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issn:2229-340
1.  A practical discussion to avoid common pitfalls when constructing multiple choice questions items 
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.
doi:10.4103/1319-1683.71992
PMCID: PMC3045096  PMID: 21359033
Pitfalls; assessment; student
2.  EVALUATION OF THREE INSTRUCTIONAL METHODS OF TEACHING FOR UNDERGRADUATE MEDICAL STUDENTS, AT KING SAUD UNIVERSITY, SAUDI ARABIA 
Background:
There is an international move from traditional curriculum towards the learner – centered, and patient-oriented curriculum. In spite of its advantages, problem-based learning requires a larger number of teaching staff and space. This study was done to compare the problem-based learning (PBL), lectures and modified PBL methods.
Methods:
Thirty-three fifth year medical students who were taking the Family Medicine rotation participated in the study at the College of Medicine, King Saud University. Three instructors participated in the teaching of three topics to the three groups of students. Students acted as control for themselves across the three instructional methods, namely; lectures, PBL and modified PBL. The main outcomes were students’ recall of knowledge, problem solving skills and topic comprehension.
Results:
In the initial assessment, there was a significant difference in favor of PBL and the modified PBL regarding comprehension of the topic as tested by the short answer questions (p = 0.0001), problem solving skills as tested by the modified essay question (p = 0.002). Non-significant results were observed at the second stage of assessment. The modified PBL method was the preferred one for 39% of the students, followed by the PBL (36%) and lastly the lectures (25%).
Conclusion:
This empirical study suggests some advantages for the PBL method and the modified PBL over the lecture method. Larger studies are needed to confirm our results of this important issue as the modified PBL is an affordable option for schools that can not meet the staff and space requirements of the PBL curriculum.
PMCID: PMC3377127  PMID: 23012180
Instructional methods; lectures; modified PBL; PBL; Saudi Arabia
3.  OUTPATIENT MANAGEMENT OF TYPE 2 DIABETIC PATIENTS: A REVIEW OF EVIDENCE-BASED LITERATURE 
Diabetes mellitus is a common, serious, and treatable disease. Good control is associated with fewer complications. The impact of the disease on the patient, family and the community psychologically and physically is staggering. This paper aims to update the reader on certain issues related to the management of diabetes. Recent criteria for the diagnosis are presented followed by non-pharmacological and pharmacological management, glycemic monitoring, prevention, continuity of diabetes care and the control of co-morbidities. Throughout, as far as possible, the best available evidence was used.
PMCID: PMC3410075  PMID: 23012096
Type 2 Diabetes; Diabetes Management; Guideline and Out-Patients
4.  COMMUNITY-BASED FAMILY MEDICINE COURSE: DOES IT HAVE IMPACT ON STUDENTS’ LEARNING ACHIEVEMENTS, ATTITUDE AND CAREER CHOICE? 
Objective:
To assess the impact of a six-week Family Medicine (FM) course on students’ self-assessment of their own knowledge, skills and their attitude towards innovative learning methods and career choice before and after the course, and their evaluation of different aspects of the course curriculum.
Design:
An observational study, where the study subjects were requested to fill out a standardized five-point Likert scale questionnaire at the start and at the end of the course. The questionnaire explored their knowledge and attitude in addition to their general evaluation of the course. One hundred forty-seven fourth year medical students who undertook FM clinical rotation were the study subjects. The course had some innovative features. For example, students were involved in the selection of the course content by identifying their learning needs.
Results:
A comparison of pre and post-test observations showed a statistically significant improvement in students’ assessment of their knowledge (p < 0.0001) and clinical skills (p = 0.012). A significant positive change was also observed in their choice of FM as a future career (p = 0.008). The intervention was not effective (non-significant difference) on (i) students’ attitude towards innovative learning methods (p = 0.314) and (ii) students’ attitude towards patients and certain ethical issues (p = 0.99). As the curriculum stemmed from collaboration of learners and teachers, the students were satisfied with the content.
Recommendations:
There is a need to improve the training in the HC by recruiting family practitioners (FP) who have had residency training for the specialty and to train the other physicians in how to supervise and guide medical students. Topics on ethical issues should be introduced into the college curriculum.
PMCID: PMC3410083  PMID: 23012063
Family Medicine; knowledge; skills; attitudes; career; King Saud University
5.  PATTERN OF INTESTINAL PARASITIC INFECTION AMONG FOOD HANDLERS IN RIYADH, SAUDI ARABIA 
Objective:
Identify the types and prevalence of intestinal parasites among food handlers, and test the effectiveness of the current pre-employment screening policy.
Methods:
A cross sectional survey was carried out in the catchment areas of seven primary health care centres (PHCCs) to represent various sections of Riyadh city. A total of 700 food handlers working in restaurants were randomly selected from the study area. All study subjects were asked to complete a data collection form and to bring a fresh stool specimen on the specified day to the designated PHCC.
Results:
About 66% of the selected subjects complied in bringing fresh stool specimens. Fifty nine (12.8%) of the specimens were positive for parasites. There was a significant association between the food handler's nationality and the likelihood of a positive specimen result, being highest among the Bangladeshis (20.2%) and Indians (18.5%) and the lowest among the Arabs (3.4%) and the Turks (10%). The commonest intestinal parasites isolated were Giardia lamblia (33.8%), followed by Enterobius vermicularis (27.4%). The current screening policy does not seem effective, as there was an absence of significant association between holding a valid PEHC and the test result, with 81% of the positive results from persons holding valid pre-employment health certificates (PEHCs).
Conclusions:
Though it is obligatory for food handlers to hold a PEHC in Saudi Arabia, the prevalence of intestinal parasites remains high. Possible solutions include health education on hygiene, more frequent stool tests, and assessment of the current annual screening procedure.
PMCID: PMC3439746  PMID: 23008653
Intestinal parasites; health education; foodhandlers; Saudi Arabia
6.  THE PATTERN OF ALTERNATIVE MEDICINE USE AMONG PATIENTS ATTENDING HEALTH CENTRES IN A MILITARY COMMUNITY IN RIYADH 
Background:
Alternative Medicine (AM) is gaining popularity worldwide.
Objectives:
This study was conducted to determine the prevalence and pattern of AM use in a military sector of the Saudi community.
Methods:
Three hundred and ten adult patients, visiting their family physicians over 6 weeks from the 1st of June 1998, were selected by systematic random sampling. They were asked to report worrying health problems and their use of modern medicine (MM) and AM.
Results:
Forty-six percent of the patients had used AM before and about 19% had used it in the past 12 months. Alternative medicine practitioners were visited by 16.5% of the study population. Herbal medicine users represented 8.7% of the study population, honey (4.5%), the black grain Nigella sative (3%) and cautery was used by one person only. Women, housewives and the illiterate were more likely to use AM. About 86% of all the study population preferred MM. The main source of information about AM was relatives (77%). A large proportion of patients who reported depression used AM (53%) or visited AM practitioners (33%). The average cost per visit to an AM pratitioner (166 Saudi Riyals) was higher than that in the USA ($27.60=100 Saudi Riyals).
Conclusion:
There is a need to educate the public through the media and health professionals on the appropriate use of AM; housewives and the illiterate should be targeted. A community-based household survey using interviewers not associated with the health system such as teachers (to avoid bias) is needed.
PMCID: PMC3437108  PMID: 23008618
Alternative medicine; Saudi Arabia; Media education
7.  THE VALIDATION OF THE GENERAL HEALTH QUESTIONNAIRE (GHQ-28) IN A PRIMARY CARE SETTING IN SAUDI ARABIA 
Objective:
The objective of this study was to validate an Arabic version of the General Health Questionnaire (GHQ-28) in a primary care setting in Saudi Arabia.
Methodology:
A total of 60 Saudi patients selected by means of systematic random sampling were asked to fill out the GHQ-28 Arabic version. The psychiatrist interviewed all patients using the Arabic version of the Clinical Interview Schedule (CIS).
Results:
The best cut-off level for the GHQ-28 indicating best trade-off between sensitivity and specificity was 4/5, where the validity values were, sensitivity; 72%, specificity; 74%, positive predictive value; 72%, negative predictive value; 74% and misclassification rate; 27%. The correlation coefficient was r = +0.61 and the Spearman's Rank-difference correlation was rs = +0.57. The area under the ROC Curve was 69%. The cut-off point 4/5 in this study is the same as recommended by others in primary care settings. Although the validity parameters are relatively low, they are within the range found by other studies in USA, UK and developing countries. This supports the suggestion to develop an Arabic Screening Questionnaire based on the translated GHQ with the addition of culturally specific items.
Conclusion:
The GHQ-28 Arabic Version is a valid instrument that may be of great help to primary care doctors in improving detection of psychiatric morbidity and in epidemiological research.
PMCID: PMC3437115  PMID: 23008578
General Health Questionnaire; Primary Care; Saudi Arabia
8.  GUIDELINES FOR THE MANAGEMENT OF DIABETIC PATIENTS IN THE HEALTH CENTERS OF SAUDI ARABIA 
This paper presents general guidelines for the management of diabetic patients within the primary health care (PHC) system in the Kingdom of Saudi Arabia (KSA). It intends to enhance PHC physicians’ knowledge and improve clinical practice to ensure better management of people with diabetes mellitus. A stepwise (Algorithm) management approach for different categories of diabetic patients, including diet, exercise, and drugs, is suggested. The peculiarities of Family Medicine, e.g., adopting the biopsychosocial model, the holistic approach, and relations with the hospital are considered.
PMCID: PMC3437129  PMID: 23008561
Guidelines; diabetes; family medicine; Saudi Arabia

Results 1-8 (8)