Is Peer assisted learning better? A modern question to answer: A comparative study.

OBJECTIVE: To determine the effectiveness of peer-assisted learning against expert-assisted learning in terms of scores achieved by medical students, and to assess the perceptions of students about peer-assisted learning. METHODS: The mixed-method study was conducted at Wah Medical College, Wah Cantonment, Pakistan, from October 2017 to December 2018, and comprised fourth year medical students who were randomised into groups A and B. In the first session the topic 'Data' was taught to group A by a peer and to group B by an expert teacher. In the next session the topic 'Sampling' was taught to group A by an expert teacher and to group B by a peer. Each session was followed by an assessment. Students' views about peer-assisted learning were collected using a predesigned questionnaire. An open-ended question about the role of expert in teaching was also asked from the students. Data was analysed using SPSS 22. Qualitative data was analysed to identify emerging themes. RESULTS: Of the 80 subjects, 41(51.25%) were group A and 39(48.75%) were in group B. Overall, there were 36(45%) males and 44(55%) females. In the first session, mean group A score was 6.85±1.99 and for group B it was 7.54±1.76 (p>0.05). In the second session, the mean score of group A was 6.12±2.06 and for group B it was 4.82±2.01 (p=0.005). CONCLUSIONS: Peer-assisted learning was found to be a valuable tool that can be incorporated in the curriculum delivery for easy topics. However the significance of expert's assistance, guidance and feedback cannot be negated.

Birth Preparedness Among Women Coming To Pof Ospital Wah; A Cross Sectional Study.

BACKGROUND: High women deaths due to pregnancy, child birth and postpartum complications were the hallmarks of the end of last century especially in Asia. Strategy adopted to achieve this is called birth preparedness whose main aim is to empower the community. This study was planned to determine the frequency of awareness about birth preparedness and the association of birth preparedness with the educational and employment status of the women. METHODS: It was a cross sectional study carried out in Pakistan Ordinance Factories Hospital Wah Cantt. A sample of 385 women was calculated by WHO sample size calculator. The sample was selected by purposive sampling. The study was carried out from September 2015 to March 2016. A structured questionnaire was filled regarding awareness about birth preparedness among women after taking informed consent from each of them. Demographic characteristics were recorded. Birth preparedness awareness was assessed by questionnaire containing 10 items. The data was entered and analyzed using SPSS version 19. Pearson correlation was applied to find the association of birth preparedness with the educational and employment status of the women at p-value of 0.05. RESULTS: In a sample of 385 women, 131 (34.1%) were prepared. Statistically significant p value of 0.000 was found between birth preparedness and educational status while a p-value of 0.153 was found between birth preparedness and employment status of the women. CONCLUSIONS: The study concluded that despite having education and availability of free medical facility the women were not aware of birth preparedness.

Quality Of Educational Environment At Wah Medical College: Assessment By Using Dundee Ready Educational Environment Measure.

BACKGROUND: Educational environment not only has an impact on the students during the academic years but has its reflections throughout their medical career. The Dundee Ready Educational Environment Measure (DREEM) is an internationally accepted useful tool to analyse undergraduate educational environments in the health professionals. The purpose of this study was to assess how students, across all the five years in a private medical college, perceive their educational environment. METHODS: It was a cross sectional study, which used the DREEM inventory at Wah Medical College over the course of 6 months (January-June 2015). All 500 students were included in the study. The fifty items DREEM inventory, having the maximum score of two hundred indicating ideal educational environment was used for data collection. RESULTS: The questionnaire was completed by 400 undergraduate medical students (response rate 80%). The overall DREEM score was 122.63/200 (61.3%), indicating that the perception of the learning environment was more positive than negative. Among the highest scoring categories were students' participation in classes, relaxed atmosphere and confidence in passing the annual exams. However, many areas requiring improvement were also brought to attention. CONCLUSIONS: Overall, the student's perception of their learning environment at Wah Medical College was found to be positive. This study did bring to light some areas that could be improved upon. This should enable the faculty to adopt changes in their teaching methods to make the learning process more productive and enjoyable for future students.

DENGUE EPIDEMICS: KNOWLEDGE PERHAPS IS THE ONLY KEY TO SUCCESS.

BACKGROUND: Dengue fever/dengue haemorrhagic fever is a re-emerging vector-borne viral illness that is endemic in Tropics and poses a major public health burden in many countries of South East Asia, The objectives of the study were to correlate the dengue fever knowledge and preventive practices with age, gender, education, occupation and marital status of people of Wah Cantt. and to determine the association between knowledge level and preventive practices. METHODS: This cross-sectional Survey was done in Wah Cantt from July to Dec 2011. Three hundred and sixty-three participants were selected through Stratified Random Sampling. Data on the knowledge and practice of the participants was collected by using structured questionnaire by the researcher. Knowledge and preventive practices were given scores on each correct response and participants were categorized into different groups according to their scores, i.e., excellent, good, poor and negligible. Associations were computed using Chi-square and Bivariate Correlation. p-value < 0.05 was taken significant. RESULTS: Mean age was 35.7 +/- 12.1 years. More participants were male (64.5%). Male sex, old age, employment without specific qualification and being parents had significant associations with both levels of knowledge and preventive practices. Level of knowledge was highly associated with levels of practice X2=79.1, df=9, p=0.000 and r=0.464 and p=0.000. CONCLUSION: The knowledge and preventive practices of people are related to their gender, marital status, age and occupation. Unexpectedly education has no association with knowledge or better preventive behaviour. Preventive practices get better where knowledge levels are more, emphasizing the need of community education programmes.

Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan.

BACKGROUND: Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse. METHODS: A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients. RESULTS: All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, "Working in the spirit of serving humanity", "Working against all odds", and "Working in a functional system and facing pressures of increased accountability". Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system. CONCLUSION: The study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures requiring better management practices could substantially improve the working environment and hence retention of nurses.

Assessment of knowledge about evidence based medicine in medical students and doctors in a Pakistani health care setting.

BACKGROUND: Evidence based practice promotes self assessment and ensures delivery of up to date care to patients. The concept of Evidence Based Medicine (EBM) in developing countries is still in its infancy where strong opinions drive patient care. METHODS: We conducted a cross sectional survey to explore the knowledge, perceptions and attitudes regarding EBM in final year medical students and physicians of our institution. The survey was distributed to all students and residents of the college and the affiliated hospital. RESULTS: The response rate was 57% (74/130). Seventy-one percent (53/74) of respondents were not aware of EBM. Out of these, 38 were medical students and 15 were house officers. Only 16 (9 students and 7 doctors) admitted that they had heard about EBM. Those who heard about EBM recognised its importance in patient care. Teaching at both under- and postgraduate level was strongly suggested. Participants recognised the need for EBM skills and expertise. Financial constraint was considered as the main hindrance in practicing EBM. CONCLUSION: The concept of EBM is still alien to most of the students and residents at our institution. There is need for incorporating formal teaching of EBM at all levels of medical education.