Exploring Empathy In A Dentist-Patient Relationship. Conclusions From Qualitative Exploratory Research Of Practicing Dentists

Objective: This study explored the factors influencing the development of empathy in a dentist-patient relationship. Design: An exploratory qualitative study. Place and duration of the study: Khyber Medical University KPK, Pakistan October 2019 to April 2020.was conducted during 2019-2020 Methodology: This exploratory qualitative study was conducted during 2019-2020. It was conducted on 12 dental surgeons, recruited from four major dental clinical specialties. A purposive sampling technique was used. In-depth interviews were conducted through a semi-structured format. The interviews were audio recorded, transcribed verbatim and analyzed, using the thematic analysis framework. Results: Three themes were extracted from data. 1) Institutionalization of empathy, indicating a need for incorporating empathy in undergraduate and postgraduate dental curriculum, 2) Barriers in the path of empathetic attitude, including a variety of factors hampering the development of empathy in a dentist-patient relationship and 3) Cultivating a Culture of empathy for better health care provision, indicating a need for changing the collective attitude of all health care professionals, administrative staff, and students. The participants of the study observed that development of empathy in a dentist-patient relationship includes a wide range of factors, ranging from curricular, personal, social, organizational, and cultural. These factors elaborate that empathy is a multidimensional phenomenon with roots deeply entrenched in professional and personal domains

Perception of Neurosurgical Residents about Learning in Operation Theatre in Tertiary Care Hospitals

OBJECTIVES To explore Neurosurgical postgraduate residents perceptions of their learning environment in operating rooms.METHODOLOGY From March 2022 to August 2022, this cross-sectional study will be carried out in the Department of Neurosurgery Hayatabad Medical Complex, Peshawar, Lady Reading Hospital Peshawar, and Ayub Teaching Hospital Abbottabad. The STEEM survey examined how surgical theatres were perceived as educational environments. After receiving informed consent, a printed questionnaire was provided to 32 surgical residents. SPSS 24 was used to conduct descriptive and inferential data analyses. RESULTS Thirty-one (31) of the 32 surgical residents that were surveyed (or 98.3%) answered. Residents' average age was 29.27 years (2.37); 27 were male, and 05 were female. Most residents were in their third (34.4%) and fourth (21.3%) years of residency. 147.66 (18.57) was the overall mean score. Participants' age and gender did not affect the mean scores; nevertheless, responses were statistically more favorable for residents in their first or fifth year of residency. Fifty-three locals responded favorably or positively overall. CONCLUSION Overall, residents had positive opinions of their training, their supervisors, the opportunities for learning in the operating room, the environment, and the monitoring they received

EFFECTIVENESS OF VARIOUS TEACHING METHODOLOGIES IN DEVELOPING CLINICAL REASONING SKILLS IN UNDERGRADUATE FEMALE MEDICAL STUDENTS

ABSTRACT OBJECTIVE: To compare the effectiveness of “summarize, narrow, analyze, probing, management plan, select a topic” (SNAPPS) model, one-minute preceptor (OMP) and traditional clinical teaching in developing clinical reasoning skills of final year undergraduate female medical students in pediatrics clinical setting. METHODS: This randomized control trial was conducted at Department of Pediatrics, Peshawar Medical College from February to July 2016. Students were randomly distributed in three groups i.e. SNAPPS, OMP and traditional teaching with 20 students in each group. All 60 students were exposed to pre-test including 4 Key Feature Problems (KFPs). Students were then taught on pre-identified 4 topics with one topic /week by respective teaching methodology. Each topic was followed by post-test using 4 KFPs. The pre-test and post-test results were recorded and analyzed on SPSS-20. ANOVA was used as test for finding significance. RESULTS: All 60 female students of final year completed the study and none dropped out. The mean marks of pretest of three groups were 12.50±0.15 with minimum number of 4±1 marks and maximum of 23±1. There was no significant difference in pre-test among the groups using ANOVA (p = .984). However, significant difference (p< 0.001) was observed in post-test among groups after intervention. There was statistically significant difference (p<0.001) in favor of SNAPPS as compared to traditional teaching methodology. There was no significant difference between OMP and traditional method. CONCLUSION: SNAPPS is significantly more effective in improving clinical reasoning than OMP and traditional teaching method in female undergraduate medical students in pediatrics clinical setting

Perceptions and comparison of bedside teaching among final year students of public and private medical colleges of Peshawar

Introduction: Bedside teaching is an important but declining strategy in medical education. The regulatory authority’s insistence on structure of an institute needs be supplemented with quality of bedside teaching. The objective of this study was to find perceptions and compare bedside teaching among students of public and private medical colleges of Peshawar. Methods: A cross-sectional study was conducted at four medical colleges of Peshawar during the month of February 2020. A Likert scale tool with 30 items and four subscales; physical environment, patient’s comfort and student attitude, teaching session and teaching fellow was filled by 242 students. Mean score for each question and each subscale was calculated for each institute for perceptions. Mean score of two public and two private institutes for each subscale was compared by unpaired t-test. Results: Physical environment mean score was highest at Khyber Girls Medical College Peshawar (2.97±0.50). Patients’ comfort and students’ attitude mean score was approximately equal in four institutes. In teaching session, the highest mean score was reported by Khyber Girls Medical College and was lowest by Khyber Medical College. For teaching fellow, mean score was highest at Khyber Girls Medical College (3.70±0.67) and lowest at Kabir Medical College (2.85±0.55). For physical environment (public 2.87±0.48 vs. private 2.59±0.60) and teaching fellow scale (public 2.87±0.48 vs. private2.59±0.60) there was highly significant difference (p=0.0001). Conclusion: Mean score in four subscales are comparable in four institutes with some variation but there are significant differences between public and private institutes in physical environment and teaching fellow subscales. There are some consistencies and conflicts with regional and international literature. This needs in-depth qualitative exploration

Role of Case-Based Discussion as Workplace-Based Assessment Tool in Urology and General Surgery

OBJECTIVES To determine the effectiveness of case-based discussion in terms of medical record-keeping, clinical reasoning, clinical judgment, and self-reflection in the management of patients. METHODOLOGY A multidisciplinary descriptive study was conducted in the Department of Urology Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, and Department of General Surgery, Hayatabad Medical Complex Peshawar, Pakistan, from January to December 2023. A total number of 20 postgraduate residents, ten from Urology and General Surgery, participated in the study with equal male and female participants. Case-based discussion (CBD) assessments focused on medical record-keeping, clinical Decision-making, clinical judgment, management, follow-up, and reflective writing. The data was collected on structured proforma and was analyzed on SPSS-25. RESULTS The total number of study participants was 20, and 410 Case-Based Discussion sessions were conducted. This constitutes an average of 4.8 assessments per week. Most encounters were related to medical clinical decisions and management. The case-based discussion showed significant improvement on the Likert scale of the supervisor’s rating, which extended over four quarters on all major parameters of formative assessment (p 0.001). The multimodal regression test showed significant enhancement in learning parameters on case-based discussions. R2=0.172 F ration=25.141 n=410 (p=0.001). There was no significant difference in the gender of residents as well as training specialty of  residents of urology and general surgery (p >0.05). CONCLUSION A case-based discussion is an effective tool for formative assessment of Urology and General Surgery postgraduate residents

Stakeholder’s Perspective on the Challenges Faced during the Implementation of the Integrated Curriculum at Medical Colleges of Khyber Pakhtunkhwa

OBJECTIVES To explore and identify the challenges stakeholders face in implementing and sustaining the integrated curriculum in undergraduate medical colleges of Khyber Pakhtunkhwa METHODOLOGY The study design was qualitative exploratory. A total of 15 participants (student, faculty member, and educationist from each institute, two public sector and three private sector medical colleges in Peshawar. The participants meeting the inclusion criteria were enrolled through a purposive sampling technique. An interview guide was developed based on the literature review, and experts’ validation was done and used to conduct semi-structured interviews with nine participants. A Focused group discussion (FGD) comprised six participants to complement the data from individual interviews. Audio recordings of interviews and FGD were transcribed verbatim manually. The ten transcripts were fragmented and searched for primary codes. A total of 166 codes in vivo codes were generated. The second cycle of 44 descriptive codes was defined. The secondary codes were merged into 17 subthemes and six themes. RESULTS A total of six themes were derived from the data. The themes were that planning curriculum integration is like planning an uphill drive, dream versus ground reality, moving up and down the ladder, teamwork is the heart of the paradigm shift, the challenges, and the road to success. Participants views on the difficulty of implementing an integrated curriculum varied widely, and these differences were attributable to the participants' unique perspectives and contextual factors of the institutes.  CONCLUSION Implementing an integrated curriculum is not a journey on the road; it faces many challenges. Teamwork is the hallmark of successful implementation.

Challenges faced by teachers of postgraduate health professions blended learning programs: a qualitative analysis

Abstract Introduction Blended learning, which integrates classroom face-to-face teaching with both asynchronous and synchronous online learning elements, has swiftly gained acceptance in educational environments. However, the implementation of blended learning presents challenges that impact all stakeholders, necessitating thoughtful consideration. Teachers play a central role in shaping the instructional experience among these stakeholders. To fully realize the potential of comprehensive blended learning, it is imperative to identify the challenges faced by these teachers and develop strategies that sensibly address and overcome them. Methodology A qualitative exploratory study was conducted with twelve teachers involved in the postgraduate blended learning health professions program at Khyber Medical University, Peshawar in 2022. One-on-one semi-structured Interviews were conducted via WhatsApp/ZOOM, transcribed by Otter AI, coded on NVivo & analyzed using Braun/Clarke’s Thematic Analysis. Results Three themes of challenges faced by teachers of postgraduate blended learning programs were constructed namely (1) Skills, such as (i) digital, (ii) instructional, and (iii) online class management, and (2) Administrative barriers in terms of (iv) resources (iv) training, and (3) Faculty resistance. Conclusion This study provides profound insights into the daunting challenges that postgraduate blended learning program teachers encounter in terms of skills, administrative barriers, and faculty resistance. These findings offer a valuable opportunity for program directors to identify the critical requirements of these faculties in their pursuit of effective teaching and learning, ultimately transforming the landscape of blended education. This study emphasizes the need for ongoing faculty development and institutional support to address the identified challenges and improve the quality of postgraduate blended-learning programs