing permission from the Institutional review board, an a-priori seven factor-model was hypothesized based on the attributes considered most essential for the graduating student of the institution. After operationally defining the attributes through extensive literature search, scenarios were constructed to assess them. A 5-point rating scale was used to rate each item on the station. A total 259 students participated in the multiple mini interviews over a period of three days. A training workshop had been arranged for the participating faculty. RESULTS: The reliability coefficient using Cronbach's alpha were calculated (range from 0.73 to 0.94), Standard Error of Measurement (ranged from 0.80 to1.64), and item to station-total correlation ranged from 0.43-0.50 to 0.75-0.83. Inter-station correlation was also determined. Confirmatory factor analysis endorsed the results of Exploratory factor analysis in the study revealing a seven model fit with multiple indices of Goodness-of-fit statistics such as Root mean square error of approximation (RMSEA) value 0.05, Standardized root mean square residual (SRMR) value with less than 0.08. All these indices showed that model fit is good. The Confirmatory factor analysis confirmed the multi-dimensional nature of our MMIs and also confirmed that our stations measured the attributes that they were supposed to measure. CONCLUSION: This study adds to the validity evidence of Multiple Mini-Interviews, in selection of candidates, with required personality traits for healthcare profession. It provides the evidence for the multi-dimensional structure of Multiple Mini interviews administered with multiple evidences for its internal structure and demonstrates the independence of different constructs being measured.

Transforming professional identity of medical teachers in Pakistan by a certificate program in health professions education: a thematic analysis of reflective essays.

Introduction: A teacher's professional identity development is a dynamic and continuous process that requires rigorous, longitudinal, faculty development initiatives which are designed to work on individual professional growth. Impact of such programs must be evaluated by qualitative means to identify the process of change; The purpose of our study was to investigate whether and how our thoughtfully designed 6-month certificate program has transformed the professional identity of medical teachers. Methods: The study was conducted in National University of Medical Sciences, Pakistan using thematic analysis, wherein a weekly task of guided reflective writing, on Moodle, was given. Data was analyzed in six phases to achieve credibility and transferability. Results: By analyzing 202 reflective writings, seven subthemes were identified which manifest transformation in certain aspects of identity of participants and grouped under three major themes. The seven subthemes represent transformative journey of participants and include recognizing millennial learners' dilemma, identifying learning gaps and overcoming barriers, discovering a newer version of self, alternative frame of thinking, transforming traditional classroom, conducive learning environment and Community of Practice. Three major themes identified were Awareness, Modeling and Socialization which represent three processes bringing transformation in participants. Conclusion: Our faculty development program has transformed certain aspects of professional identities of medical teachers by incorporating informal teaching strategies of experiential learning, professional socialization, reflections, and role modeling. Participants' beliefs and practices on teaching were challenged by giving a disorienting dilemma of millennial learners and learning theories. They underwent critical discourse with professional peers and mentors in community of practice, reflected on their traditional teaching practices, acquired new insight, underwent self-discovery, and introduced digitalization and interactive learning strategies within their classrooms.

Assessment of musculoskeletal disorders among cricketers playing in domestic clubs of Lahore.

OBJECTIVE: To assess musculoskeletal disorders among male cricketers in an urban centre. METHODS: The cross-sectional study was conducted from October to November 2020 in Lahore, Pakistan, and comprised male cricket players aged 10-25 years playing in four domestic clubs. Data was collected about musculoskeletal disorders experienced during the preceding 12 months using the Extended Nordic Musculoskeletal Questionnaire. Data was analysed using SPSS 22. RESULTS: Of the 89 players with a mean age of 19.24±3.12 years, 35(39.3%) were bowlers, 26(29.2%) were batsmen, 17(19.1%) were all-rounders, and 11(12.4%) were wicketkeepers. The anatomical distribution of disorder was lower-back 68(76.4%), shoulder 40(44.9%), neck 39(43.8%), upper-back 37(41.6%), knees 31(34.8%), ankle/feet 29(32.6%), thighs 27(30.3%), wrist/hands 18(20.2%), and elbows 17(19.1%). There were 22(24.7%) players who had at any time seen a doctor or a physiotherapist, while 24(27%) players had a history of taking sick leave. CONCLUSIONS: The most affected anatomical segments were lower-back, shoulder, knee, ankle and upper-back.

Using Pensieve: Guiding and Evaluating a Learning Session on Reflections.

The objectives of this study were to guide students on reflective essay writing, evaluate their understanding and explore the immediate impact of a well-designed session on learning of students. A 1.5-hour learning session was designed following Gagne's nine events of instruction and conducted on final year MBBS students to guide them on reflective practice and its significance. The session was evaluated by a self-designed, structured questionnaire given as a pre-test and post-test. Of 158 students, self-scoring of reflective essay, by hand raising method, revealed that nearly 60% students were critical reflectors, 30% were reflectors and 10% were non-reflectors. Five out of nine questions showed a significant effect (p <0.001) in two-tailed t-test. This learning session led to a significant improvement in understanding of students regarding role of reflective practice in modifying their future behaviour, and its role in making them a better professional. Key Words: Learning, Reflections, Satisfaction, Feedback, Written, Educational assessment, Medical students.

Identification and comparison of factors related to academic failure in medical colleges; A Bi-centre, comparative study.

OBJECTIVE: To evaluate student's perceptions related to their academic failure, and to compare these perceptions with their nationality. METHODS: The non-interventional, bi-national, comparative study was conducted in medical colleges of Pakistan and Saudi Arabia from 2015 to 2017 and comprised medical students who had scored less than 50% in their professional examinations. Data was collected using a pre-designed 22-item questionnaire that was scored by the students on a 5-point scale. Data was analysed using SPSS 23. RESULTS: Of the 210 students, 115(55%) were Pakistanis and 95(45%) were Saudis. Common reasons of failure identified were information overload 114(50%), difficult examination 101(48%), poor teaching skills of teachers 82(39%), system of education 75(36%) and unfair examination 78(37%). In terms of nationality, 11 items were found significant (p<0.05). CONCLUSIONS: Regardless of cultural and environmental differences in factors contributing towards failure in students of different countries, the risk factors were found to be common, with most students blaming external factors rather than internal ones.

Evaluating the impact of faculty development programme initiative: Are we really improving skills in MCQ writing?

A series of seven workshops were conducted in 2018, at the National University of Medical Sciences and its affiliated institutes, to evaluate the effectiveness of a three-hour workshop in improving faculty competence in developing high quality test items. Participants' satisfaction was evaluated with a post-workshop feedback questionnaire. A self-made structured questionnaire was required to be filled as a pre-test and post-test assessment. Paired t-test was applied and difference in mean scores of responses was evaluated. A total of 141 faculty members were trained. The training session led to high satisfaction in all elements of workshop, significant improvements in boosting confidence in item writing skills (p=0.001), recognising parts of MCQs (p=0.001), identifying item writing flaws (p=0.001), and levels of Millers pyramid and blooms taxonomy (p=0.001). Training sessions of short duration are effective in improving faculty competence in writing high quality test items, if hands-on experience is built-in and effective feedback is provided.

Students' perceptions of factors for academic failure in pre-clinical years of a medical school.

OBJECTIVE: To identify and explore medical students' perceptions about their academic failure. METHODS: The qualitative study was conducted at Shifa College of Medicine, Islamabad, Pakistan, from December 2016 to January 2017, and comprised medical students. Two focus group discussions and 5 semi-structured interviews were conducted with students who had obtained <50% marks in their first professional examinations. Key words and important points in the written text were highlighted, coded, themed and categorised. Data was analysed manually. RESULTS: There were 22 students in the two focus group discussions; 13(59%) males and 9(41%) females. Of the 5 interviewees, 3(60%) were males and 2(40%) were females. Variable factors related to failure ranged from curriculum, assessment, environment, educators and personal factors to issues relating to stress and time management, learning resources, financial support, living away from home, poor attendance, peer pressure during small group discussions and indoctrination by parents. CONCLUSIONS: Both personal and environmental factors were found to be affecting academic performance of medical students.

Potential risk factors related to academic failure in a medical college: A comparative approach.

OBJECTIVE: To compare risk factors related to medical students' failure based on gender, year of study and living away from home. METHODS: The cross-sectional, non-interventional, comparative study was conducted at a private medical college of Islamabad, Pakistan from 2015 to 2017, and comprised students who had even once scored <50% marks in their professional examinations. Data was collected using a questionnaire that was scored on a five-point Likert scale. Data was analyzed using SPSS 23. RESULTS: Of the 115 students, 62(52%) were day scholars compared to 55(48%) hostellers; 64(56%) were females compared to 51(44%) males; and 50(43%) belonged to the second year. Overall, differences in terms of gender, year of study and living away from home were not significant (p>0.05). CONCLUSIONS: Risk factors for poor academic performance were found to be common among all students.