Background and Objectives:
Patients are essential for the acquisition and development of medical students clinical skills for their tasks. The study aimed to identify factors that influence patients’ attitudes towards the involvement of medical students in clinical examination and care in Western Saudi Arabia.
A cross-sectional study using self-administered questionnaire was conducted among Saudi and non-Saudi patients at two university hospitals in Jeddah, Western Saudi Arabia. Information sought included demographic characteristics (age, gender, educational level, job, income, and marital status); patients’ attitude and comfort level towards different types of students’ involvement; factors influencing patients’ cooperation with medical students (students’ level of training, manner, skills, and attire. All these were assessed on a five-point Likert scale. Data was entered and analyzed using SPSS v 19.
Four hundred and seventeen adult patients participated. Fifty-one percent indicated a positive attitude towards involving medical students in clinical examination and care. Female and young patients (<45 years old) were more likely to be negative in their attitude and be less comfortable towards involving medical students in their care. The highest overall mean comfort score was with medical students taking history followed by observations and less invasive examination. Patients’ mean confidence scores regarding students’ attire were the highest for female traditional attire and for scrub suit for males.
Of the influential factors that could affect patients’ willingness to cooperate with medical students, clinical skills followed by manner and level of training ranked first. Ensuring that students mastered specific procedures before coming into direct contact with patients using patient simulators, for example, would improve patients’ acceptance of student participation.
Attitude; medical; patients; students
Background and Objectives:
Although the prevalence of childhood obesity has increased significantly in Saudi Arabia, parents are unable to appreciate obesity in their child. The objective of the study was to identify the percentage of parents who misclassify the status of child's weight, and determine whether there is a difference between those parents whose children are overweight and obese and those with children of normal weight.
Materials and Methods:
This cross-sectional study included 601 children aged 6-10 years. The children were recruited from the primary schools located in Al-Qassim, Saudi Arabia. The body mass index of the children was assessed in the school, and their parents responded to a self-administered questionnaire which contained questions on parental perception of the children's weight/obesity status. Data were entered and analyzed using SPSS.
Parents with overweight/obese children had significantly more misclassification than those with normal weight children. Ninety percent of parents of the 81 overweight children misclassified and reported that their child had normal weight, while 65% of parents of the 61 obese children, misclassified the child's weight status.
The level of misclassification of children's weight status by parents is high. Saudi parents with overweight and obese children do not recognize their child's weight status. Parents’ awareness of childhood obesity and its negative health impact needs to be improved.
Children; obesity; parental perception; Saudi Arabia
Stress and its psychological manifestations are currently a major source of concern. Medical education poses challenging and potentially threatening demands for students throughout the world.
To determine the prevalence and factors associated with perceived stress in medical students in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia.
Materials and Methods:
This was a cross-sectional study on all medical students of batches 9, 10, and 11, which constituted all the enrolled students. Data were collected using a questionnaire based on the Kessler10 psychological distress instrument with a total score ranging from 10 to 50 points in addition to some sociodemographic characteristics. Appropriate statistical test procedures were used to study the magnitude of stress and its risk factors.
Mean stress score of the eighty participants was 26.03 ± 9.7. Students with severe stress constituted 33.8%, and 30% were well. Severe stress was significantly associated with female gender and junior level. Nervousness, feeling hopeless, feeling restless, and depressed were the most important factors affecting students’ stress scores. Factor analysis revealed three hidden factors for stress in this group, namely, depression, nervousness, and age.
Stress in medical students is prevalent and significantly associated with the female gender and the junior level. Implementation of coping programs is necessary.
Factors; medical students; Riyadh; stress
Dates are a concentrated source of essential nutrients, vitamins, minerals, and carbohydrates (CHOs), which are necessary for the maintenance of optimum health. Most of the CHOs in dates come from sugars including glucose and fructose. Dates are commonly consumed in Saudi Arabia, particularly at the time of breaking the fast to provide instant energy and maintain blood sugar level. However, dates may cause hypoglycemia in a rare condition named as heredity fructose intolerance (HFI), and a few families have been to see us with a history of that nature. This is to report the preliminary results of an on-going study of a group of patients who get symptoms of hypoglycemia following the ingestion of dates and have suffered for years without an accurate diagnosis.
This report is based on three patients, from the same family, living in a date growing region of the Kingdom of Saudi Arabia (KSA). The patients had been to several medical centers without getting any definite answers or diagnosis until they were referred to the Gastroenterology Clinic of King Fahd Hospital of the University, Al-Khobar, KSA. The data were obtained by careful history and laboratory investigations, and a final diagnosis of HFI made on fructose intolerance test (FIT).
The patients reported that they had avoided eating dates because of various symptoms, such as bloating, nausea, and even hypoglycemia when larger amounts were consumed. Their other symptoms included sleepiness, sweating, and shivering. After full examinations and necessary laboratory tests based on the above symptoms, FIT was performed and the patients were diagnosed with HFI. They were referred to a dietitian who advised a fructose-free diet. They felt well and were free of symptoms.
HFI may remain undiagnosed until adulthood and may lead to disastrous complications and even death. The diagnosis can only be suspected after a careful dietary history is taken supported by FIT. This can prevent serious complications. Restricting dietary fructose may give relief from symptoms in a high proportion of patients with this disorder.
Dates; heredity fructose intolerance; hypoglycemia
Good communication skills and rapport building are considered the cardinal tools for developing a patient-doctor relationship. A positive, healthy competition among different health care organizations in Saudi Arabia underlines an ever increasing emphasis on effective patient-doctor relationship. Despite the numerous guidelines provided and programs available, there is a significant variation in the acceptance and approach to the use of this important tool among pediatric residents in this part of the world.
To determine pediatric residents' attitude toward communication skills, their perception of important communication skills, and their confidence in the use of their communication skills in the performance of their primary duties.
Materials and Methods:
A cross-sectional study was conducted among all pediatrics trainee residents working in 13 different hospitals in Saudi Arabia. A standardized self-administered questionnaire developed by the Harvard Medical School was used.
A total of 297 residents out of all trainees in these centers participated in the data collection. The 283 (95%) residents considered learning communication skills a priority in establishing a good patient-doctor relationship. Thirty four percent reported being very confident with regard to their communication skills. Few residents had the skills, and the confidence to communicate with children with serious diseases, discuss end-of-life issues, and deal with difficult patients and parents.
Pediatric residents perceive the importance of communication skills and competencies as crucial components in their training. A proper comprehensive communication skills training should be incorporated into the pediatric resident training curriculum.
Communication skills; pediatrics; residents; Saudi Arabia
The aim was to compare Eastern, Makkah, and Asir regions in term of residents’ perception of the achievement of training objectives, and to assess various rotations based on residents’ perception.
Settings and Design:
This cross-sectional study was done among family medicine residents in the Eastern, Makkah, and Asir regions.
A questionnaire was developed by the investigator and validated by two experts. All residents, except R1 residents, were included. All data were collected by the investigator by direct contact with the residents.
Statistical Analysis Used:
Cronbach's alpha, analysis of variance, t-test, and univariate regression model as appropriate, were used.
Reliability of the questionnaire was found to be 75.4%. One hundred and seven (response rate: 83.6%) residents completed the questionnaire. There were 51 (47.7%), 27 (25.2%), and 29 (27.1%) residents in the program in the Eastern region, Makkah, and Asir, respectively. The mean age was 29.1 ± 2.5 years; half of the residents were male, most of (83.2%) were married, and more than half (54.2%) of had worked in primary health care before joining the program. Overall, 45% of the residents perceived that they had achieved the training objectives. The highest rotations as perceived by the residents were psychiatry and otolaryngology while the lowest were orthopedics and ophthalmology. There were significant differences among the study regions with regard to the rotations in family medicine, internal medicine, orthopedics, general surgery, and emergency medicine.
Overall, a good percentage of the residents perceived that they had achieved the training objectives. The rotations differed in the studied regions. Psychiatry and otolaryngology had the highest percentage of family medicine residents who perceived that they had achieved the training objectives while lowest was in internal medicine and obstetrics and gynecology. The highest rotations as perceived by the family medicine residents were psychiatry and otolaryngology while lowest were orthopedics and ophthalmology. Sharing of experience and further studies are needed to improve the program rotations.
Clinical training; family medicine; postgraduate training
Inadequate, inequitable distribution of the medical workforce remains a challenge across the globe, and India is no exception. Odisha, a state in India faces a major shortage of doctors particularly in rural and remote areas. In order to address this challenge, it is essential to understand medical students’ career plans, specialization preferences, choices of job location and sector, and views on working in rural and remote areas. This study explored the immediate and long-term career plans of final year medical students, their intended practice locations and underlying reasons for the choices.
A cross-sectional survey was conducted in all the medical colleges (three government and three private) in the state of Odisha. Through the systematic sampling method, data were gathered from 390 final year students. A semi-structured questionnaire was administered to the students and data were analyzed using SPSS version 20.
Of the 390 students, 290 (74.35%) were from a government college. The most preferred immediate career goal was postgraduation studies (45.9% of students in government medical schools and 54% in private). About 17% of government students and 9% of private students showed willingness to work in rural areas, in the long run. Nearly 44.5% mentioned opportunities for career growth, followed by the possibilities for higher education (26.8%) as major the factors for preferring an urban posting. Similarly, higher pay scales, better working conditions were major factors for preferring the private sector. Most of the students maintained that good housing, better salaries, and adequate facilities at the workplace would attract more students toward rural service.
Since public funded medical students are not motivated to serve in rural settings, increasing the number of places or establishing new medical institutions may not be an effective solution to the issue. Approaches such as extended clinical apprenticeship in rural health facilities, long-term community engagement during medical studentship could be considered.
Career choice; health workforce; medical students; public sector; rural health
Medical grand rounds (MGRs) are considered key educational tools in most academic medical institutions. In this multi-center cross-sectional survey, we tried to determine the current attitudes of local medical practitioners to MGRs, as well as perceived barriers.
A total of 120 physicians from the National Guard Hospital, King Fahad Medical City, King Khalid University Hospital and King Faisal Specialist Hospital participated in the survey. The questionnaire consisted of statements on attitudes and perceived barriers against participating in MGRs, as well as participants’ levels of agreement.
Most participants attend MGRs regularly (94.2%), claiming that it is mandatory (88%). Participants also agreed that MGRs were important tools for continuing medical education (89.2%) and that they provided an opportunity to both present materials and interact with their colleagues in other divisions (86.7% and 81.6%, respectively). The vast majority of respondents agreed that “topic review/update” and “inviting guest speakers” were the two most preferred suggestions for improving MGRs (94.2% and 92.5%, respectively). Major barriers included constraints of time (43.3%) and topics that were not patient-related (40.8%).
MGRs in the major Tertiary Hospitals in Riyadh are well attended, and the majority of the local practitioners believe in the positive effect of MGRs in delivering quality and up to date medical knowledge. Time and physician-specific issues were identified as major barriers that needed to be addressed in order to maximize participation of medical staff.
Attitudes; barriers; grand rounds; Riyadh; Saudi Arabia
The study was conducted to evaluate the educational environment (EE) in Family Medicine Training Programs.
Materials and Methods:
A cross-sectional survey, The Postgraduate Hospital Educational Environment Measure (PHEEM), was distributed to all residents at the four training centers in the central region. Cronbach's alpha was used to test the reliability. The mean and standard deviation (SD) for each item, the overall score and the three domains were calculated. A multiple linear regression model was developed with PHEEM scores as an outcome. The Mann–Whitney–Wilcoxon test was used to compare each item based on the selected factors.
The overall score was 67.1/160 (SD: 20.1). The PHEEM's domains scores: 24.2/56 (SD: 7.13) for perception of role autonomy; 25.3/60 (SD: 8.88), for perception of teaching; and 17/44 (SD: 5.6), for perception of social support. Training center and Level of training were the significant outcome predictors. Centre 1 (Joint Program) significantly had better scores than Centre 2. The instrument showed great reliability with a Cronbach's alpha of 0.92.
There are many problems in the training program. Urgent actions are needed to improve the residents' learning experience particularly during rotations. Also, the curriculum should be restructured, and effective training methods introduced using the Best Evidence in Medical Education to meet the expectations and learning needs of family physicians.
Educational environment; family medicine training; residency
The obesity epidemic, which is among the most common nutritional disorders, is rising rapidly worldwide. It leads to several health problems such as metabolic disorders, stroke, and even cancer. Efforts to control obesity with exercise and diet have a limited value in obese patients and different approaches to do this have been tried. In this paper, we share our experience with bioenteric intragastric balloon (BIB) in treating obesity: Its safety, tolerability, and its efficacy in weight reduction.
Materials and Methods:
From January 2009 to September 2012, a total of 190 gastric balloons was inserted on patients at the endoscopy unit in King Fahd Hospital of the University, Al-Khobar. This is an evaluation of the first 100 patients. All the patients had a body mass index of over 30 kg/m2 and were within the age range of 17-55 with a mean age of 32 years. After consent, preballoon investigation tests and anesthesia evaluation, BIB was inserted under monitored anesthesia care sedation in the endoscopy suite. The balloon was filled with 500-700 mls of stained saline. All patients' were given an analgesic and antiemetic for a week and antisecretory proton pump inhibitor's for 6 months. Diet and the importance of the exercise were part of the preballoon insertion phase and protocol. The balloon was removed after 6-12 months.
The weight loss response to BIB in the 100 patients are classified into four groups: In the uncooperative, noncompliant patients - the maximum weight loss was 7 kg, while in the most compliant patients the weight loss reached up to 39 kg. In addition, there was significant improvement into diabetes mellitus, hypertension, dyslipidemia, and fatty liveras. Its safety and tolerability were extremely acceptable.
Our data indicates that in well-selected patients, BIB is an effective device, which with minimum complications helps to achieve body weight loss and resolve many obesity related morbidities in cooperative and dedicated obese patients.
Dedicated patients; gastric balloon; obesity
The aim of this paper was to determine the validity and reliability of a questionnaire tool for measuring students' attitudes toward components relevant to research training programs in the Kingdom of Saudi Arabia.
Materials and Methods:
The paper reports the responses of 564 Saudi Arabian students from seven government universities to the questionnaire comprising 16 items on 3 conceptual subscales, which measured students' attitude to research activities in the college; students' opinion of faculty involvement in research; and infrastructural facilities in the college. The results of this study provide the final scale, with all the 16 items of the initial Likert scale, for which strong evidence was obtained.
Results indicated that the students' attitude toward the research (SAR) scale had three latent factors, which explained 62% of the variance: The three subscales measured includes: (i) Research activities offered in the college, (ii) students' opinion of faculty involvement in research, and (iii) infrastructural facilities offered in the college for research. The full scale including three subscales had good internal consistency (rs = 0.72 and α = 0.77 for full scale; and α between 0.71 and 0.79 for three subscales).
This study provides evidence of reliability and validity of the SAR scale for the measurement of students' attitudes toward research training programs in Saudi Arabian Universities. The research findings will provide the basis for further research on health science students.
Attitude; reliability; research; validity
To the researchers’ knowledge, there are no published studies that have investigated the learning styles and preferred teaching methods of physical therapy students in Saudi Arabia.
The study was conducted to determine the learning styles and preferred teaching methods of Saudi physical therapy students.
Settings and Design:
A cross-sectional study design.
Materials and Methods:
Fifty-three Saudis studying physical therapy (21 males and 32 females) participated in the study. The principal researcher gave an introductory lecture to explain the different learning styles and common teaching methods. Upon completion of the lecture, questionnaires were distributed, and were collected on completion.
Statistical Analysis Used:
Percentages were calculated for the learning styles and teaching methods. Pearson’s correlations were performed to investigate the relationship between them.
More than 45 (85%) of the students rated hands-on training as the most preferred teaching method. Approximately 30 (57%) students rated the following teaching methods as the most preferred methods: “Advanced organizers,” “demonstrations,” and “multimedia activities.” Although 31 (59%) students rated the concrete-sequential learning style the most preferred, these students demonstrated mixed styles on the other style dimensions: Abstract-sequential, abstract-random, and concrete-random.
The predominant concrete-sequential learning style is consistent with the most preferred teaching method (hands-on training). The high percentage of physical therapy students whose responses were indicative of mixed learning styles suggests that they can accommodate multiple teaching methods. It is recommended that educators consider the diverse learning styles of the students and utilize a variety of teaching methods in order to promote an optimal learning environment for the students.
Education; Gregorc Style Delineator; physiotherapy
Students who perceived their learning environment positively are more likely to develop effective learning strategies, and adopt a deep learning approach. Currently, there is no validated instrument for measuring the educational environment of educational programs on respiratory care (RC). The aim of this study was to develop an instrument to measure students’ perception of the RC educational environment.
Materials and Methods:
Based on the literature review and an assessment of content validity by multiple focus groups of RC educationalists, potential items of the instrument relevant to RC educational environment construct were generated by the research group. The initial 71 item questionnaire was then field-tested on all students from the 3 RC programs in Saudi Arabia and was subjected to multi-trait scaling analysis. Cronbach's alpha was used to assess internal consistency reliabilities.
Two hundred and twelve students (100%) completed the survey. The initial instrument of 71 items was reduced to 65 across 5 scales. Convergent and discriminant validity assessment demonstrated that the majority of items correlated more highly with their intended scale than a competing one. Cronbach's alpha exceeded the standard criterion of >0.70 in all scales except one. There was no floor or ceiling effect for scale or overall score.
This instrument is the first assessment tool developed to measure the RC educational environment. There was evidence of its good feasibility, validity, and reliability. This first validation of the instrument supports its use by RC students to evaluate educational environment.
Educational environment; instrument; perception; respiratory care; Saudi Arabia
“Off-service” clinical rotations are part of the necessary requirements for many residency training programs. Because these rotations are off-service, little attention is given to their structure and quality of training. This often leads to suboptimal educational experience for the residents on these rotations.
The aim of this study was to assess medical residents’ perceptions, opinions, and levels of satisfaction with their “off-service” rotations at a major residency training site in Saudi Arabia. It was also to evaluate the reliability and validity of a questionnaire used for quality assurance in these rotations. Improved reliability and validity of this questionnaire may help to improve the educational experience of residents in their “off-service” rotations.
Materials and Methods:
A close-ended questionnaire was developed, Pilot tested and distributed to 110 off-service residents in training programs of different specializations at King Fahad Naitonal Guard Hospital and King Abdulziz Medical City, Riyadh, Saudi Arabia, between September 2011 and December 2011.
A total of 80 out of 110 residents completed and returned the questionnaire. Only 33% of these residents had a clear set of goals and educational learning objectives before the beginning of their off-service rotations to direct their training. Surgical specializations had low satisfaction mean scores of 57.2 (11.9) compared to emergency medicine, which had 70.7 (16.2), P value (0.03). The reliability of the questionnaire was Cronbach's alpha 0.57. The factor analysis yielded a 4-factor solution (educational environment, educational balance, educational goals and objectives, and learning ability); thus, accounting for 51% variance in the data.
Our data suggest that there were significant weaknesses in the curriculum for off-service clinical rotations in KAMC and that residents were not completely satisfied with their training.
Knowledge attitudes and perception; needs assessment; off-service rotations; residents; validity of questionnaire
To determine the prevalence, the nature, and the possible socio-demographic risk factors involved in the development of common transmissible skin disorders (TSD) among the studied population.
Materials and Methods:
A cross-sectional consecutive survey was carried out from November 15, 2008 to May 14, 2009 in Al-Ahsa governorate. This study included 1337 male primary school children. Data were collected using the following tools: Socio-demographics and hygienic habits according to pre-established forms and a thorough dermatological examination of all the included children.
The prevalence of TSD was 27.15% with a statistically significant difference according to rural/urban locations (33.74% vs. 22.27%). Fungal infections were the leading diseases (9.1%) followed by bacterial infections (8.9%), parasitic infestations (4.3%), and viral infections (4.1%). TSD were significantly more frequent in students whose fathers have a primary or preparatory educational status and in the students having the habit to play barefooted.
Our study found that TSD was relatively frequent among male primary school students in Al-Ahsa. Our study has several limitations. One major limitation is that female primary school students were excluded from the study. Despite this major limitation, we hope the findings may be useful in planning health care programs for Saudi children with the hope of reducing the prevalence of TSD in the future.
Childhood; skin infections; skin parasitic infestations
The objective of the present study was to determine the views and attitude of clinical medical students toward gross anatomy courses taught to them in preclinical years and their relevance to their medical practice.
Materials and Methods:
A structured questionnaire of 16 items was distributed to 146 clinical students. The study group included both genders (104 males and 42 females). A total of 121 students (83%) responded to the questionnaire.
The responses obtained in relation to the clarity of the anatomy course outline its impact on their ability to think and solve problems, develop their skills as members of a team, and its relevance to their clinical practice and their ability to engage in common clinical practices were negative.
There is an urgent need to redesign the anatomy curriculum in King Khalid University in order to enable the graduates to deliver adequate health care to the community.
Anatomy course; attitude; King Khalid University; medical students
Palliative care is a rapidly growing subspecialty that aims at improving the quality of life and relieving suffering associated with life threatening disease. Despite its rapid growth and huge demand, the knowledge of health care professionals on palliative care remains inadequate.
This study aims to determine the knowledge of residents at King Abdul-Aziz University Hospital (KAAUH) on palliative care.
Materials and Methods:
Through a cross-sectional design, all residents in the hospital were invited to complete a two-part self-administered questionnaire in June 2010. The first part of the questionnaire included variables describing the socio-demographic characteristics and educational background, and the second part developed by palliative care education initiative at Dalhousie University in Canada in 2000 had 25 items on the knowledge of palliative care.
Of the 80 residents 65 (81%) responded, the overwhelming majority of whom were Saudis (92.3%) with an equal representation of males and females. The mean age of the participants was 29.1 ± 2.4 years. Less than one-third (29.2%) indicated that they had previous didactic education on palliative care. The percentage of right answers on items reflecting knowledge on palliative care accounted for 29.9% ± 9.9%. No statistically significant difference was found in the level of knowledge among the residents according to their demographics or graduation and training characteristics.
Resident physicians enrolled in postgraduate programs have suboptimal knowledge of basic palliative care. Substantial efforts should be made to incorporate a palliative care module into the theoretical and practical training of medical students and resident physicians.
Knowledge; palliative care; residents; Saudi Arabia
Teaching Evidence Based Medicine (EBM) helps medical students to develop their decision making skills based on current best evidence, especially when it is taught in a clinical context. Few medical schools integrate Evidence Based Medicine into undergraduate curriculum, and those who do so, do it at the academic years only as a standalone (classroom) teaching but not at the clinical years. The College of Medicine at King Saud bin Abdulaziz University for Health Sciences was established in January 2004. The college adopted a four-year Problem Based Learning web-based curriculum. The objective of this paper is to present our experience in the integration of the EBM in the clinical phase of the medical curriculum. We teach EBM in 3 steps: first step is teaching EBM concepts and principles, second is teaching the appraisal and search skills, and the last step is teaching it in clinical rotations. Teaching EBM at clinical years consists of 4 student-centered tutorials. In conclusion, EBM may be taught in a systematic, patient centered approach at clinical rounds. This paper could serve as a model of Evidence Based Medicine integration into the clinical phase of a medical curriculum.
Clinical years; evidence based medicine; medical curriculum; medical education
How students accomplish their learning and what they learn is an indicator of the quality of student learning. An insight into the learning approaches of a student could assist educators of the health profession in their planning for the first year of study. The aim of this study was to develop a reliable and valid Arabic version of the revised two-factor study process questionnaire.
Materials and Methods:
The translation of the revised two-Factor Study Process Questionnaire (R-SPQ-2F) into Arabic was done by an established forward–backward translation procedure. The Arabic version was then distributed to high school graduates applying for a place in the medical program at King Fahad Medical City. A total of 83 students voluntarily completed the questionnaire. The internal consistency and construct validity of the Arabic version of the R-SPQ-2F were computed.
The exploratory factor analysis revealed two components. The two factors were similar to the main scales described in the original English questionnaire. The main scales were the deep and surface approach. The items for the subscales (deep motive, deep strategy and surface motive, surface strategy) had a high internal consistency of more than 0.80.
The results of this study should provide a valid and reliable instrument for the evaluation of the study approaches of Arabic speaking students.
Learning approach; R-SPQ-2F; study process
To assess the attitude and practice of doctors in the Military Hospital Primary Care Centers in Riyadh (RMH) toward research and to identify the main barriers to conduct research.
Materials and Methods:
A cross-sectional study was conducted from March to April, 2010, at RMH primary care centers. The sample included all general practitioners (GPs) working in primary healthcare centers. A self-administered questionnaire was formulated from different sources and used as a tool for data collection.
The response rate was 75%. Among the respondents 96.9% agreed that research in primary care was important for different reasons. Most of the GPs had a positive attitude toward research: 68% had been influenced by research in their clinical practice and 66% had an interest in conducting research, and74.2% of the respondents had plans to do research in the future. Insufficient time was the most frequently cited barrier (83.5%) for participating in research, followed by the lack of support (58.8%).
Many of the GPs had a positive attitude toward research, but had no publications or plan for new research. Lack of time, support, and money were the main constraints for carrying out research.
Family doctors; publishing; research
Adolescents experience rapid biological, psychological, and social transitions that can be associated with mental health problems. During the high school period there are also more academic stressors.
(1) To study the prevalence of mental disorders in high school (grade 12) students. (2) To study some related sociodemographic data.
Materials and Methods:
A cross-sectional study, using GHQ-28, that included 354 students randomly selected from grade 12 in four high schools – two male and two female high schools – in the National Guard Housing (Iskan), in Kashmalaan (suburb of Riyadh).
The overall prevalence of mental disorders was found to be 48% (41% in males and 51% in females); more than 80% of these cases were mild to moderate. Females showed significantly more severe disorders than males (P = 0.017) and students with excellent performance degrees showed a significantly lower rate of mental disorders than others (P = 0.021). However, our study did not show a significant association between psychiatric disorders and other social variables (family size, birth order, and polygamous family) or smoking.
The adolescent age groups in our community had high rates of mental disorders, which required more attention from the family, as well as the educational and health institutes in our country.
Adolescents; GHQ-28; high school students; mental disorder; prevalence; Saudi Arabia
To study the sociodemographic profiles of children under institutional care, identify the characteristic features of the families prone to have destitute children, and suggest measures for prevention of destitution of children in the community.
Material and Methods:
A questionnaire-based cross-sectional study was conducted in a population of 507 boys and girls from 6 to 18 years admitted to four different institutes for care and support. A sample of 170 children was selected using systematic random sampling technique. A survey was done to study the health status of the children. Data was analyzed using SPSS software. Frequency and proportion were calculated and chi square test was used. P value of >0.05 was considered significant.
65.9% of children were in the 6 to 12 age group. 63.5% were Hindu by religion. The majority i.e., 80.9% of the boys and 80% of the girls were urban in origin, 82.4% of the juveniles were from nuclear families, 40.0% of boys and 62.3% of the girl juveniles were from lower socioeconomic status. 75% of boys and 25% of the girls had been child laborers just before institutionalization. Only 12.7% of juveniles were from large families, the rest, the majority (87.3%) were from medium to small sized families.
Nuclear families of medium to small size which belong to the lower socioeconomic status and of urban origin were found to be unable to provide care and support to their children putting them at the risk of becoming destitute.
Children under institutional care; destitute child
The new agenda for Public Health in India includes the epidemiological transition, demographical transition, environmental changes and social determinants of health. Based on the principles outlined at Alma-Ata in 1978, there is an urgent call for revitalizing primary health care in order to meet these challenges. The role of the government in influencing population health is not limited within the health sector but also by various sectors outside the health systems. This article is a literature review of the existing government machinery for public health needs in India, its success, limitations and future scope. Health system strengthening, human resource development and capacity building and regulation in public health are important areas within the health sector. Contribution to health of a population also derives from social determinants of health like living conditions, nutrition, safe drinking water, sanitation, education, early child development and social security measures. Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate change and disasters on health, improving community participation and governance issues are other important areas for action. Making public health a shared value across the various sectors is a politically challenging strategy, but such collective action is crucial.
Health sector; intersectoral issues; public health; role of government
The Kingdom of Saudi Arabia (KSA) has witnessed unprecedented growth in higher education and E-learning in recent times. In the last five years, one university and five colleges have been commissioned every month; 800 scholarships have been awarded every month for overseas study; a national center for E-learning has been established; and E-units or departments have been set-up in almost every university. E-learning has become important for discussion to quote Shakespeare ‘To E or not to E that is the question.’
To examine current and future developments and challenges of E-learning in KSA.
Materials and Methods:
A qualitative approach was used to explore views of 30 senior academicians involved in E-learning during their attendance at a two-week course on the subject.
All participants considered themselves as decision makers on E-learning in their units or departments. They felt that E-learning had come to stay, but acknowledged challenges in respect of resources, organization, management, and information technology.
The fast development of E-learning poses many challenges. Clear vision and strategic planning with prospective E-learners in mind are essential to make E-learning programs cost effective.
Challenges and development of E-learning in Saudi Arabia; E-learning; vision and strategic planning of E-learning
This paper is an attempt to produce a guide for improving the quality of Multiple Choice Questions (MCQs) used in undergraduate and postgraduate assessment. Multiple Choice Questions type is the most frequently used type of assessment worldwide. Well constructed, context rich MCQs have a high reliability per hour of testing. Avoidance of technical items flaws is essential to improve the validity evidence of MCQs. Technical item flaws are essentially of two types (i) related to testwiseness, (ii) related to irrelevant difficulty. A list of such flaws is presented together with discussion of each flaw and examples to facilitate learning of this paper and to make it learner friendly. This paper was designed to be interactive with self-assessment exercises followed by the key answer with explanations.
Pitfalls; assessment; student