Parent training for autism spectrum disorder

Objective: The main purpose of the present study was to investigate the effectiveness of behaviour therapy training to mothers of autistic children on verbal and non-verbal improvement of their children.Methods: A total of 33 mothers of autistic children were selected for training based on non-probability purposive sampling procedure. Autism Spectrum Disorder (ASD) Knowledge Scale was used to assess mothers\u27 knowledge about autism and Vineland Adaptive Behaviour Scale was used for assessment of the communication skill in autistic children.Results: This study revealed that behaviour therapy training significantly improved communication skills of children with autism by training mothers. The results of paired t-test revealed that trained mothers developed improved communication skills.Conclusions: These results showed improvement in communication skills of autistic children whose mothers were trained in behaviour therapy

Development and validation of an instrument for assessment of professional behaviour during laboratory sessions

Objective: To develop an instrument to assess professional behaviour among medical students, and to determine its validity, reliability, feasibility and acceptability.Methods: This cross-sectional study was conducted at Bahria University Medical and Dental College, Karachi, from July to September 2017, and comprised of medical students in years 1 and 2 of their academic programme. The instrument was developed for the Physiology laboratory sessions using nominal group technique and was tested for validity, reliability, feasibility and acceptability by two assessors through validity and reliability statistics. Data was analysed using SPSS 23.Results: Of the 250 students enrolled, 232(92.8%) had their assessment completed. Applicability of the scale was indicated by exploratory factor analysis. Two factors were isolated which explained 57.65% of the variation. The first factor, comprising of 7 sub-factors, was labelled as \u27practical performance\u27, and the second factor, consisting of 5 sub-factors, as \u27personal interactions\u27. A final 12-item instrument was retained. Cronbach\u27s alpha was determined to be high at 0.863. Intra class correlation was 0.863 for both years 1 and 2 combined.Conclusions: It was possible to develop an instrument for professional behaviour assessment in Physiology laboratory skills session which could indicate valid, reliable, feasible and acceptable results

Empathy in clinical practice: A qualitative study of early medical practitioners and educators

Objective: To explore the reasons for decline in empathy among physicians and to identify strategiesfor fostering empathetic clinical practice.Methods: The qualitative study was conducted at the Aga Khan University Hospital, Karachi, from February to June 2017, and comprised focus group discussions involving separate sessions with medical students, residents and clinical teachers. Content analysis was used to analyse the verbatim transcripts for identification of codes which led to derivation of themes from the data. Consolidated criteria for reporting qualitative research was used to assess the quality of the study.Results: Of the 109 subjects, 57(52.3%) were medical students, 30(27.5%) residents and 22(20.2%)clinical teachers. Of the 9 focus group discussions, 4(44.4%) were held with the students, 3(33.3%) with residents and 2(22.2%) with the teachers. Four themes that generated were delineating empathetic clinical practice, reasons for decline, challenges for promoting empathetic clinical practice, and recommendations for developing and facilitating empathetic clinical practice. All the participants unanimously agreed that there was a decline in empathetic clinical practice. Primary challenges included increased workload and time constraints inhibiting empathetic practice..Conclusions: It is essential to teach empathetic clinic practice to students and residents during medical training while continuous professional development should reinforce the significance of empathetic clinical practice among medical practitioners and educators

Developing role models in clinical settings: A qualitative study of medical students, residents and clinical teachers

Objective: To explore how positive role modelling attributes can be developed in students, residents and clinical teachers.Methods: The qualitative study using focus group discussions was held at Aga Khan University, Karachi from March to May 2018, and comprised medical students, residents and clinical teachers. Overall 11 focus group discussions were conducted till data saturation was achieved. Content analysis was used to analyse the data which was transcribed verbatim.Results: Of the 116 subjects, 60(51.7%) were medical students, 35(30.2%) were residents and 21(18%) were clinical teachers. Of the 11 focus group discussions, 4(36.5%) each were held with the students and the residents, while 3(27%) were held with the teachers. Five major themes that emerged from the study included definition of role models, attributes of role models, role modelling as a learnt behaviour, challenges in developing role models, and recommendations for developing positive role models. A number of attributes of positive and negative role models were identified by the participants. All the participants including students, residents and teachers appreciated the importance of role modelling in developing professionalism among health professionals and medical students. Factors hindering development and demonstration of positive role modelling were also identified and possible solutions were suggested.Conclusions: Clinical teachers needed to be made cognizant of their role as positive role models in developing professionally competent physicians. The medical institutions needed to develop and implement policies that would enhance positive role modelling by the teachers and facilitate learning of positive attributes at all levels

Urinary incontinence: Understanding the silent plight of women

Urinary incontinence (UI) is defined as the complaint of involuntary loss of urine. UI affects both men and women but is more common in women. It has been identified as a World Health Organization priority. The burden related to UI at local, national, and global levels is huge and its impact in terms of physical, social, mental, and financial aspects makes it a concerning issue. However, there exist several barriers in terms of knowledge and attitude in seeking healthcare among women experiencing UI. This calls upon a multi-disciplinary approach involving professionals from different disciplines and tackling it with collaborative and collective efforts

Insight into COVID-19 responses and initiatives from Pakistan

The coronavirus pandemic is a rapidly evolving outbreak that has tremendously distressed people worldwide. The paper aims to present some key rapid responses and initiatives to COVID-19 undertaken in Pakistan. The information has been gathered by reviewing material and documents pertinent to COVID-19 in the context of Pakistan. The incidences of COVID-19 cases are gradually increasing; however, the case fatality rate is relatively lower in Pakistan as compared to developed countries. The government has taken massive actions, in terms of lockdowns, quarantine homes, testing facilities, closure of schools, and mass gatherings at places, to combat COVID-19. However, the measures seem to be insufficient due to the fear and stigma attached to it and the low socio-economic conditions. The government has launched initiatives, like Ehsaas cash dissemination programme, for the underprivileged families to address their basic needs; and philanthropic organisations are also coming forward to support these families. The spread of the pandemic is gradually increasing in Pakistan and we recommend strategies like increasing public awareness campaigns, improving screening capacity, and contact tracing to augment the efficiency of the current responses and initiatives

Medical students\u27 perceptions of clinical teachers as role model

Introduction: Role models facilitate student learning and assists in the development of professional identity. However, social organization and cultural values influence the choice of role models. Considering that the social organization and cultural values in South East Asia are different from other countries, it is important to know whether this affects the characteristics medical students look for in their role models in these societies.Methods: A 32 item questionnaire was developed and self-administered to undergraduate medical students. Participants rated the characteristics on a three point scale (0 = not important, 1 = mildly important, 2 = very important). One way ANOVA and student\u27s t-test were used to compare the groups.Results: A total of 349 (65.23%) distributed questionnaires were returned. The highest ranked themes were teaching and facilitating learning, patient care and continuing professional development followed by communication and professionalism. Safe environment and guiding personal and professional development was indicated least important. Differences were also observed between scores obtained by males and females.Conclusion: Globally there are attributes which are perceived as essential for role models, while others are considered desirable. An understanding of the attributes which are essential and desirable for role models can help medical educators devise strategies which can reinforce those attributes within their institutions

Mental health challenges and psycho-social interventions amid COVID-19 pandemic: A call to action for Pakistan

The increase in death and spread-related coronavirus (COVID-19) has shifted the world focus to the containment of the disease by emphasising measures to prevent spread in the general population. Such a complex, threatening, and unprecedented situation has left the psycho-social wellbeing needs of general public unaddressed. This paper aims to review the current COVID-19 scenario and its effects on the psycho-social wellbeing of people; and an attempt to shed some light on the aforementioned questions. Furthermore, the review will propose some recommendations for overcoming the mental illness issues, during and after the COVID-19 outbreak. We extracted information from reliable published international and national literature and reviewed anecdotes from media content from January to June 2020. The mental health implications of this outbreak will be long-lasting; however, by prioritising, investing diligently, and taking a collective approach, this challenge can be dealt with in a promising manner

Reliability and validity of WATCH: Warwick assessment instrument for clinical teaching

Objective: To determine the reliability, validity, feasibility, acceptability and perceived educational impact of WATCH: Warwick Assessment insTrument for Clinical teacHing among doctors in Pakistan.Study design: Cross-sectional research study.Place and duration of study: The College of Physicians and Surgeons, Pakistan, from September 2018 to August 2019.Methodology: Postgraduate trainees were asked to rate the clinical teaching sessions, using WATCH, which consists of 15 items. Percentage was used to calculate gender and participation from different specialties. Inter-item correlations of 15 items with individual mean scores, standard deviations and Cronbach\u27s Alpha were reported, including Friedman test, in order to observe the scores across multiple conditions. The Hotelling\u27s T2 test was used to test whether the answers provided by the study participants to the questionnaire were equal. Construct validity was determined using factor analysis while feasibility, acceptability, and educational impact was evaluated by seeking participants\u27 feedback on five semi-structured questions.Results: More than 80% ranked WATCH from good to excellent. Oveall 8 items were perceived as excellent, while 7 items received rating of good. Inter-item correlation ranged from 0.61 to 0.81. Cronbach Alpha was reported to be 0.975, with significant difference in mean scores of different items (Friedman\u27s Chi-Square=4285.54; p\u3c0.001). The Hotelling\u27s T2 test (21598.871 with F=185.249, df=14,2654; p\u3c0.001) indicated that the mean values of the responses of different questions in the instrument were statiscally different. Factor analysis indicated one factor accounting for 73.97 of variance. The majority (93%) of the participants found the instrument easy to complete, most participants (91.5%) indicated it as an acceptable method of assessment, and majority (90.8%) perceived that it can improve clinical teaching.Conclusion: WATCH demonstrated valid, reliable, feasible, and acceptable results for assessment of teaching of medical doctors and it can be used for providing feedback and rewarding teachers who excel in teaching. Key Words: Clinical teaching, Validity, Reliability, Feasibility, Medical students, Residents, Doctors

The impact of COVID-19 safety interventions on creating a controlled environment on campus

Objectives: During COVID-19 the re-opening of educational institutes was frequently debated, however with the decline in the number of COVID-19 cases, The Aga Khan University (AKU) in Karachi, Pakistan opened its campus for medical and nursing students after more than 6 months of closure. To ensure gradual resumption of activities on-campus, a combination of interventions was diligently deployed to minimize student infection rates. Scarce literature exists on students' perceptions regarding decisions implemented by university leadership. The aim of the study was to determine the efficacy of these interventions. Methods: We conducted a convergent, parallel, mixed-methods observational study targeting medical and nursing students. An online questionnaire was disseminated to elicit students' degree of (dis)agreement on a four-point Likert scale. Focused group discussions (FGDs) were conducted to comprehend reasons for (dis)agreement. Results: Total of 183 students responded to questionnaire (59.0% nursing, 67.8% female), 11 FGDs were conducted with 85 students. Interventions with highest agreement were mandatory face masks policy (94.54%), weekly mandated COVID-testing (92.35%) and students' Academic Bubble (91.26%); highest disagreement was for Sehat Check application (41.53%); and stay strong campaign (40.44%). Four themes emerged from FGDs: Effective safety interventions, Safety interventions with limited effectiveness, Utility of Sehat Check Application and Future recommendations for informing policy. Conclusion: It is paramount to seek student-feedback at forefront of university re-opening strategy. Clear communication channels are as important as an administrative response system's robustness. Bidirectional communication channels are fundamental and requisite during ever-changing policies and regulations. Engaging student representatives in decision making or implementation processes (such as “pilot” before “roll-out”) would allow any potential issues to be managed early on. Gather real-time anonymous feedback and identify key areas that need further promulgation and those that need to be replaced with more effective ones