Faculty Development Initiatives at the College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman

Faculty development is necessary to improve and update teaching and learning methodologies. As such, a variety of learning activities have been designed to improve teaching competencies of individual teachers. The College of Medicine & Health Sciences at Sultan Qaboos University, Muscat, Oman, recognised the need for teacher training in order to bring faculty up-to-date in teaching and assessment methodologies. A programme of regular and one-time interventions consisting of short courses, workshops and a series of lectures was offered. Feedback from the participants and facilitators led to programme expansion and enhancement. This special contribution discusses the impact of the programme on faculty and the college.Keywords: Teacher Training; Medical Education; Oman

Students’ Perceived Benefits of Integrating a BSc in Health Sciences within a Medical Degree at Sultan Qaboos University

Objectives: After completing the pre-clinical phase of a Doctor of Medicine (MD) curriculum, undergraduate medical students may choose to add a Bachelor of Science (BSc) degree in health sciences to their MD degree. Limited data exists on the motives behind students’ decisions to undertake such intercalated degrees. Hence, this study aimed to identify the factors that influence students in making this choice. Methods: Undergraduate students who chose the research-based academic track of the intercalated phase of the BSc programme at the College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman, between 2014–2018 were enrolled. A standardised and validated self-explanatory questionnaire examining motivations to join the intercalated phase was administered to all students in the first week of enrolment. Results: Over a five-year period, out of 557 eligible students, 18 (3%) were enrolled in the intercalated phase and all completed the questionnaire. The mean age was 22 ± 1.5 years and the majority (83%) were female. Out of the 18 students, 10 (55%) had taken the university’s foundation programme. A total of 45% of students chose to intercalate out of their own interest, regardless of career ambitions. The main reasons to intercalate were an opportunity to enhance research experience, alignment with long-term career goals and a chance to publish in indexed journals. Conclusion: Despite the benefits of obtaining an additional degree, a relatively small proportion of MD students were attracted to the intercalated phase. A better presentation of the BSc degree is needed to help students make a more informed decision.Keywords: Medical Education; Undergraduate Medical Education; Career Choice; Curriculum; Oman

Effective stress law for the permeability of a limestone

The effective stress law for the permeability of a limestone is studied experimentally by performing constant head permeability tests in a triaxial cell with different conditions of confining pressure and pore pressure. Test results have shown that a pore pressure increase and a confining pressure decrease both result in an increase of the permeability, and that the effect of the pore pressure change on the variation of the permeability is more important than the effect of a change of the confining pressure. A power law is proposed for the variation of the permeability with the effective stress. The permeability effective stress coefficient increases linearly with the differential pressure and is greater than one as soon the differential pressure exceeds few bars. The test results are well reproduced using the proposed permeability-effective stress law. A conceptual pore-shell model based on a detailed observation of the microstructure of the studied limestone is proposed. This model is able to explain the experimental observations on the effect of the total stress and of the pore pressure on the permeability of the limestone. Effective stress coefficients for the stress-dependent permeability which are greater than one are obtained. It is shown that the controlling factor is the ratio of the different bulk moduli of the various constituents of the rock. This ratio is studied experimentally by performing microhardness tests.Comment: International Journal of Rock Mechanics and Mining Sciences (2008) In pres

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Re: Evaluation Tools in Postgraduate Medical Education–Do we need “Made in Oman” tools?

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Analytical and experimental study of the poroelastic behaviour of clean and clay-rich sandstones

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Spatial and Temporal Assessment of Vegetation Cover in Al- Suwaiq Using Satellite Images Analysis

Digital change detection techniques using multi-temporal satellite imagery helps in understanding landscape dynamics. The present study assesses the spatial and temporal dynamics of vegetation cover change in the coastal wilayat of Al-Suwaiq, Sultanate of Oman using field and remote sensing data. The study was conducted at various distances from the coastline, considering the variability in soil and water salinity. Normalized Difference Vegetation Index was calculated using the Landsat 5 TM and Landsat 8 OLI satellite images and classified into three main classes to evaluate the monthly and annual vegetation cover change between 1987 and 2016. Soil and water samples were collected during the cultivated season in Al-Suwaiq and analyzed mainly for salinity. Vegetation cover maps showed a general shift in vegetation biomass from regions closer to the coast (north-side) as water salinity increased with time. Between 1988 and 1999, vegetation cover increased by 7.7%, whereas it declined by 1.5 % in the study area along the coast. However, between 1999 and 2016, the vegetation cover decreased further by 5% along the coast while increasing by 12.2% farther from the coast. The largest increase in the area was for vegetation covers falling within the moderate (0.33-0.67) and high (0.67-0.86) NDVI classes. In conclusion, vegetation cover in Al-Suwaiq reduced along the coastline and shifted agriculture activities and increased cultivation from the North to the South of Wilayat. Therefore, agriculture activities on the Southside of the Wilayat should be controlled to prevent further degradation of water quality and its possible effect on agricultural farmlands

Assessment Methods in Undergraduate Medical Education

Various assessment methods are available to assess clinical competence according to the model proposed by Miller. The choice of assessment method will depend on the purpose of its use: whether it is for summative purposes (promotion and certification), formative purposes (diagnosis, feedback and improvement) or both. Different characteristics of assessment tools are identified: validity, reliability, educational impact, feasibility and cost. Whatever the purpose, one assessment method will not assess all domains of competency, as each has its advantages and disadvantages; therefore a variety of assessment methods is required so that the shortcomings of one can be overcome by the advantages of another