Evaluating the effectiveness of \u27MCQ development workshop using cognitive model framework: A pre-post study

A workshop on MCQ development using cognitive model framework was conducted for health educators from Aga Khan University (AKU) and other academic institutions. The aim was to develop the skill of preparing MCQs for assessing higher cognitive levels. A pre-post study was conducted, participant satisfaction was evaluated and pre-post test scores were used to assess learning capability of the workshop participants. Out of the 19 who attended the workshop, 16 participated in the pre- and post-tests and were included in the study through convenience sampling. The total duration of the study was six months. There was a significant difference in the overall pre-post test scores of the participants with a mean difference of -4.176 ± 4.83 (p-value \u3c 0.05). A significant difference was observed in the mean pre-post test scores of junior faculty (-6.350± 4.5829; p-value = 0.02). The mean pre-test scores of junior faculty were significantly lower 4.950±2.83 as compared to the senior faculty 10.417±1.56 (p-value= 0.001). Active participation in faculty development workshops may lead to enhancing skills for preparing one-best MCQs based on international guidelines

Needs assessment for faculty development in health professions education at a medical university in Karachi, Pakistan

Faculty Development (FD) embraces all educational activities used by teachers to improve their knowledge and skills for enhancing their academic competencies. This study aimed to identify the areas in Health Professions Education (HPE) in which formal faculty development is required. A needs assessment survey was conducted from among the faculty members at the Aga Khan University (AKU), Karachi, Pakistan, and the French Medical Institute for Mother and Children, Afghanistan. Data was analysed using SPSS 20.0 and reported frequencies and percentages according to various academic tracks. Competency-based curricula (51%), providing effective feedback (51%), developing Objective Structured Clinical Exam (51%), and clinical supervision (48%) were identified as significant areas for faculty development. Faculty in clinician teacher and clinician educator track require advanced training, i.e., Masters and PhD in HPE. The needs assessment facilitated prioritising the areas for FD. This will contribute to enhancing academic practices and inculcating the culture of lifelong learnin

Workplace based assessment: Tools to assess competencies in a clinical setting

The apprenticeship model has been used for long in surgical training. It initially provides opportunity to the trainee to observe the attending surgeon, followed by gradual introduction to surgical technique under direct supervision and later with detached supervision. The attending provides informal feedback at different intervals to the trainee. Several changes have been made in postgraduate programmes with a shift towards using workplace-based assessment tools for formative and summative evaluation of the trainee\u27s clinical skills

Capacity Building To Inculcate Twelve-Roles Of Medical teacher Using Patient-Safety Theme

Background: Teacher’s role has evolved from a knowledge-transmitter to that of a learning-facilitator. To professionally develop postgraduate medical/dental trainees-as-teachers (PGTT) considering teaching as one of the exit-level outcomes of their Master’s program. A course was conducted on twelve-roles of medical teacher with patient-safety theme. This study was intended to explore the level of PGTT’s satisfaction regarding their roles developed in response to their engagement in course activities. Methods: In 2015, a one-week course, ‘Fundamentals of Health-Professions-Education (FHPE)’ was conducted for 25 PGTT, underpinned with adult learning principles in context of patient-safety theme for the development of twelve-roles of medical teacher. Variety of teaching approaches with formative and summative assessments were done to promote learning-by-doing (Kolb’s-theory). A self-administered cross-sectional questionnaire on a 5-point Likert scale was used with 29 questions on role of course facilitators, Course plan & conduct and Development of their own teaching skills. Satisfaction-level was expressed in the form of percentages. Results: All 25 PGTT responded on three major domains of the questionnaire. All (100%) agreed on the effectiveness of the roles of course facilitators and the course plan & conduct. Majority (96%) of them showed agreement on the improvement of their teaching skills developed during this course. Conclusion: The FHPE-course was found as a worthwhile opportunity for PGTT in acquiring the desired outcomes under-supervision and with respect to its future implications in their respective settings. Building capacity for scholarship of teaching & learning is a way forward to successful academic achievements. Key Words: Roles of medical teacher, patient-safety, post graduate students as teachers, capacity building, health professions education

Succession des communautés végétales des jachères protégées en zone sahélienne: cas de Banizoumbou (Niger)

Objectif: L’importance de la perturbation (en durée ou en intensité) semble décisive pour déterminer l'état de la végétation et la dynamique successionnelle. L’objectif de la présente étude est d'examiner les variations des paramètres écologiques des champs et des jachères protégées de Banizoumbou.Méthodologie et résultats: Les relevés phyto-sociologiques ont été réalisés selon la méthode sigmatiste de Braun-Blanquet (1932). L’échantillonnage a été effectué sur la base de types des systèmes, ainsi les jachères et les champs ont fait l’objet d’inventaire suivant 6 transect, des placettes de 1000 m2 équidistantes de 500 m ont été placé. Ainsi au total 33 relevés ont été effectués dont 18 dans la jachère et 15 relevés dans le champ. Il ressort de l’étude que la diversité dépend de stade successionnel même à l’intérieur d’un même type d’occupation. L’analyse des indices montre qu’en plus des jachères, les champs sont aussi d’importantes sources de biodiversité. Ainsi l’indice de diversité de Shannon évolue en fonction de l’âge de jachère et de champ, mais toute fois il évolue beaucoup plus rapidement au niveau de jachère que le champ. La densité moyenne de la zone d’étude est de 260 individus par hectare dont Guiera senegalensis représente plus de 70%. La hauteur moyenne, le diamètre moyen, la densité moyenne et le recouvrement moyen les plus élevés sont observés au niveau des jachères.Conclusion et application of résultats: la présente étude a montré que la variation de la diversité végétale est une fonction de l’âge aussi bien au niveau des champs que les jachères. Ainsi la diversité évolue plus rapidement au niveau des jachères.Mots clés: Succession des communautés végétales, jachères protégées de BanizoumbouEnglish AbstractObjective: The importance of disturbance (duration or intensity) seems decisive in determining the state of vegetation and successional dynamics. The purpose of this study is to study and examine variations in the floristic richness, diversity and production of protected fallow land in Banizoumbou.Methodology and Results: The phyto-sociological surveys were carried out according to the sigmatist method of Braun-Blanquet (1932). Sampling was carried out on the basis of land use types, so fallows and fields were  inventoried following 6 transect, 1000 square meter equidistant plots of 500 m were set. A total of 33 surveys were carried out, including 18 in the fallows and 15 in the fields. Our findings show that diversity depends on the successional stage even within the same type of land use. Analysis of the indices shows that in addition to fallow land, fields are also important sources of biodiversity. Thus, Shannon's diversity index increases according to the fallow and field age, but this increase is much higher in the fallows in than the fields. The results reveal also that average density of the study area is 260 individuals per hectare, of which Guiera senegalensis represents more than 70%. The mean height, mean diameter, average density and highest average cover were observed at fallow land.Conclusion and Application of results: The present study showed that variation in plant diversity is a function of age at both field and fallow land. Thus diversity evolves more rapidly at fallow land.Keywords: Succession of plant communities, protected fallow land of Banizoumbo

Evaluation Of Diploma In Family Medicine Ensuring Quality Through CIPP Model

Background: To ensure quality of Diploma in Family medicine (DFM). An evaluation was conducted to determine the components and outcomes of the course for further development of the program. Methods: A Cross-sectional study was conducted with 15 students of three batches of DFM. Data collection form was designed on CIPP evaluation approach. It was used to collect information regarding goals and objectives, implementation strategy, satisfaction of instructor and trainees and impact of the program on the target population Descriptive measures (frequency and percentage distributions) were used to analyze the data on SPSS 19. Results: Majority (92%) were satisfied with the course content, organization, learning environment and teaching methods of Family medicine rotation. Most of the respondents (92%) were also satisfied with learning recourses accessible and assessment methodologies employed for ongoing assessment. They found ‘the atmosphere conducive for learning’ ,‘the rotations were a good experience, well organized with learning objectives provided at all rotations’ some suggestions made by students for improvement of the course ‘were teaching should be more interactive and more opportunity should be provided to participate with consultants’ The top rated rotations were dermatology, emergency medicine, ENT and orthopedics; where organizational learning environment and quality of delivery were considered as the best parts. Conclusion: The program was found successful in achieving its broad objectives. The graduating students found the training effective in enhancing team building abilities, independent thinking, analytical and problem solving skills and professional development. They were very satisfied with the administrative support (67%), infrastructure of the department (33%) and guidance by supervisors (67%). Key Words: Evaluation, Family medicine, Diplom

Effect of cadmium chloride and ascorbic acid exposure on the vital organs of freshwater Cyprinid, Labeo rohita

The present study was carried out to evaluate the impact of sub lethal concentrations of heavy metal, cadmium chloride (CdCl2.H2O), ascorbic acid (vitamin C) and their combination on Labeo rohita. The effect was investigated on the basis of histopathological examinations of control and experimental groups exposed to heavy metal. The acute semi statistical toxicity test for L. rohita revealed 96 h LC50 value 22.92 mg L-1 for cadmium chloride (CdCl2.H2O). 215 fingerlings of L. rohita were exposed to three different experimental conditions for 96 h: 11.46 mg L-1 CdCl2.H2O, or 450 mg Kg-1 ascorbic acid or combination of both these doses. No alterations were observed in gill sections upon comparison between treated and untreated groups. Congestion in sinusoids, fatty change, an increase in Kupffer cells and intrahepatic lymphocytes was observed in CdCl2.H2O treated group. In kidney sections of heavy metal treated group, degeneration of the glomerular tissue, occlusion in tubular lumen and necrosis were observed. Similar changes but in less severe form, as described above, were observed in the fish exposed to combination of CdCl2.H2O and ascorbic indicating that ascorbic acid do detoxify the effect of heavy metal to some extant. Our results indicate that cadmium chloride (CdCl2.H2O), if present in fresh water bodies, may act as strong toxic agent for L. rohita.Keywords: Labeo rohita, cadmium chloride (CdCl2.H2O), ascorbic acid, histopatholog

Challenges Arising from Self-Administered Misoprostol for Unintended Pregnancies Amidst Covid-19 Lockdown

Background: The COVID-19 pandemic placed unprecedented strain on healthcare globally, which exacerbated factors leading to unplanned pregnancies. This study aimed to assess the complications of self-administration of misoprostol for miscarriage during the COVID-19 lockdown. Methods: This was a retrospective cohort study conducted at the Department of Obstetrics and Gynecology, Abbasi Shaheed Hospital, Karachi, from 1st March to 30th September 2020. Case records were compiled and analyzed. All women who reported after self-administration of misoprostol were included. The primary outcome measure was complications; anemia, blood transfusion, heavy bleeding, shock, sepsis, ruptured ectopic pregnancy, and ruptured uterus. A bivariable analysis was done to see the effect of gestational age at intake of misoprostol on the complications encountered, the chi-square test or Fischer’s exact test was also applied. Results: In this study, a total of 54 cases were studied. The most common complication was anemia (63%) followed by incomplete abortion (61.1%). Heavy bleeding (p˂0.001), blood transfusion (p=0.020), and incomplete abortion were significantly (p˂0.001) more common in women who used misoprostol at gestational ages greater than 6 weeks. Conclusion: Our results suggested that health complications were found in women who self-medicated misoprostol for induced abortions after gestational ages greater than 6 weeks during the COVID-19 lockdown

Paediatric respiratory isolation: A challenge for a secondary care hospital! A service innovation project

Objective: The aim of this project was to broaden the secondary care hospital\u27s scope of services and provide safe, effective and quality care for the patient presenting with measles.Methods: Six Sigma DMAIC [define measure, analyze, improve, and control (DMAIC)] methodology was used in this quality improvement project. The quality project was started in October 2015 using a Gantt chart quality tool.Results: The paediatric team with the support of administration of the hospital has established isolation rooms and devised a policy for the care and management of patient with airborne infection to avoid cross transmission. During six months period after establishment of isolation room there were sixty two suspected or confirmed measles cases who were admitted in our hospital, out of them only 4(6.4%) of patients were referred because of their sick condition and need of ventilator support. Further, the percentage of patient\u27s satisfaction level also improved from 60 to 80%.Conclusions: After this clinical service innovation, there was significant reduction in referrals of measles patients to another hospital and consequently there was an increase in the patient\u27s satisfaction