Pre-admission criteria and pre-clinical achievement: Can they predict medical students performance in the clinical phase?

RATIONAL: Various factors affect medical students' performance during clinical phase. Identifying these factors would help in mentoring weak students and help in selection process for residency programmes. OBJECTIVE: Our study objective is to evaluate the impact of pre-admission criteria, and pre-clinical grade point average (GPA) on undergraduate medical students' performance during clinical phase. METHOD: This study has a cross-sectional design that includes fifth- and sixth-year female medical students (71). Data of clinical and pre-clinical GPA in medical school and pre-admission to medical school tests scores were collected. RESULTS: A significant correlation between clinical GPA with the pre-clinical GPA was observed (p < 0.05). Such significant correlation was not seen with other variables under study. A regression analysis was performed, and the only significant predictor of students clinical performance was the pre-clinical GPA (p < 0.001). However, no significant difference between students' clinical and pre-clinical GPA for both cohorts was observed (p > 0.05). CONCLUSION: Pre-clinical GPA is strongly correlated with and can predict medical students' performance during clinical years. Our study highlighted the importance of evaluating the academic performances of students in pre-clinical years before they move into clinical years in order to identify weak students to mentor them and monitor their progress.

Medical teachers' perception towards simulation-based medical education: A multicenter study in Saudi Arabia.

OBJECTIVE: This study aims to evaluate the perception of medical teachers toward the integration of simulation-based medical education (SBME) in undergraduate curriculum and also identify contextual barriers faced by medical teachers. METHODS: This cross-sectional observational study included medical teachers from three universities. A questionnaire was used to report teachers' perception. RESULTS: SBME was perceived by medical teachers (basic sciences/clinical, respectively) as enjoyable (71.1%/75.4%), effective assessment tool to evaluate students' learning (60%/73.9%) and can improve learning outcome (88.8%/79.7%). Similarly, (91.1%/71%) of teachers think that simulation should be part of the curriculum and not stand alone one time activity. Teachers' training for SBME has created a significant difference in perception (p < 0.05). Lack of teachers' training, time, resources and the need to integrate in medical curriculum are major perceived barriers for effective SBME. CONCLUSION: Results highlight the positive perception and attitude of medical teachers toward the integration of SBME in undergraduate curriculum. Prior formal training of teachers created a different perception. Top perceived barriers for effective SBME include teachers' formal training supported with time and resources and the early integration into the curriculum. These critical challenges need to be addressed by medical schools in order to enhance the integration SBME in undergraduate curricula.

Undergraduate medical students' perceptions on the quality of feedback received during clinical rotations.

OBJECTIVE: This study aims to report undergraduate medical students' evaluation of the frequency and the quality of feedback received on their clinical performance during their clerkships. METHODS: This is a prospective observational study with a cross-sectional design including students from two cohorts (fifth and sixth years). In a structured interview, a questionnaire was used to report students' perception on feedback. RESULTS: In all, 53.3% and 66% of the students (fifth, sixth years, respectively) had rarely received feedback from clinical teachers, and only around 18% of them had corrective feedback during patient encounter. Students rated feedback on domains of communication skills with patients, and investigations requested as poorly acknowledged. Students appreciate the impact of feedback, however, 85% and 94% of them (fifth, sixth years, respectively) had poor feedback seeking attitude. The overall process of feedback was rated by the two cohorts collectively as 43.6% poor and 24.5% fair. CONCLUSION: Results demonstrate that feedback on students' clinical performance is often not forthcoming and when offered it is deficient and fails to concentrate on the development of different clinical skills. This highlights the critical challenges that need to be addressed by teachers, medical education unit and all hospital departments in order to enhance giving effective and structured feedback to medical students during clerkships. Results also raise the extreme need for the establishment and enhancement of a culture that supports feedback among all levels of clinical supervisors.

Academic and socio-demographic factors influencing students' performance in a new Saudi medical school.

OBJECTIVE: The objective of this study is to examine factors such as the students' demographic data, motivation, educational factors and socio-cultural factors, and identify whether these factors affect the academic performance of undergraduate medical students. METHODS: A cross-sectional study design utilising grade point averages (GPAs) of two cohorts of students in both levels of the pre-clinical phase. In addition, self-administered questionnaire was used to evaluate the effect of these factors on students with poor and good cumulative GPA. RESULTS: Academic performance was significantly affected with factors such as gender, marital status, interest and motivation, and the transportation used to reach the faculty. Students with a cumulative GPA of 3.0 or greater significantly differed than those with a GPA of less than 3.0 being higher in female students, in married students, students have interest to study medicine and type of transportation used to reach the college. Factors including age, motivation, learning resources, study time and type of transportation used have shown to create a significant difference in GPA between male and females. CONCLUSION: Factors such as age, gender, marital status, interest and motivation to enter medical school, learning resources, study time and the transportation used have been shown to significantly affect medical student's cumulative GPA as a whole batch as well as when they are tested for gender.

Real-time polymerase chain reaction shows that density centrifugation does not always remove Chlamydia trachomatis from human semen.

OBJECTIVE: To evaluate the efficiency of sperm washing procedures to remove Chlamydia trachomatis from semen both in clinical samples and experimental inoculations. DESIGN: Laboratory-based study. SETTING: Research laboratory in a university hospital. PATIENT(S): One hundred men attending for diagnostic semen analysis as part of infertility investigations and three sperm donors providing ejaculates for research purposes. MAIN OUTCOME MEASURE(S): Number of DNA copies of C. trachomatis, infectivity in an HeLa cell monolayer, and immunofluorescence. RESULT(S): Of the 100 semen samples examined, 13 contained detectable levels of C. trachomatis DNA (675-15,920 copies/mL) and in only 7 was this completely removed after sperm washing. In the remaining six DNA-positive samples, the number of copies in the postwash preparation ranged from 36-455 per mL. Experimental inoculations found that postwash preparations containing C. trachomatis DNA as low as 61 copies/mL were able to establish an infection in vitro. CONCLUSION(S): Undiagnosed C. trachomatis infections in men attending for assisted conception could potentially lead to infection or contamination of the IVF culture system as sperm washing methods are not 100% effective.

Interaction of Chlamydia trachomatis serovar E with male genital tract epithelium results in secretion of proinflammatory cytokines.

Although much has been reported on the in vitro interaction of Chlamydia trachomatis with cells derived from the female genital tract, little is known of its interaction with male genital tract epithelium. The aim of this work was to investigate the effect of C. trachomatis serovar E on immortalized normal human urethral epithelial cells and on immortalized normal adult human prostate epithelial cells with regard to chlamydial growth and secretion of cytokines. After infection, these epithelial cells were assessed for their support of chlamydial growth in comparison with HeLa cells, and cytokine levels in cell culture supernatants were determined by ELISA. Although the male-derived epithelial cells supported growth of chlamydiae, the best growth was seen in HeLa cells. In contrast to prostate epithelial cells, the urethral epithelial cells released much larger quantities of interleukin 1alpha (IL-1alpha) following infection, whereas both IL-6 and IL-8 were produced in larger quantities by infected prostate cells. At 7 days post-infection, HeLa cells consistently produced large quantities of all three cytokines. In conclusion, the male-derived cell lines were shown to support the invasion of C. trachomatis and initiate a proinflammatory response to infection. From in vitro studies the suggestion that high levels of IL-6 could be a possible marker for chlamydial prostatitis is confirmed. Although not as marked a change, it is also suggested that higher IL-8 levels could be associated more with infection of the prostate than the urethra. Differential cytokine production by different male-derived epithelial cells could help determine the site of chlamydial infection and help in the study of pathogenesis.