Acadenic Research Services at the Medical Sciences Library, Faculty of Medical Sciences Library, The University of the West Indies, St. Augustine

To profile academic library services at the Medical Sciences Library, The University of the West Indies, St. Augustine Trinidad and Tobago, highlighting reseources and initiatives that support the Faculty of Medical Sciences curriculum, research, and scholarly communication. To outline the resources and services available at the Medical Sciences Library to support teaching and learning with a focus on research.

The use of Instagram as an educational tool in an undergraduate Oral and Maxillofacial Radiology course in Trinidad and Tobago

Objectives: The purpose of this study was to identify the use of Instagram both prior to and during an undergraduate oral radiology course at The University of the West Indies and to ascertain the perceived impact of Instagram as an educational tool on the course's teaching and learning. Method: A private Instagram account was created in 2017 for use in the fourth-year oral radiology course. Subjects included 30 dental students registered for the year long course. One dental radiograph was posted per week with associated questions. A piloted and previously tested questionnaire modified to our study was administered and statistically analyzed. Results: 24 (80%) students completed the research questionnaire. 8 (33%) students indicated that they did not have an Instagram account prior to the study. 14 (61%) students agreed and 9 (39%) students strongly agreed that the radiographic posts and discussions generated throughout the course of the study were helpful. Conclusion: The findings revealed in this study were that the use of Instagram in the oral radiology course was helpful to the students and most reported that they would enjoy the use of this platform in other courses.

Ethical issues in anesthesia: the need for a more practical and contextual approach in teaching

Teaching ethics to medical students is one of the current topics of major interest. Issues of ethics pertaining to anesthesia are unique. This article reviews these issues with respect to the preoperative, intraoperative, and postoperative periods. The author shares the experience of incorporating ethical issues into every clinical scenario in the problem-based learning sessions of both undergraduate and postgraduate students. In addition to separate modules in didactic and clinical formats, incorporating the ethical aspects into every clinical problem has many advantages. This approach will stimulate students to ponder over the ethical dimension of every clinical scenario, and the reinforcement of this approach during teaching in the clinical setting may help in inculcating these qualities in the students. Additionally, this approach contextualizes these issues to the local and regional perspective, instead of lecturing on the ethical codes developed elsewhere.

Engaging academic staff in reflective analysis of their teaching: a study of teaching at the Faculty of Medical Sciences, UWI, St. Augustine [abstract]

A qualitative study incorporating reflective analysis of lectures was conducted with four medical teachers of different subject disciplines. The researcher and medical educators engaged in discussions related to the transcribed audio-tapes, as well as video recordings of their lectures, clarifying reasons for evident teaching approaches, sometimes practiced sub-consciously. In all cases, the medical teachers came upon teaching practices that they set about to strengthen or modify, and were able to articulate a teaching philosophy as a result of the research experience. In addition, a focus group discussion with their students was also utilized to gain insight into the effectiveness of salient teaching approaches. The methodology is being proposed as suitable for a project on individualized staff development to enhance quality of teaching. (AU)

Teaching a masters unit using four different modes of delivery [abstract]

Over the last two years, the need for flexibility in delivery of courses to post-graduate students enrolled at the Australian Catholic University became pressing. Factors which contributed to this realization included the relatively small numbers of students enrolled over the five campuses of the University and the fact that these students resided thousands of kilometers apart. At the same time, the University decided to enter the world market for on-line education and targeted particular Faculty courses. The Master of Nursing Leadership, conducted by the Faculty of Health Sciences, was one such course. For lectures who teach units in these programmes, this created new opportunities for creativity in teaching. Over the last two years, I have taught four units in the Master of Nursing programme. One unit (Leadership in Nursing Practice) has been taught in four different modes: face to face, video conference, telephone conference and on-line. This has required a high degree of innovation with a number of different strategies being employed for each of the modes. The strategies employed depended on their suitability for the particular mode. These included the development of communication, through the sending of overheads via e-mail, and a telephone protcol. Students also learnt incidental skills such as how to manage a telephone and a video conference, as well as managing the technology. (AU)

Ethics, medicine and society: imperatives for the future

Historically, medicine has been a caring profession and social factors have directly and indirectly affected clinical practice, yet the social roots of disease and suffering in patients and the ethics of patient care have often been left out of medical teaching and discussions at medical conferences. As health and social problems are inseparable, ethically, medicine and medical teaching need to respond to social suffering, and should help to solve the economic problems in health care. Further, since all intervention in the lives of human beings carries ethical content through the nature of care, ethical competence involving ethical analysis, critical thinking, and problem-solving should be developed in medical students and doctors simultaneously with clinical judgement and expertise.(AU)

Perceptions about mental illness among pre-clinical medical students in Trinidad and Tobago

Perceptions about mental illness among medical practitioners are likely to determine their capacity to recognise, treat appropriately and refer patients who have mental health problems. It is therefore important that training of medical students in psychiatry is undertaken with knowledge of their attitudes to mental health disorders. We determined the perceptions of 108 pre-clinical medical students (69 males, 39 females; mean age 22 years) toward mental illness in Trinidad and Tobago by analysing their responses to a questionnaire based on a case vignette of a young man with a paranoid psychotic illness. 88 percent felt that medical treatment in hospital was the best means of treating the illness and 86 percent suggested that discharge should be conditional on regular visits to a doctor. 89 percent however opposed the patient's marrying into their families and 85 percent to his teaching their children. This was associated significantly with having a personal relationship with someone having a mental illnes (p < 0.03). Surprisingly, 25 percent believed that mental illness could be caused by supernatural forces, particularly females who were almost twice as likely as males to express this belief.(AU)

Comparison of performance of interns completing the old (1993) and new interactive (1997) Advanced Trauma Life Support courses

BACKGROUND: The 1997 edition of the Advanced Trauma Life Support (ATLS) course emphasized interactivity as its major change. The impact of this change is assessed in this study. METHODS: We compared two matched groups of 16 interns completing either the old (group I) or new (group II) ATLS course. Cognitive skills (40 standard ATLS questions plus 10 additional questions on airway and shock) and clinical trauma management skills (four trauma objective structured clinical examinations [OSCEs] on simulated trauma patients) were tested. OSCE station scores (standardized to a maximum of 20), priority scores (graded 1-7), organized approach global passing grades (graded 1-5), and initial assessment test station scores (graded 1-5) were compared. RESULTS: Using ATLS criteria, three interns failed in each group. Post-ATLS examination quesiton scores were similar (84.5 +/- 6.9 for group I, 85.9 +/- 7.1 for group II); scores for the airway and shock questions were higher but not different between the two groups. The four OSCE station mean scores varied between 13.9 +/- 2.0 and 15.4 +/- 2.1 for group I and were higher (P < 0.05) for group II (17.9 +/- 1.6 to 19.1 +/- 1.0). Priority scores were similar (group I, 6.3 +/- 1.1; group II, 6.4+/- 1.2), but approach scores (3.9 +/- 0.1 for group I and 4.9 +/- 0.8 for group II). There were 8 honors grades in group I and 40 (p < 0.05) in group II. Interactive teaching, adult education principles, opportunities for discussion, provision of feedback, and stimulation of self-learning were rated more highly in the new course. CONCLUSION: Using standard ATLS pass criteria, performance after the new and old ATLS courses was similar. Superior performances were measured using OSCE methodology for clinical trauma management skills after the new compared with the old ATLS course in this population of interns.(Au)

Pre-hospital Emergency Medical Services, Phase I: Role of the Department of Community Health and Psychiatry

The Department of Community Health and Psychiatry was contracted by the Ministry of Health to assist with the implementation of a pilot programme in the Western Health Region to train fire fighters as basic level Emergency Medical Technicians (EMTs), and was responsible for its design, implementation and monitoring for first 18 months. The course was covered in 440 hours over a 10 week period, and included training in emergency medical response, driving an emergency medical vehicle, emergency medical despatching and inventory control. Of 76 fire fighters selected for training, 62 graduated, receiving Certificate of Merit from the Ministry of Health, Jamaica and were deployed into service on 17th April 1996. During the period 17 April to 31 December, 1996, the newly trained EMT's responded to 1,299 calls. Medical and surgical cases represented approximately 55 percent of all calls, followed by trauma (19 percent), motor vehicle accident (9 percent) and obstetric emergencies (8 percent). Between 15 percent and 20 percent of calls in Montego Bay and Negril involved tourists. This first group of EMT's has performed well and was well received by the communities and the persons who used the service.(AU)

Ethnics, medicine, and society in the Caribbean

While the Medical Faculty of the University of the West Indies has produced many outstanding scholars and practitioners over the past 50 years, social processes in many Caribbean countries have resulted in much suffering. Despite this, the social roots of disease and suffering often have been left out of our medical teaching and ethical discussions. The moral basis of medical care is oriented not only by the individual suffering of patients, but also by the collective experiences of humankind. Hence, failure to engage the social aspects of suffering undermines the moral and pragmatic aspects of medical practice. In the Caribbean, if you are poor, you are likely to have a poor health status. So ethically, medicine and medical teaching need to respond to social suffering, as health and social problems are inseparable. Moreover, the last 3 decades have all seen the call for respect for persons and justice as important values in medical practice in many societies. These values have given medicine its contemporary identify, stressing the paramountcy of the welfare of the patient, the need for informed consent, the requirement to make decent health care equitably available to all, and the importance of empathy and kindness as hallmarks of humane medical care. Historically, the practice of medicine has rested on two pillars: medical knowledge and expertise, and irreproachable medical conduct. Unfortunately, in the Caribbean society a huge discrepancy exists in the time and attention paid to these essential pillars. Nearly all of a doctor's occupations have ethical implications due to the nature of care involving persons: therefore medical teaching and conferences that focus only on the scientific and technical aspects of medicine, without addressing the ethics of care for patients or the developing and improving of the ethical competence of students and practitioners, are incomplete.(AU)

The relationship between health care, teaching and research

The practice of medicine has changed radically over the last generation. The advances in medical technology and the application of new knowledge of human biology have led to a huge rise in the costs of delivering health care. There is probably no country in the world now that does not ration health care either in terms of what is provided, to whom it is provided or when it will be available. Longevity has increased, but many of the survivors living into old age carry with them disabilities that require care and treatment. The management of chronic disability, as well as the treatment of acute illness, is part of the responsibility of all health care systems. Moreover, the stress of modern life, not least in urban communities, has led to a rise in illness not necessarily related to organic disease. The fundamental responsibility of a doctor in the health care team is diagnosis; in other words to answer the questions, "What is wrong?" and "Why is it wrong?" The other questions that emerge out of the consultation, such as "What can be done?" What should be done? Who should do it? What can I expect?" are ones to which the whole health care team, not just doctors, can contribute. Indeed the question, "What should be done?", given the availability and uncertainity of modern technology, is now important in the provision of health care. The changed demands on health care systems and the changing role of doctors have led to a realisation of the need for a radical reform of medical training, at both undergraduate and postgraduate levels. In the United Kingdom this process has been led by the General Medical Council, which in 1993 published a discussion document on "Tomorrow's Doctor" setting out principles for curriculum change which are now being developed in all medical schools in the UK. The process of change does not just relate to the content of the curriculum but also to the manner in which it is taught. More opportunities for problem-sloving, self-learning and special study modules are being introduced. Cell biology and molecular genetics, along with an increase emphasis on ethics and law, communication skills, public health medicine and team work with other health professionals are being introduced alongside the old disciplines.(AU)

Student perceptions of a good teacher: the gender perspective

BACKGROUND: A large-scale survey of pupils' perceptions of a good teacher in the Caribbean republic of Trinidad and Tobago is reported. An essay-based, interpretative mode of research was used to elicit and identify constructs used by boys and girls. AIMS: The study explores similarities and differences between boys and girls in their perceptions of a good teacher, in a society where girls achieve superior academic performance (than boys). SAMPLE: A total of 1756 pupils and students aged between 8 and 16 provided the sample, which was proportional, stratified, clustered. Within these constraints classrooms were randomly selected to be representatives of primary and secondary school schools across the two islands. METHOD: Altogether 1539 essays and 217 interviews were content analysed, coded for age development and compared between boys and girls. Content items identified by the pupils were logically grouped into: physical and personal characteristics of the teacher, quality of the relationship between the teacher and pupil, control of behaviour by the teacher, descriptions of the teaching process, and educational and other outcomes obtained by pupils due to teacher efforts. RESULTS: Female pupils identified more good teacher concepts at all age levels than males. There was some commonality concepts at all age levels than males. There was some commonality between the sexes in concepts regarding interpersonal relationships and inclusiveness in the good teachers' teaching practices and boys showed significantly greater concerns regarding teacher control and use of punishment. Males as young as 8 years stated that good teachers should be sensitive to their needs. Only among the 16 year old males and males noted as good teachers. CONCLUSION: Consideration is given to the roles of male and female teachers, how their classroom actions may set the basis for future success (or failure) of their pupils, and the needs of pupils with regard to teacher support within developing and developed countries(AU)

Examination performance of medical students: a view from Trinidad

We analysed the outcome of the final MBBS (Bachelor of Medicine and Bachelor of Surgery) examination oat the St. Augustine Campus, University of the West Indies, for 686 students attempting them for the first time between 1975 and 1986. The mean failure rate was lowest in medicine between 1975 and 1981, in obstetrics and gynaecology between 1982 and 1989 and in surgery during the last 7 years. The students' poor performance in some areas indicates the need for recognizing the importance of creating and establishing an educational climate in which the quality of teaching comes under scrutiny. The marking system in medicine should be reviewed.(AU)

Corporal punishment in elementary education: views of Barbadian schoolchildren

Most previous research has suggested that children often express little unconditional disapproval of the use of corporal punishment in schools. However, this might be expected to change when pupils become aware that such treatment is no longer permitted in many countries, or hear it labelled as "abuse." This paper reports on research conducted in elementary schools in the Caribbean island of Barbados, where head teachers (or their authorized deputies) are still permitted by law to use corporal punishment. Findings indicated that approximately three-quarters of pupils surveyed still approved use of corporal punishment with their own age group, although their comments also suggested that a considerable amount of routine (and illegal) "flogging" or "lashing" by regular classroom teachers occurred, which many wished to see stopped. The growing risk of clashes between parents and schools was also identified. While this and other recent studies in Barbados provide little evidence of support for the total abolition of corporal punishment within the educational system, it is hoped that research may have some role to play in exerting pressure on schools to eliminate some of their more ritualized and pedagogically counterproductive practices (AU)

Pupils' perceptions of a good teacher: a developmental perspective from Trinidad and Tobago

The study reports on a large-scale survey of pupils' perceptions of a good teacher in the Caribbean republic of Trinidad and Tobago. An essay-based interpretive mode of research was used to elicit and identify constructions used by pupils between ages 7 and 17. The sample was a proportional stratified, clustered, yet randomly selected representation of primary and secondary schools across the two islands. 1633 essays were content analysed and coded for age developmental comparison. Factor analysis showed no consistent underlying grouping of the 166 conceptual items by age, thus analysis was undertaken within logically constructed sets of items that are described: physical and personal characteristics of the teacher, quality of the relationship between teacher and pupil, control of behaviour by teacher, descriptions of the teaching process, and expected educational and other outcomes obtained by pupils due to teacher efforts. Results showed a general increase in number of conceptual items (and words per essay) by age but this confuses four further criteria of item used. The four criteria were: age constancy, characteristics of younger pupils, characteristics of 11-13 year olds, and characteristics of the oldest pupils. All ages perceived teachers by physical presentation (clothing and appearance), teachers' care for pupils, descriptive teaching actions, and trustworthiness. Younger pupils focused on appearance, subjects taught, and assertion of physical punishment. Mid-aged pupils focused on the range of classroom control used by the teachers (including distributive and retributive punishment), actions involved in the teaching process, and a growing awareness of the individual needs of the pupils. Oldest pupils understood that good teachers must be well trained and highly motivated, should be sensitive and responsive to the needs of pupils, draw the pupils into the learning process, and have a major responsibility in preparing the pupil for the world of work and further education. Important aspects of the study shows the link between the pupils' conceptual reality and classroom environment, that pupils are concerned about the relationship between themselves and teachers, and that the curriculum dominated approach to teaching does not meet pupil expectations.

Problem-based learning (PBL) at Mount Hope: the student's view - abstract

The new curriculum at the Mount Hope Medical School, Trinidad, has introduced many novel concepts in medical teaching in the Caribbean. The preclinical exposure has been increased to 3 years where problem-based learning (PBL) is employed and introduction to clinical skills is done in a skills laboratory rather than on the wards. Fewer lectures are given and more (applied) basic science education is imparted via PBL sessions where 6 to 8 students are assigned to a tutor. Students are exposed to 2 rather than 3 years' clinical experience on the wards. In order to assess the students' views of this curriculum, a questionnaire was designed and given to 62 students of the class of 1994 after they had completed their first clinical clerkship. Data from 41 (66 per cent) students were analysed, using a personal computer. Most students (82 per cent) preferred to shorten their preclinical exposure to 2 years or less, and felt they could learn the same amount of basic science in the time. They preferred to have more lectures (68 per cent) and to have more tutor participation in PBL sessions (80 per cent). All students felt learning clinical skills on the wards was far superior to developing these in the skills laboratory. In view of these findings, consideration should be given to reviewing the curriculum, and further studies should be done to continue assessment of curriculum changes (AU)