The clinical elective course and its effects on medical students and graduates of Jordanian medical schools.

BACKGROUND: The elective course is part of the 6th-year medical school curriculum in Jordan. Students choose the specialty in which they wish to spend 8 weeks and choose their location even if it is outside their university's affiliated hospitals. In this study, we try to understand student choices regarding the country of elective, chosen specialty, type of placement (observership/clerkship), and elective general value from participants' perspectives. METHODS: This paper used a cross-sectional study. The survey was distributed through social media platforms (mainly Facebook and WhatsApp) targeting 6th-year medical students and doctors who graduated from one of the 5 Jordanian medical schools (the University of Jordan, Jordan University of Science and Technology, Mutah University, Yarmouk University, and Hashemite University). RESULTS: The majority of participants had an international elective (69.6%), mainly in the USA, followed by the UK. Internal medicine was the primary field of interest for 14.8%, followed by general surgery. Of these, 241 (62.6%) actively participated in work at their chosen hospitals as they had a clerkship/hands-on experience. In contrast, 142 (36.9%) were observers. The majority indicated that the elective is worth the time, money, and effort. Moreover, they had adequate supervision throughout the course and could achieve their preset objectives. CONCLUSIONS: The elective course gives a unique experience to our students. General satisfaction is an indicator of the success of the course in actively exposing medical students to clinical practice.

Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives.

BACKGROUND: As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning. METHODS: This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size (n = 588) is derived from the online Raosoft sample size calculator. RESULTS: A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students. CONCLUSION: With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.

Congenital Diaphragmatic Hernia at a Non-ECMO Center in Jordan.

OBJECTIVES: We studied the clinical characteristics and outcomes of neonates with congenital diaphragmatic hernia (CDH) admitted to a non-extracorporeal membrane oxygenation (ECMO) center. METHODS: A retrospective chart review of neonates with CDH admitted to a University Hospital, in Amman, Jordan, between 2005 and 2019. Demographic characteristics and their management details were extracted and factors associated with survival were analyzed. RESULTS: A total of 28 neonates born with CDH were included; their survival rate was 39.3%. Onset of respiratory distress, pre-operative ventilation, and length of hospitalization were significantly associated with mortality. Survival after surgery was significantly associated with a higher gestational age and a longer hospital stay. CONCLUSION: Our study showed a high mortality rate for CDH patients. Decreasing the health inequity and improved clinical interventions could improve outcomes.

Improved Patient Outcomes with Electrocauterization Following Wedge Resection and Curettage for Ingrown Toenails: A Prospective Comparative Study.

Background Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively ( p = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively ( p = 0.001). Conclusion Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.

Intussusception in a 4-Year-Old Male Due to Burkitt Lymphoma.

Intussusception is the invagination of a proximal bowel segment into a distal segment causing bowel obstruction, especially in children. In some cases, it can be caused by a pathological lead point, such as Burkitt lymphoma. Burkitt lymphoma has several patterns of clinical presentations, such as jaw or facial bone tumor in the endemic form, in contrast to an abdominal presentation most often with massive disease and ascites. We describe a case of a 4-year-old male who presented bowel obstruction. Using X-ray and ultrasound findings, ileocecal intussusception was then diagnosed. Resection and anastomosis was performed after multiple trials of failed hydrostatic reduction. On the pathology report of the resected segment, Burkitt lymphoma was found to be the cause and chemotherapy was initiated. The patient is doing well and is following up every 6 months for 2 years. A pathological lead point, especially Burkitt lymphoma, should be suspected in patients with failed conservative treatment, and prompt diagnosis of the pathology should be performed to prevent further sequela of the disease.

Double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula in uncircumcised patients with distal hypospadias.

Urethrocutaneous fistula may complicate hypospadias repair. We noticed that double-layered preputial dartos flaps added to tubularized incised plate urethroplasty can reduce the risk of urethrocutaneous fistula. The aim of this study was to compare the outcomes of tubularized incised plate urethroplasty with double-layered preputial dartos flaps to with single-layered local fascial flaps in preventing urethrocutaneous fistula. A retrospective cohort study was conducted between January 2017 and December 2020 at Jordan University Hospital (Amman, Jordan). Boys who were aged between 6 months and 5 years, diagnosed with distal hypospadias, and not circumcised were included. The primary outcome was the occurrence of urethrocutaneous fistula in patients who underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The results showed a total of 163 boys with distal hypospadias; among them, 116 patients underwent tubularized incised plate urethroplasty with a single-layered fascial flap, and 47 underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The development of urethrocutaneous fistula was higher in the group receiving tubularized incised plate urethroplasty with a single-layered fascial flap than in the group receiving tubularized incised plate urethroplasty with a double-layered fascial flap after 1 month, 6 months, and 12 months (6.9% vs 0, 10.3% vs 0, and 5.2% vs 0, respectively), and the difference after 6 months was statistically significant (P = 0.02).

Enhanced recovery concepts in paediatric patients who underwent appendectomy: a retrospective cohort study at a tertiary university hospital.

OBJECTIVE: To investigate if the implementation of enhanced recovery after surgery (ERAS) pathways could be effective in paediatric patients undergoing appendectomy. METHODS: This retrospective study analysed the data from patients aged ≤18 years that underwent appendectomies. The data collected included age, sex, application of enhanced recovery concepts (ERCs) and clinical outcomes. RESULTS: A total of 93 paediatric patients were retrospectively categorized into two groups: patients in group 1 did not experience the use of ERCs during their appendectomies; and patients in group 2 had ERCs applied during their appendectomies. Patients in both groups were exposed to some elements of ERAS, including preoperative patient/parent counselling, limited fasting durations, antibiotic prophylaxis and no bowel preparations. Duration of hospital stay was significantly longer in group 1 compared with group 2 (3.47 ± 1.81 days versus 2.24 ± 1.52 days, respectively. There were no significant differences between the two groups in term of postoperative pain control, hospital cost, readmissions, reoperations and emergency room visits. CONCLUSION: Implementing ERCs in paediatric patients undergoing appendectomies provided a significant improvement in patient recovery with a shorter hospital stay, with no increase in postoperative pain, hospital cost, rate of readmission and reoperation.

The Economy of Motion for Laparoscopic Ball Clamping Surgery: A Feedback Educational Tool.

The Ball Clamping module of the Laparoscopic Surgery Training Box involves the transfer of beads across the training board using laparoscopic tools. Fundamentals of Laparoscopic Surgery (FLS) requires practitioners to move their hands at as short a distance as possible to perform the functions in the shortest amount of time. This study introduces a feedback tool that presents to the student, after attempting their exam, the right direction (step by step) of obtaining the optimal pathway for minimizing distance traveled in the Ball Clamping Module of the Laparoscopic Surgery Training Box. The shortest distance tour for the ball clamping task is determined using the Traveling Salesman Model (TSM). A sensitivity analysis is conducted to assess the model's applicability to different types and settings of trainer boxes.•Find the best sequence of points resulting in the shortest distance tour for the ball clamping task.•The effects of adding or removing columns from the box cannot be intuitively predicted.

A Rare Case of Bilateral Abdominoscrotal Hydrocoele in a 10-Month-Old Infant Managed Laparoscopically.

Abdominoscrotal hydrocoeles (ASH) are an increasingly rare form of hydrocoeles. They can present in any age group; however, they are more commonly reported in the paediatric population. Although not yet confirmed, the aetiology of ASH has been under scrutiny for the past two centuries, and scarcity of reported cases hinders this process. Clinical examination is oftentimes sufficient to make the diagnosis; however, confirmatory ultrasonography is recommended. Although old reports favoured a more conservative approach with watchful waiting, the risk of serious secondary complications is high, and surgical intervention is hence considered standard of care. Different approaches have been described, each with their own benefits, with minimally invasive surgery becoming more prevalent as of late. A case of a 10-month-old boy with bilateral ASH treated with a laparoscopic technique is presented.

Complex, Isolated Pulmonary Arteriovenous Malformation in Two Children With Severe Cyanosis.

We present two cases of Isolated complex pulmonary arteriovenous malformations in two children presenting with cyanosis and exercise intolerance. We present the anatomical features and the management of each case. One patient was treated with surgical ligation of the draining vein, and one patient was treated percutaneously by closure of the feeding segmental artery.

Kikuchi-Fujimoto disease in the Eastern Mediterranean zone.

Kikuchi-Fujimoto disease (KFD) is a rare benign and self-limiting syndrome. We aim to review cases of KFD at our institution as a rare illness in the Arab ethnic descent and to analyse reports from most countries in the East Mediterranean zone. This is a retrospective study in which the histopathology database was searched for the diagnosis of KFD. A full review of KFD patients' medical records was done. Data regarding demographic features, clinical presentation, laboratory findings, comorbidities, and management protocols were obtained. Published KFD cases from east Mediterranean countries were discussed and compared to other parts of the world. Out of 1968 lymph node biopsies studied, 11 (0.6%) cases of KFD were identified. The mean age of patients with KFD was 32 years (4-59). 73% (8/11) were females. The disease was self-limiting in 5 patients (45%); corticosteroid therapy was needed in 4 patients (34%). One patient was treated with methotrexate and one with antibiotics. One patient died as a consequence of lymphoma. Jordanians and Mediterranean populations, especially those of Arab ethnic background, seem to have low rates of KFD. The genetic susceptibility theory may help to explain the significantly higher disease prevalence among East Asians. Early diagnosis of KFD-although challenging-is essential to reduce the morbidity related to this illness.

Children with Hirschsprung disease in a developing country: A cohort study of the predictors of a positive rectal biopsy result.

Chronic constipation, which may be habitually or pathologically caused, is one of the most common complaints in children. One of the important pathological causes is Hirschsprung's disease (HD), which is diagnosed via multiple modalities, mainly rectal biopsy. Our aim was to compare the presentation and different predictive factors for positive rectal biopsy results in a developing country in the Middle East, such as Jordan. This cohort study was conducted at the Jordan University Hospital (JUH). All consecutive children aged <14 years who presented with refractory constipation and underwent rectal biopsies between January 2014 and December 2019 were retrospectively enrolled in the study. In the entire cohort study, 79 patients were enrolled: 45 (57%) were males and 34 (43%) were females. Regarding the biopsy results, 51 (64.6%) cases of refractory constipation without HD and 28 (35.4%) patients with refractory constipation with HD were diagnosed with open rectal biopsies. The male-to-female ratio of HD patients was 3:1. Moreover, 3 (10.7%) children who passed the meconium within the first 24 to 48 hours showed features of HD, while 17 (60.7%) children with delayed passage of the meconium showed features of HD. Abdominal distension was found to be a positive predictor of positive biopsy results (odds ratio [OR] = 4.09, P = .011), and soiling was found to be a negative predictor of positive biopsy results (OR = 0.07, P = .024). In developing countries, children presenting with HD seem to have similar symptoms and signs to those observed with traditional sampling and staining techniques.

Medical students and risk of COVID-19 infection: A descriptive cross-sectional study from the University of Jordan.

BACKGROUNDS: The coronavirus disease-2019 (COVID-19) pandemic with increasing morbidity and mortality has impacted the lives of the global population, including medical education. With the return of on-site medical education in Jordan, it is important to know whether this would pose any risk of COVID-19 infection in medical students. OBJECTIVE: To investigate COVID-19 infection infection rates among medical students and whether there is difference between preclinical and clinical students' infection rate. METHODS: The study is a cross-sectional study, designed to (1) determine the incidence of COVID-19 in clinical and preclinical medical students (2) determine if there is a difference in infection rates between clinical and preclinical students. The study was situated at the University of Jordan and its affiliated hospitals. Data were collected from the 4th of December 2020 till the 17th of February 2021through a structured web-based questionnaire. RESULTS: A total of 1,830 responses were retrieved. Thirty-nine percent were males, and (61.5%) were females. Overall, 237(13%) of students reported testing positive for COVID-19 infection by PCR, of which 123 were clinical students (15.2%) and 114 were pre-clinical students (11.2%), representing a relative risk of 1.36 of COVID-19 infection among clinical students compared to pre-clinical students. This difference is statistically significant (P = 0.010). Rates of COVID-19 in females 13%; CI 7.5,18.4), were very close to those of males (12.9%; 95% CI 6.0,19.8). Positive COVID-19 cases peaked in November and October forming 36.3% and 32.9% of the cases, respectively. CONCLUSION: The incidence of positive COVID-19 tests was found to be higher among clinical students as compared to pre-clinical students. Commitment to general health safety precautions did not appear to be protective enough for clinical students. It is fundamental that additional strategies, including access to vaccines, are set, and deficiencies in current protections are identified to maintain students' safety and well-being.

Preoperative Dexamethasone for Airway-Related "Calibration Tube" Complications After Sleeve Gastrectomy: a Randomised Clinical Trial.

BACKGROUND: Bariatric surgeries utilise Bougie device to guide stomach resection. The device implementation is associated with many underreported complications. This study aims to compare nebulised vs. intravenous preoperative dexamethasone in mitigating airway-related Bougie complications after sleeve gastrectomy. METHODOLOGY: This is a prospective double-blinded interventional study conducted by a tertiary hospital. The study involved 105 patients allocated to 3 groups: Group (I) received 8 mg dexamethasone intravenously (IV) preoperatively, group (N) received 8 mg dexamethasone from a nebulizer mask preoperatively, and Group (S) received nebulised normal saline. Outcomes evaluated were postoperative sore throat, odynophagia, change of voice, and nausea and vomiting. RESULTS: Nebulized dexamethasone was found to be significantly superior to IV dexamethasone in terms of postoperative sore throat at zero-hour (p = 0.001) and 1-h intervals (p = 0.011). No significant difference was found at 6- and 24-h intervals. For odynophagia, post hoc analysis showed there was no significant difference between (I), (N), and (S) groups. Incidence of change of voice was significantly lower in (N) and (I) groups compared to (S) group, with p values of 0.0067 and 0.00014, respectively. The incidence of post-operative sore-throat (PONV) in (I) group was significantly lower than incidences in (S) group (p = 0.00002) and (N) group (p = 0.0004). CONCLUSION: Preoperative nebulized and IV dexamethasone are effective strategies in mitigating complications related to mechanical effects of Bougie insertion. IV dexamethasone was as effective as nebulized dexamethasone in terms of late postoperative sore throat, and was superior in postoperative nausea and vomiting.

The impact of the Covid-19 pandemic on emergency surgery in a tertiary hospital in Jordan. A cross sectional study.

BACKGROUND: Since the emergence of COVID-19 pandemic, governments around the world reacted by implementing curfews and sometimes nation-wide lockdowns intended to control the spread of the disease and help the already overwhelmed healthcare systems from imminent collapse. The Jordanian government was one of those countries that implemented a complete nation-wide lockdown which lasted for 3 months during the peak months of 2020. The aim of this study is to shed the light on the impact of this lockdown on the surgical emergency practice at a tertiary referral center in Amman, the capital of Jordan. METHODS: A retrospective review of the medical records of the patients who were admitted to the hospital through the emergency department over the lock-down months in 2020 and compare them to the records of the patients admitted within the same period in 2019. RESULTS: A total of 143 patients were admitted in the 2020 group, compared to 201 patients in the 2019 group, marking a 28% reduction in admission rate. The average duration of symptoms before the ER visit was significantly longer in the 2020 period compared to 2019 (95.32 ± 148.62 min, 57 ± 64.4 min respectively, p = 0.01) which resulted in a Significant increase in the ICU admission in the same period (P=.00001). As for the type of management, there was no difference between the two groups with similar percentage of surgeries performed in the two periods (p = 0.333). Additionally, the average length of stay did not also differ (p = 0.141). CONCLUSION: The COVID-19 pandemic has negatively affected the health care systems around the world to the point of collapse in some countries. This study has demonstrated its effects on the emergency surgery practice at our institution which was mainly related to the delay in getting medical care caused by the strict lock-down laws implemented in the country. Thus, we recommend that special measures should be taken to improve the access to medical care during future events that may require limiting the movement of people and vehicles in the country.

Is the open approach superior to the laparoscopic hernia repair in children? A retrospective comparative study.

BACKGROUND: For many years now, inguinal hernia repair in children has been done either by the open approach or laparoscopically with laparoscopy having the edge in terms of cosmesis and postoperative pain. However, recent studies have called for a return of the open approach as it had a comparable result to laparoscopy with lesser cost. This study aims to compare the outcomes of the two approaches at our institution. METHODS: This is a retrospective analysis of the prospectively collected data of all patients aged between 6 months and 13 years who underwent open or laparoscopic inguinal hernia repair in the period between January 2017 and July 2019 at our institution. RESULTS: 155 patients were included in the study. 100 (64.5%) underwent open inguinal repair while 55 (35.5%) were done laparoscopically. There was no significant difference in the postoperative complications between the open and laparoscopic groups (P = 0.66). The overall mean operative time for the laparoscopic group and the open group is (45.7 ± 15.2, 45.5 ± 15.4 min, P = 0.83) respectively. However, a subgroup analysis showed a statistical difference in the operative time in bilateral hernias favoring the laparoscopic approach, (44 ± 13.2, 63.2 ± 26.4 min respectively, P = 0.049). Laparoscopy was also associated with shorter times to full recovery compared to the open group (4.7 days, 7.5 days, P = 0.013). Surprisingly, there was no difference in the cosmetic outcome between the two groups which is contrary to the published literature. CONCLUSIONS: Laparoscopic inguinal hernia repair in children is a feasible and reproducible procedure. It permits the evaluation of the contralateral groin without further incisions. In our study, laparoscopy was superior in terms of operative time in bilateral hernias and the time to recovery. Finally, an added benefit to laparoscopy is that it offers more training opportunities for fellows and residents to improve their laparoscopic skills.

Patients response to pre-operative counseling for the appropriate type of bariatric surgery.

INTRODUCTION: Obesity is a major cause of metabolic and health disorders like diabetes mellitus (DM) and gastro esophageal reflux disease (GERD). Patients usually offered a professional preoperative consultation and objective information regarding the bariatric surgery type and the advantages and disadvantages of each type for best outcome and satisfaction. PURPOSE: To study the patient response to preoperative advice and recommendation and the patient's decision to undergo the recommended bariatric surgery. OBJECTIVE: To determine the statistical significance of preoperative recommendation and the patient personal choice of the type of bariatric surgery. MATERIALS AND METHODS: This original article is a cross-sectional survey of 188 patients underwent bariatric surgery between February 2015 and December 2018 in the General Surgery Departments - Bariatric Surgery Clinics in Jordan University Hospital affiliated to the College of Medicine in the University of Jordan and Al Karak Governmental Hospital affiliated to the College of Medicine in Mutah University. 144 patients underwent longitudinal sleeve gastrectomy (LSG) and 44 patients underwent Roux en-Y gastric bypass (RYGB) as the recommended type of surgery for the selected comorbidities diabetes, gastroesophageal reflux disease, or both. RESULTS: Of 188 patients data collected, 54 patients who should had undergone RYGB as the recommended type of surgery, preoperative counseling did not have a significant effect on their decision to undergo the appropriate type of bariatric surgery. The number of patients who had pre-operative recommendation = 37 (68.5%). Out of these, only 15 patients choose the surgical team recommended surgery; p-value 0.183, odds ratio 2.22, (95% confidence interval (CI) = 0.6-8.12). CONCLUSION: Preoperative surgical procedure type advice did not have a significant effect on patients' choice of the recommended bariatric procedure.

E-Learning during COVID-19 pandemic; Turning a crisis into opportunity: A cross-sectional study at The University of Jordan.

OBJECTIVES: To assess the medical students' satisfaction and knowledge attainment through distant learning during the COVID-19 pandemic. METHODS: This is a cross-sectional, self-reported, questionnaire-based study that was conducted at the School of Medicine at the University of Jordan in April 2020. The targeted population was the students at the school of medicine. An online questionnaire was created using Google Forms. Satisfaction and knowledge attainment among students were assessed using independent-samples t-test. RESULTS: A total of 1000 medical students completed the survey, 506 (50.6%) basic science students and 494 (49.4%) were clinical science students. 655 (65.5%) of all students were either satisfied or neutral with e-learning. 63.6% of basic science students and 59.5% of clinical students stated that they gained and understood knowledge in the same way as or better than they did before initiation of exclusive e-learning. Satisfaction and knowledge gain were significantly affected by student preparedness (p < 0.000), teacher performance (p < 0.000), and website accessibility (p < 0.000). CONCLUSION: Transition from traditional in-class teaching to distant learning, whether full or blended, is an inevitable step. In our sample, students were generally satisfied with e-learning and the knowledge attained using it. There was a significant relation between satisfaction and attainment and preparedness of students, teachers, and the medical school.

Knowledge, Practice, and Attitude Toward COVID-19 Among Physicians in Jordan and Palestine: Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Coronavirus disease-2019 (COVID-19) is an emerging disease threatening the world with a rapid increase in cases and deaths since it was first identified in December 2019. Adequate knowledge, practice, and attitudes (KPA) toward COVID-19 among physicians at the frontline defense against the COVID-19 pandemic may enhance their ability to avoid the risk of self-infection, decrease mortality, and provide adequate medical care service in this pandemic. This study aimed to assess KPA toward COVID-19 among physicians in Jordan and Palestine. METHODS: This is a cross-sectional study using an online survey conducted from 10 April to 26 April 2020 among Jordan and Palestine physicians. Invitations were sent to physician groups on Facebook and WhatsApp. This survey contains 36-items, divided into four main sections to assess the participants' socio-demographic characteristics, knowledge, practice, and attitude about COVID-19. RESULTS: A total of 454 physicians participated in this study. The mean score of basic knowledge was 4.4 ± 0.8 (range 2-4). There were significant differences between basic knowledge mean scores among physicians in different professional degrees and physicians in various health sectors (P=0.0315, P=0.0137, respectively). The mean scores of self-protection measures, were 6.1 ± 1.1 (range 3-7) and measures if physician self-suspected of COVID-19 were 9.9± 1.1 (range 5-11). The mean score of attitudes toward COVID-19 was 41.5 ± 3.3 (range 21-45) and significantly related to the age and different experience years (P=0.0022, P=0.0077, respectively). CONCLUSION: As the global threat of COVID-19 continues to emerge, physicians from Jordan and Palestine showed adequate KPA toward COVID-19. There was a significant difference in knowledge level and attitude between physicians. Policymakers and physicians should keep continuous educational activities, training, and follow-up updates during this pandemic.