Exploring factors affecting undergraduate medical students’ study strategies in the clinical years: a qualitative study

The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia during the period from November 2007 to December 2008. We conducted semi-structured focus groups interviews with students and conducted individual interviews with teachers and students to explore students’ and clinical teachers’ perceptions and interpretations of factors influencing students’ study strategies. Data collection was continued until saturation was reached. We used Atlas-ti Computer Software (Version 5.2) to analyse the data, apply the obtained themes to the whole dataset and rearrange the data according to the themes and sub-themes. Analysis of data from interviews with twenty-eight students and thirteen clinical supervisors yielded three major themes relating to factors affecting students’ study strategies: “clinical supervisors and supervision”, “stress and anxiety” and “assessment”. The three themes we identified played a role in students’ adoption of different study strategies in the “community of clinical practice”. It appeared that teachers played a key role, particularly as assessors, clinical supervisors and as a source of stress to students

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

The Leadership Authenticity of Women in the Academic Setting

Purpose: Leadership characteristics and career development of women in a health sciences university in Saudi Arabia was investigated. This was also extended to leadership authenticity of women graduated from a master's in medical education (MME) program. Method: In this cross-sectional study, a self-administrated authentic leadership questionnaire (ALQ) was utilized where the data were collected at three campuses of a health sciences university. Results: The study sample consisted of 71 MME graduates and 75 academic leaders. Women represented 42.25% of the MME graduates, with an average age of 41.04 (±5.49) years. Among MME graduates, there were 17 (56.67%) women holding the positions of deans, associate deans, or assistant deans compared with 14 men (34.16%) with a p value of 0.59. There were fourteen (46.67%) women holding Doctor of Philosophy compared with 19 men (46.34%) either holding a clinical fellowship of a master's degree. There were no significant differences between the scores of women and men in the four ALQ domains. Among academic leaders. twenty (26.67%) women were academic leaders with an average age of 47.31 (±9.63) years; compared with 55 men (p = 0.53). Twelve (60.00%) women leaders were from professions other than medicine with a p value of 0.07. Seventeen (85.00%) women were appointed at a middle management position; compared with 43 (78.18%) men with a p value of 0.16. Women showed tendency for higher scores in all ALQ domains; however, it did not reach statistical significance. Discussion: Women received opportunities to be enrolled in the MME program and the authenticity of their academic leadership skills did not significantly differ from men. Women accounted for a quarter of academic leaders, with more appointments in middle management positions and a tendency toward a better authenticity of leadership skills

Value of subspecialty experience in internal medicine undergraduate training

We aimed from our study to assess how students and clinical supervisors perceive students′ achievement in the internal medicine subspecialty clinical attachments in comparison with the general attachments. We conducted a cross-sectional study comparing students′ self-assessment ratings during the Medicine Block general and subspecialties clinical attachments at our college of medicine during the period between February 2007 and June 2009. We assessed the level of agreement between students′ self-assessment in the different subspecialties with their self-assessment in the general attachments. We repeated the same calculation for the supervisors′ assessment. Eighty-three students were included; these students attended eight different clinical attachments. A total of 517 self-assessment forms were completed (120 general internal medicine clinical attachments and 397 forms in different specialty attachments). The clinical supervisors completed parallel assessment forms. The undergraduate medical students′ perceived their achievement in the subspecialty attachments well. This was similar to their perception of their achievement in the general clinical attachments. The clinical supervisors perceived students achievement in the subspecialties to be similar to their achievement in the general clinical attachments. In conclusion, we do encourage the implementation of specialty and subspecialty undergraduate clinical attachments for all students as part of their curriculum requirements. Furthermore, we encourage the strategic utilization of specialties/subspecialties attachment distribution aiming to enhance students′ future interest to achieve balance in the different health specialties/subspecialties manpower. Further research to support this recommendation is needed

From Clinical Center to Academic Institution: An Example of How to Bring About Educational Change

Background: The usual scenario for change management in the medical education field is an academic institution creating a patient care facility. The opposite change is however rather rare and challenging. There is not much in the medical education literature on experiences of change management that provides sufficient support to readers who are involved in such process of change. Methods: We analyzed the experience of a clinical institution that has changed into an academic one. The methods used were archival analysis and interviews with those involved. The raw data were analyzed using a framework derived from the change management literature. Results: Despite the complex change and the use of a directive change strategy, the change managers׳ strategic thinking and timely use of different change strategies have helped in eliminating the initial change difficulties. The directive change strategy was turned into an advantage that has facilitated quick implementation. Conclusion: A directive change strategy is not always a disadvantageous method leading to chaos in the process of change. The educational change management experience gained by King Saud bin Abdulaziz University for Health Sciences can be considered a model for other clinical institutions changing into academic ones

COVID-19 vaccination and menstrual disorders among women: Findings from a meta-analysis study

Background: COVID − 19 vaccine can lead to various local and systemic side effects, including menstrual irregularities in women. There is no robust quantitative evidence of the association between the COVID − 19 vaccine and menstrual irregularities. A meta-analysis was performed to estimate the pooled prevalence of a range of menstrual disorders that may occur in women following COVID − 19 vaccination. Methods: After searching for epidemiological studies, we systematically performed a meta-analysis on PubMed/Medline, EMBASE, and Science Direct. Sixteen studies were finally included in the study. We estimated the pooled prevalence and corresponding 95 % confidence intervals (CIs) for a group of menstrual disorders, including menorrhagia, polymenorrhea, abnormal cycle length, and oligomenorrhea. Heterogeneity was assessed using the I2 statistic and the Q test. Results: Overall, the pooled prevalence of menorrhagia was 24.24 % (pooled prevalence 24.24 %; 95 % CI: 12.8–35.6 %). The pooled prevalence of polymenorrhea was 16.2 % (pooled prevalence: 16.2 %; 95 % CI: 10.7–21.6 %). The pooled prevalence of abnormal cycle length was relatively lower than that of the other disorders (pooled prevalence: 6.6 %; 95 % CI: 5.0–8.2 %). The pooled prevalence of oligomenorrhea was 22.7 % (95 % CI: 13.5–32.0 %). Conclusion: The findings indicate that menorrhagia, oligomenorrhea, and polymenorrhea were the most common menstrual irregularities after vaccination. The findings also suggest that a relatively high proportion of women suffer from menstrual irregularities. Further longitudinal studies are needed to confirm the causal relationship between COVID-19 vaccination and menstrual irregularities

Effect Modification by Age and Gender in the Correlation Between Diabetes Mellitus, Hypertension, and Obesity

Background: Literature has reported differences in the epidemiology or natural history of non-communicable diseases among both the male and female sexes. Stratification of multimorbidity burden based on sex is crucial to identify and implement targeted prevention and control interventions for chronic diseases. Objectives: To determine the burden of hypertension, type-2 diabetes mellitus, and obesity; and to compare the related multimorbidity among male and female patients. Methods: The study was a retrospective analysis of 375 802 medical records from primary care centers. Data was extracted from March 2022 to March 2023. A multivariate probit estimation methodology was employed using a 3-equations multivariate multiple probit model to jointly estimate the association of a person’s sex with the diagnosis of the 3 chronic conditions: obesity, diabetes, and hypertension. A multinomial logistic regression analysis was conducted to allow each unique combination of these 3 chronic diseases. Results: Females had a relatively higher proportion of obesity (58.1% vs 41.2%), obesity and diabetes only (58.9% vs 41.1%), obesity and hypertension (63.6% vs 36.4%), and joint diagnosis with 3 conditions (65.7% vs 34.3%). Females’ participants consistently had a significantly higher likelihood of diagnosis compared with males except for diabetes (OR = 0.59, 95% CI: 0.56-0.62) and the combination of only diabetes and hypertension (OR = 0.67, 95% CI: 0.61-0.74). The likelihood of other combinations ranged from 1.04 (95% CI: 0.98-1.10) for only hypertension to 2.30 (95% CI: 2.10-2.53) for the joint diagnosis of all 3 conditions. An increased likelihood of a single or combined occurrence of 3 chronic conditions was observed with increased age. Conclusion: The multimorbidity distribution for diabetes mellitus, hypertension, and obesity differs significantly among male and female patients. The overall burden of morbidity, and mortality, however, tends to rise after 46 years of age, with the highest burden among individuals above 60 years of age