assessing interprofessional continuing education and planning ahead

The purpose of this survey is to check the concept of Interprofessional education (IPE) to continuing education among working physicians.It assessed 150 randomly selected working physicians of the Aga Khan University Hospital. One -best type questionnaire was designed and piloted to check its completion within 90 seconds.Four quick questions were dedicated at C1 & C2 level focused to check the knowledge and understanding of the physicians to IPE. The results showed 100% response rate. Majority (i.e. \u3e 80%) of the respondents were familiar with the term IPE.The next three items tested physicians understanding regarding the IPE ability to improve communication, teamwork, healthcare coordination and quality (n=69 i.e. 46%); impact of IPE on patient-centered care and physician care (n=89 i.e. 59%); and its contextual understanding (n=40 i.e. 27%). The studyis subject to desirability bias and more overa single university setting restricts the generalizability of the results.The conclusion will alert the CME providers within Pakistan to address physicians’cognitive gaps in this innovative interdisciplinary model.There is no other study of its kind in the Pakistani contextand hence is of high interest

Oral Hygiene KAP Assessment and DMFT Scoring Among Children Aged 11-12 Years in an Urban School of Karachi

Objective:To assess the oral hygiene knowledge, attitude and practices among school children and evaluate their DMFT (Decayed/Missing/Filled Teeth) scores. Study Design: Cross-sectional study. Place and Duration of Study: A private school of Karachi from March to April 2008. Methodology: Convenient sample comprising 300 students of grade 6 within the age group of 11-12 years was selected. A knowledge, attitude and practices survey questionnaire based on quantitative indicators was filled by the students. Clinical examination was done for DMFT. Data analysis was done by using SPSS version 11. Associations were assessed using chi-square test and a p-value of \u3c 0.001 was considered significant. Results: There were 160 males and 140 females in the target group. The mean DMFT was found to be 1.27. The children had satisfactory knowledge of oral health’s effect on general health and the problems associated with poor dental hygiene. However, 50.3% children did not have positive attitude towards importance of a dentist’s role in maintaining their dental health. Only a few students (11.3%) had familiarity with dental floss. A statistically significant association was found between frequency of brushing and children’s knowledge of the problems related to irregular tooth brushing (p \u3c 0.001). Conclusion: The attitude of school children towards dental health and dental service utilization is determined by certain social and cultural factors. The mean DMFT of 1.27 showed that there must have been some poor oral practices that are contributing towards a higher mean

Continuing medical education and pharmaceutical industry

Continuing medical education providers\u27 (academia) and industrial relationship is drawing attention all over the world. To date, there are no national commercial support guidelines available in Pakistan to properly regulate cooperation between the two distinct entities. However, the fact is that the future of all continuing medical education depends on pharmaceutical support and the providers are heavily dependent on the pharmaceutical industry to remain in action. It should always be remembered that medical education and profession is regarded as a moral of enterprise based on a blind faith between the physician and the patient. The funding support by the industry should not bind or influence physician\u27s prescription for any reason. To be trusted, medicine must be free of all such dependency; it should be accountable only to the society it serves and to its own professional standards

Task-based learning versus problem-oriented lecture in neurology continuing medical education.

Objective: To determine whether general practitioners learned better with task-based learning or problem-oriented lecture in a Continuing Medical Education (CME) set-up. Study Design: Quasi-experimental study. Place and Duration of Study: The Aga Khan University, Karachi campus, from April to June 2012. Methodology: Fifty-nine physicians were given a choice to opt for either Task-based Learning (TBL) or Problem Oriented Lecture (PBL) in a continuing medical education set-up about headaches. The TBL group had 30 participants divided into 10 small groups, and were assigned case-based tasks. The lecture group had 29 participants. Both groups were given a pre and a post-test. Pre/post assessment was done using one-best MCQs. The reliability coefficient of scores for both the groups was estimated through Cronbach\u27s alpha. An item analysis for difficulty and discriminatory indices was calculated for both the groups. Paired t-test was used to determine the difference between pre- and post-test scores of both groups. Independent t-test was used to compare the impact of the two teaching methods in terms of learning through scores produced by MCQ test. Results: Cronbach\u27s alpha was 0.672 for the lecture group and 0.881 for TBL group. Item analysis for difficulty (p) and discriminatory indexes (d) was obtained for both groups. The results for the lecture group showed pre-test (p) = 42% vs. post-test (p) = 43%; pre- test (d) = 0.60 vs. post-test (d) = 0.40. The TBL group showed pre -test (p) = 48% vs. post-test (p) = 70%; pre-test (d) = 0.69 vs. post-test (d) = 0.73. Lecture group pre-/post-test mean scores were (8.52 ± 2.95 vs. 12.41 ± 2.65; p \u3c 0.001), where TBL group showed (9.70 ± 3.65 vs. 14 ± 3.99; p \u3c 0.001). Independent t-test exhibited an insignificant difference at baseline (lecture 8.52 ± 2.95 vs. TBL 9.70 ± 3.65; p = 0.177). The post-scores were not statistically different lecture 12.41 ± 2.65 vs. TBL 14 ± 3.99; p = 0.07). Conclusion: Both delivery methods were found to be equally effective, showing statistically insignificant differences. However, TBL groups\u27 post-test higher mean scores and radical increase in the post-test difficulty index demonstrated improved learning through TBL delivery and calls for further exploration of longitudinal studies in the context of CME

Task-based learning versus problem-oriented lecture in Neurology CME of general practitioners to assess improvement in understanding and clinical reasoning skills - a quasi experimental study

Background: Determine the impact of task-based learning versus problem-oriented lecture in terms of improved understanding and clinical reasoning skills of general practitioners in CME on Headache disorders. Methods: Methodology TBL group consisted of 30 self-selected general practitioners divided into10 small groups with case-based specific tasks and explicitly defined outcomes. The lecture group consisted of 29 physicians who completed pre/post-test. TBL session was split in two; morning period was based on exploring, constructing, integrating learning and experiences into a PowerPoint presentation. Subsequent session was followed by sharing of information to large group. The lecture group had a problem-oriented lecture. Understanding and clinical reasoning skills of all participants were assessed through a thirty minute pre/post-test, which consisted of 20 one best type multiple choice questions. Reliability coefficient of pre/post-test scores of both groups was calculated through Cronbach’s Alpha. Paired T– test was used to determine the statistical significance between pre/post-test scores. Independent –T test was used to compare the impact of two teaching methods on physicians learning. Results: The data was analyzed using IBM SPSS Statistics19. Reliability coefficient of pre/post-test scores was (lecture group=0.672; TBL group= 0.881). Paired T- test statistics depicted lecture group pre/post-test mean scores as (9 SD 3 vs. 12.4 SD 2.6; p Conclusions: Improvement in participant scores in both educational interventions was clearly noticed. We conclude that both problem-oriented lecture & task-based interventions were equally effective and resulted in statistically insignificant difference, so could be considered as vital teaching tools in continuing medical education. Indeed, TBL groups’ some edge over lecture group in terms of post-test mean scores, favour TBL’s further exploration in longitudinal studies in the context of CME. Key words: Task-based learning; problem-oriented lecture; Problem-based learning; general practitioner

Quality assessment of a private university dental hospital in Karachi: case study using European Foundation for quality management (EFQM) excellence model

Background Defining and measuring quality is a challenging task. It can be defined and measured in many ways: All depends on who is defining the quality i.e. purpose of definition and which tool, model or framework was used to measure it. An extensive mushrooming of the dental institutions in Pakistan has raised concern about their quality. The quality of dental teaching institutes, like any other teaching institutes, may be evaluated on the basis of infrastructure, curriculum, qualification and skills of teaching faculty, selection criteria of the students, and financial considerations. The European Foundation for Quality Management (EFQM) Excellence Model can be used as a way to benchmark with other organizations, on the basis for common vocabulary and a way of thinking, and a structure for the organization\u27s management system EFQM has also been extensively used as a self assessment tool for organizations to help in their efforts to make a quality diagnosis and assessment, and to stimulate its continuous improvement. The model is based on eight fundamental concepts, which forms the foundations over which organizations could build their excellence. These concepts are: 1) Results orientation, 2) Customer focus, 3) Leadership and constancy of purpose, 4) Management by processes and facts, 5) People development and involvement, 6) Continuous learning, innovation and improvement, 7) Partnership development, and 8) Corporate social responsibility Objective This study assesses the quality of an academic dental hospital across its core activities using conceptual framework derived from EFQM Excellence model and finally to outlinethe strengths, gaps and areas for improvement. Methodology The study was conducted at Hamdard University Dental Hospital from July to September 2007. The hospital holds a large market share of dental services among the private sector dental hospitals in Karachi, and it is considered as one of the finest platform for students\u27 supervised dental clinical training in Karachi. The hospital provides dental services and consultation in various specialties such as Periodontology, Restorative Dentistry, Prosthodontics, Oral and Maxillofacial, Surgery and Orthodontics, catering to nearly hundred to hundred and twenty patients daily, under the supervision of forty four faculty members on board. It was a facility based case-study, in which all components of the EFQM model were assessed qualitatively. In-depth interviews were carried out using a semi- structured interview guidelines which covered all the key aspects of quality pointed out in the EFQM model. A total of fourteen in depth interviews were conducted ensuring inclusion of all the internal stake holders. Nine participants were from the management, three from the faculty and two represented the students. Study findings Study participants responded in the light of the eight fundamental concepts of the EFQM excellence model. The majority of the concepts were even though present, if not been practiced. An efficient and a well-defined system for assessing the needs of patients existed and they work in a system where students are accountable. The structure for assessing the needs of the management and the faculty and a tool to measure patient satisfaction was missing. Participants could not recall sighting or hearing the vision of their institute and expressed concern over lack of involvement of faculty and other stakeholders in decision making at all levels. Most of the interdependent and interrelated activities were clearly defined. Responsibilities were assigned without giving proper authority. The participants valued and reflected positively on the concepts of continuous learning and improvement, partnership development and the social responsibilities of the organization. Conclusion Finally through the analysis of the in interviews and applying the EFQM excellence model, the results exhibited are not merely based on technical issues of gaining the excellence but a complex relationship between the head of the institution, the management staff, the faculty, and the students was observed. Proper division of job responsibilities and powers to the staff at all cadres is an essential and efficient mean to achieve the excellence in spite of the resource constraint. It is also essential to develop the processes that are built through consensus based on broader participation among the management, faculty and the higher officials. Thus in order to chase a quality journey, concepts of leadership and constancy of purpose, people development and involvement, management by processes and facts and results orientation are needed to be strengthened