Do Saudi medical schools consider the core topics in undergraduate medical curricula?

BACKGROUND: Most of the medical schools in Saudi Arabia are currently evolving their curricula in accordance with the most recognized medical education trends worldwide. Undergraduate medical school's curriculum should be compatible with community health needs. Therefore, the study aims to explore the current contents of Saudi undergraduate medical curricula and to check if the core topics that were internationally recognized were implemented in their curriculum. METHODOLOGY: An online questionnaire was designed and sent to 37 deans of medical schools in Saudi Arabia. The deans or the vice-deans in charge of the curriculum were asked to complete the pre-designed questionnaire, which assessed the status of inclusion of the core topics in the curriculum of their affiliated schools. Each listed core topic was evaluated according to five options for each subject: not included, separate required course, part of the required course, separate elective course, and part of an elective course. RESULTS: Twenty four out of 37 (65%) Saudi medical schools completed the survey questionnaire. Almost all core topics, such as communication skills, evidence-based medicine, patient safety, professionalism were included in the curricula of Saudi medical schools as separate required courses or as part of required courses or elective courses. Complementary and alternative medicine and the history of medicine were the topics least taught in Saudi medical colleges, as 25% of the schools did not include them in their curricula. CONCLUSION: The majority (65%) of the internationally recognized core topics were included in the Saudi undergraduate medical curricula. Evidence-based medicine, complementary medicine, the Saudi healthcare system, patient safety, and professionalism/medical ethics should be part of compulsory credited courses in all Saudi undergraduate medical curricula.

Effectiveness of emotional freedom techniques (EFT) vs sleep hygiene education group therapy (SHE) in management of sleep disorders among elderly.

Sleep disorders are common among elderly persons, with deleterious effects on their physical and mental health. Many approaches are used to manage such disorders. To compare the Emotional Freedom Techniques-Insomnia (EFT-I) and Sleep Hygiene Education (SHE) group therapy as two treatments for insomnia in a geriatric population when delivered, and their effects on sleep quality, depression, and life satisfaction. This open-label randomized controlled trial study was conducted at El-Abbasia Mental Hospital and Osana family wellness elderly nursing home at Maadi, Cairo. It included 60 elderly patients suffering insomnia sleep problems randomized into two equal groups: one group received a Sleep Hygiene Education (SHE) intervention, the other had a form of Emotional Freedom Techniques (EFT) adapted for use with insomnia (EFT-I). A self-administered questionnaire with tools for sleep quality (Pittsburgh Sleep Quality Index [PSQI]), depression, and life satisfaction was used to collect data. The fieldwork was from January to March 2021. The two groups had equal median age (70 years), and almost similar gender and place of residence distribution. After the intervention, 73.3% of the EFT group had good sleep quality, compared to 100.0% in the SHE group (P = 0.005); the median score of depression (3.00) was higher in the EFT group compared with 0.00 in the SHE group (P < 0.001); as for life satisfaction, the difference was not statistically significant. The multivariate analyses identified the study intervention as the main statistically significant negative predictor of PSQI and depression scores, and a positive predictor of life satisfaction. Being in the SHE group was a negative predictor of PSQI and depression scores. Both SHE and EFT approaches are beneficial for elderly patients' sleep quality, with SHE being more effective in ameliorating sleep. Further replication of this study is needed on a large probability sample from different geographical areas to help for the generalization of the results.

Efficacy of ticagrelor compared to clopidogrel in improving endothelial function in patients with coronary artery disease: a systematic review.

BACKGROUND: Ticagrelor and clopidogrel are antiplatelet drugs that act by binding to the adenosine diphosphate P2Y12 receptor. Previous studies have compared between them regarding the endothelial function effect. OBJECTIVES: This systematic review aims to summarize the evidence comparing the efficacy of ticagrelor vs. clopidogrel in improving endothelial function in patients with coronary artery disease (CAD). METHODS: In August 2021, the Scopus, PubMed, Web of Science, and Cochrane library were searched systematically for eligible trials. We included randomized controlled trials that compared the efficacy of ticagrelor vs. clopidogrel in improving endothelial function in patients with CAD. RESULTS: Seven trials (n = 511) were included in our systematic review. Ticagrelor resulted in a greater elevation of the level of progenitor cells CD34+ KDR+ and CD34+ 133+ (P = 0.036 and P = 0.019, respectively), with a lower rate of endothelial cell apoptosis rate (P < 0.001). Moreover, ticagrelor showed superiority regarding nitric oxide, radical oxygen species, and soluble P-selectin levels (P = 0.03, P = 0.02, and P = 0.019, respectively). Flow-mediated dilation findings differed between the studies (P = 0.004 vs. P = 0.39). CONCLUSION: Ticagrelor appears to exert an additional improvement in endothelial function compared with clopidogrel in patients with coronary heart disease.

Burnout and Associated Risk Factors in Pediatric Residents.

Background: Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment. The aim of this study was to identify burnout incidence in pediatric residents and evaluate possible risk factors for burnout. Methods: Using a cross-sectional study design, we approached all pediatric residents in the Saudi Pediatrics Residency Program in Riyadh, Saudi Arabia (n=457) between January and March 2019. The Maslach Burnout Inventory-Human Services Survey was used to assess burnout incidence. In addition, demographic factors, schedule burden, career choice satisfaction, and work-life balance were assessed. Results: The response rate was 57.8% (264/457). Males represented 46.6%. Only 14% of the residents in the study were satisfied with their work-life balance, and 62% were satisfied with their career choice of pediatrics. The overall high burnout incidence was 15.9%, the high emotional exhaustion incidence was 63.6%, the high depersonalization incidence was 27.7%, and the low sense of personal accomplishment incidence was 48.5%. In the multivariate analysis, an increase in the average number of on-calls per month (odds ratio [OR]=1.66, 95% CI 1.12-2.46; P=0.012) and satisfaction with salary (OR=0.47, 95% CI 0.33-0.66; P<0.001) showed significant associations with high overall burnout. Conclusion: We found a high level of emotional exhaustion and a low sense of personal accomplishment among respondents. However, less than one-third of residents had feelings of depersonalization or overall high burnout. Residency program directors may need to make modifications in their programs to ensure a good work-life balance for residents that will help ensure that these physicians provide safe and sustained patient care.

SaudiMEDs and CanMEDs frameworks: similarities and differences.

Background: The SaudiMEDs framework was founded and adopted by the Saudi Deans' Committee in 2011 to ensure that Saudi medical graduates learned core competencies. Meanwhile, CanMEDs was established by the Canadian Royal College of Physicians and Surgeons in 1996 and aimed to establish the abilities and skills of all aspects of medical practice, as well as to ensure the acquisition of basic knowledge related to medical education. The main purpose of this study was to explore the similarities and differences between both frameworks. Methods: In March and April 2017, 15 researchers conducted an extensive review of both the SaudiMEDs and CanMEDs frameworks using a semi-quantitative evaluation with color codes to determine the following: the exact similarities in both frameworks, the close similarities, and the unique differences. Results: According to the coloring system, most of the frameworks were similar. For example, Leadership, Communication and Professionalism were almost identical in both frameworks. There was some degree of similarity between both frameworks in "Collaborator". Furthermore, the SaudiMEDs framework had a unique input which involved the most essential skills that undergraduate medical students must acquire. Conclusion: SaudiMEDs has great potential to improve the quality of Saudi medical graduates in a manner that fits our current and future needs. CanMEDs focuses mainly on outcomes and processes, while SaudiMEDs focuses more on outcomes. SaudiMEDs was not created to provide a copy-and-paste curriculum. The ultimate goal was to create an outcome-based curriculum that ensures the quality of Saudi medical school graduates.