Evaluation of Impact of Prescribing Safety Assessment Workshop on Medical Doctors Using Kirkpatrick Model

Background Clinical pharmacology training is a prerequisite for all medical graduates. Prescription writing errors are not infrequent at primary health care level leading to threat to patient safety. Prescribers lacks uniform structured training and assessment which is one of the major factors for this situation across the country. In lots of institutions despite proper curriculum, learners lack interest because the subject importance is insignificant. Hence to bring more interest in pharmacology for prescribers there is a dire need for innovative and interesting methods of teaching and assessment, one of which is prescribing safety assessment (PSA). Objectives To assess if the PSA is superior method of training prescription writing than CPW To evaluate the workshop on prescription writing using guidelines of Kirkpatrick Model   Methods It was an experimental study. 44 medical doctors participated; a pre-test was taken 01 week before the workshop. Afterwards, they were randomized into 02 groups, group A went through PSA and group B followed conventional prescription writing (CPW) 01-day workshop. At the end, post-test was taken from both groups. The qualitative data was also collected from participants on feedback proforma consisting of few closed ended questions on Likert scale. Results The independent t-test was used to compare the data as it was in normal distribution. Posttest performance of PSA group significantly increased P ˂ 0.001 as compared to CPW. Reaction  to closed ended 13 questions on Likert scale showed high satisfaction from 4.32 to 4.84 on 5 points  Likert scale on workshop satisfaction. Conclusion PSA is an effective teaching and assessment strategy for learning clinical pharmacology. The study objectively proves its effectiveness in comparison to CPW and provides a guideline to implement this innovative and useful tool for teaching and assessment. Keywords Prescribing safety assessment, conventional prescription writing, Faculty development, Workshop, Impact, Kirkpatrick model

Problems in Physician-Patient Communication: What do our Students See and Hear? A Qualitative Study with a Pragmatic Approach

Background: Efficient communication with patients is an indispensable necessity for physicians of the 21st century. Over the past decades, much work has been done nationally and internationally to instill this essential skill in undergraduate students and medical graduates are now formally trained to become better communicators. However, deficiencies persist and medical students of today still observe various issues when they observe physician-patient communication interactions in their training.Objective: To understand perceptions of undergraduate medical students about the difficulties in Physician-Patient communication (PPC) & take suggestions on how to overcome them.Methods: A qualitative study design was employed, with data collection through three focus group discussions with medical students studying in Wah medical college, Pakistan in October 2019. Thematic data analysis was done using Atlas-ti 8 software. A pragmatic approach was used to understand student perceptions about difficulties in PPC.Results: After open and selective coding of data, six major themes were identified. Five of these were in relation to students' perceptions about major difficulties with PPC. These included gap between teaching & practice; doctor patient ratio; lack of counselling; lack of empathy and no informational care. The last theme, Effective teaching of behavioral sciences was related to student suggestions for overcoming problems in PPC.Conclusion: The various issues regarding the problems in physician patient communication portray a realistic picture of our current communication practices. Various factors have been identified in this study and, the most practical solution to these problems lies in the effective teaching of behavioral sciences

Issues and challenges in bringing reform in UGME

Background: Over the last few years medical schools and health care delivery centers in developing countries facing with the variety of challenges from patients, society doctors and students. In response to this reforming in undergraduate medical curricula took place. The objective of this paper is to identify the factors (issues& challenges) which can influence the successful implementation of reformed curriculum. Summary of work: As an ongoing activity of program evaluation at the end of first & second year in 2010, Focus Group Discussions & feedback questionnaire (on 5 point Likert scale) comprises of 19 items, duly filled by the teaching faculty, module developers & coordinators, students and medical educationist. Summary of results: Feedback of faculty & medical educationist identify the 11 issues/factors and challenges. On analysis of quantitative data, 85% of student’s favors the integrated system of study, better learning through SGD/PBL as compares to lectures. On analysis of qualitative research, students supports that PBL facilitates & promotes the acquisition of soft skills and generic competencies. Conclusions and Take-home messages: Curriculum reforming needs careful attention in its planning before its implementation to make its successful. The factors (issues& challenges) which can influence its successful implementation are; all stake holders (BODs, BOGs, Dean, department heads, faculty and students) must be involved in its planning and they should own it and train (faculty development) in its usage and implementation

From Traditional To Integrated Curriculum

Overview Why should a participant attend this workshop? At the end of this workshop, the participant should be able to: Appreciate the reason and need of transition from traditional to integrated curriculum in Pakistan. Describe the needs for the curricular adaptation rather adoption. Describe impact of curricular reform in assuring quality in medical education. Devise a plan of curricular transition in their respective institutes

The fate of health professions education as a profession: a road less travelled

Objective: To explore the views of academics about the identity of Health Professions Education as a discipline, its fate and sustainability as a profession. Method: The qualitative exploratory study was conducted from February to July 2021 after approval from the ethics review committee of Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan, and comprised both fulltime and part-time health professions educationists of either gender teaching in different institutions of seven cities of Pakistan; Taxila, Kamrah, Rawalpindi, Peshawar, Lahore, Multan and Karachi. Using Professional Identity theory, data was collected through semi-structured one-on-one interviews which were conducted online. The interviews were transcribed verbatim, coded and thematically analysed. Result: Of the 14 participants, 7(50%) had qualifications and experience of other specialities as well, while 7(50%) were pure health professions educationists. Overall, 5(35%) subjects were from Rawalpindi, 3(21%) were serving in multiple cities including Peshawer, 2(14%) were from Taxilla and 1(7.5%) each was from Lahore, Karachi, Kamrah and Multan. Accumulated data led to 31 codes with 3 themes and 15 sub-themes. The main themes were identity of health professions education as a discipline, its fate and sustainability. Conclusion: Health professions education has established its identity as a discipline in Pakistan, with independent, fully functioning departments in medical and dental colleges across the country. Key Words: Health professions education, Future, Health professions educationists, Profession

Development and validation of self-assessment instrument to measure the digital professionalism of healthcare professionals using social media

Abstract Background The use of social media across the globe has risen incrementally. During the COVID-19 pandemic, these sites undeniably provided new avenues for professional networking but also led to a surge in cases of online misconduct. Professionalism instruments and scales do not assess the digital attitude and behaviour of healthcare professionals (HCPs). The purpose of this study was to identify the domains and items of digital professionalism related to social media use and to validate a self-assessment instrument to assess the digital professionalism of HCPs using social media. Methods An instrument development multiphase mixed method study (exploratory sequential) was conducted in two phases: item development and qualitative content validation followed by validation of the instrument. Feedback was taken from 15 experts for qualitative content validation in phase 1. In phase 2, content validity was established through three rounds of modified Delphi. Validity evidence was collected for the content (content validity index), response process (cognitive interviews), internal structure (confirmatory factor analysis), and internal consistency (Cronbach’s alpha). Results The 48-item preliminary instrument was reduced to a 28-item instrument with eight domains: self-anonymity, privacy settings, maintenance of boundaries and confidentiality, conflict of interest, accountability, respect for colleagues, and ethics. The content validity index of the scale was 0.91. The reliability and construct validity of the instrument was established by responses from 500 healthcare professionals from multiple hospitals. Confirmatory factor analysis showed a model with a goodness-of-fit index of 0.86, root mean square error of approximation of 0.06, and observed normed χ2 of 2.7. The internal consistency through Cronbach's alpha α was 0.96. Conclusion The digital professionalism self-assessment instrument (DP-SAI) has an appropriate level of content and measures the construct reliably. It can be used by medical doctors, dental clinicians, nurses, physiotherapists, and clinical pharmacists to self-assess and reflect on their social media practices. This will help to address these issues to enhance the quality of online communication through various social media platforms

Collaboration cognizance: Development of a self-assessment tool to measure intra-professional collaborative practices (IPCP) in postgraduate medical residents at tertiary care hospitals

Abstract Background The ever-evolving healthcare system of today demands physicians who steer their roles as treatment providers, managers and collaborators. Professionals are highly interdependent due to increased complexity of health problems and risk of errors increases with transitions in care. In hospitals, the main workforce is postgraduate residents; therefore, intraprofessional collaboration amongst residents is essential. Several instruments are available to evaluate interprofessional collaboration amongst physicians, nurses and hospital teams but none specifically assessed intra-professional collaborative practices amongst residents working in tertiary care hospitals in multi-disciplinary teams. This study intends to develop and validate an instrument to self-assess intraprofessional collaborative practices in postgraduate residents undergoing residency in multiple specialties at tertiary care hospitals. Approach This study on Instrument Development employed mixed method study design executed in two phases. In phase 1, six domains of intraprofessional collaborative practices were identified from literature and 35 items were developed. Fifteen experts participated in qualitative content validation and provided comments. To establish content validity in phase 2, content validity index (CVI) and content clarity average (CCA) were assessed by seventeen experts. Response process validity was established by cognitive interviewing of 5 postgraduate residents. Pilot testing was done on a sample of 407 residents. Cronbach’s alpha was determined, and confirmatory factor analysis established construct validity. Results During phase 1, items were modified based on qualitative feedback from 15 experts. In round 2, CVI and CCA were determined based on responses of 17 experts. The items having an I-CVI greater than 0.90 were accepted and six items underwent modifications as their I-CVI fell between 0.78 and 0.90. Similarly, four items with a CCA of less than 2.4 were modified to increase clarity. Cognitive interviews of participants on 30 items resulted in the deletion of 1 item and changes in 5 items. The final instrument had 29 items categorized under six constructs. All items had good factor loadings during CFA, so none was deleted. Cronbach’s Alpha α was 0.937. Conclusion Intraprofessional collaborative practices in residents is a valid and reliable self-assessment tool comprising 29 items measuring six constructs. It may be used by residents to assess their collaborative practices and incorporated in curricula to help develop collaborative practices and their assessment during training of postgraduate residents

Developing consensus on content & format of e-portfolio for MHPE students: a Delphi study

Objectives: To build a consensus on portfolio framework for master’s in health professional education students and document programme learning outcomes, tasks for students related to each outcome, and the pieces of evidence regarding the completion of each task. --Continu

Core Competencies needed for performing effective digital teaching by medical teachers

Background: The digital teaching is quite different from the traditional in-person classroom teaching. The purpose of the thematic review was to identify the development and future prospects of digital teaching with reference to medical and dental teachers as well as to identify any published competency frameworks in this regard.Method: The authors conducted a thematic review of the relevant literature published between1994-2022. The databases searched included PubMed, Education Resources Information Center (ERIC), and Google Scholar. Manual search was also carried out so as not to miss any relevant published literature.Results: The initial search yielded 31,389 publications. At the search phase, the identification of publications was based on the titles of the publications. At the screening phase, 31,322 records were excluded because of their being irrelevant or duplicated. The remaining 67 articles were further screened by reading the abstracts. Out of these 67 publications, 24 were excluded because of being non-relevant. At the appraisal phase, 43 publications were assessed for eligibility. At final synthesis phase of the literature review, 26 publications were included.Conclusion: The available published literature on digital teaching was focused predominantly on primary and secondary school students. The digital competency frameworks were designed for the transfer of the knowledge component and dealt mostly with children. These frameworks did not meet the specific requirements of medical teachers. The latter have to transfer not only the knowledge domain, but also teach clinical skills and professional attitudes to their adult learners. Hence, they need a framework which should provide for these added competencies and real-life, patient-oriented clinical scenarios

Language of actions: The effects of teacher's kinesics on student learning and learning environment

BACKGROUND: A teacher's appropriate use of nonverbal communication skills, mainly kinesics, can play a crucial role in the success of the students. Medical educators are unaware of the effective use of nonverbal communication as an instructional skill that can be used to engage learners, balance learners' participation by controlling the classroom environment, and motivate them to have a passion for learning. The purpose of the study was to explore the students' perceptions regarding the effect of teachers' kinesics on students' learning and their learning environment. This can be helpful for teachers in modifying their teaching styles and delivering quality education. MATERIALS AND METHODS: A qualitative study with an exploratory design was conducted at a private medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteered to participate in the study. Focus group discussions were conducted with the students to explore the experiences of the medical students regarding the use of nonverbal communication skills by their teachers and its effect on their learning in the classroom. The data collected was analyzed manually. RESULTS: The results of the study revealed that teachers' nonverbal behaviors in the classroom significantly influence students' motivation, engagement, and learning in the classroom. Students preferred interaction with the teachers who were friendly and confident and used their nonverbal communication skills (eye contact, facial expressions, hand gestures) effectively, compared to strict and judgmental teachers. CONCLUSION: Teachers need to motivate their students by improving their teaching styles and incorporating nonverbal behaviors positively in the classroom. By creating an impactful learning environment, students' participation and learning will increase, which will, in turn, improve their academic performance