الملخص
Objectives: The aim of this study was to compare the acquisition of basic clinical skills by George and Doto’s five step method compared to the Traditional SODOTO approach, and to ascertain the perception of the students regarding these diverse methods. Materials and Methods: Fifty-four 2nd MBBS 1st semester students posted in the Department of Medicine at GMERS, Gotri, were enrolled for the study. After teaching the theory, both groups were taught per abdomen (P/A) examination and respiratory system (R/S) examination – one system by the five-step method and the other by the SODOTO approach. Skill acquisition was tested by pre-validated checklists. Finally, feedback was collected on the perception of students using a pre-validated questionnaire. The data were analysed using GraphPad. Results: There was an average 20% improvement (P < 0.001) in the group taught by the five-step method compared to the one taught by the traditional approach (P/A – 45.14/60 [5.64] vs. 57.86/60 [1.83] [Group B vs. Group A]) (R/S examination – 26.17/40 [6.65] vs. 34.79/40 [3.56] [Group A vs. Group B]). Conclusion: George and Doto’s five-step method has been found to be more effective than the traditional SODOTO approach.
الملخص
Background & objectives: Standard treatment guidelines (STGs) are the cornerstone to therapeutics. Multiple agencies in India develop STGs. This systematic review was conducted to find out STGs available in India, evaluate if these were as per World Health Organization (WHO) recommendations for STGs and compare these with National Institute for Health and Care Excellence (NICE) guidelines. Information on legal authority and responsibility for formulating STGs was also sought. Methods: PRISMA guidelines were followed. Publications from PubMed and Google Scholar were searched for STGs using terms 'Standard Treatment Guidelines AND India'. Data from STGs were compiled in excel as per the WHO and authors' criteria for STGs and compared with NICE guidelines. Results: PubMed and Google Scholar search provided 56 publications (out of 1695 search results) mentioning 27 STGs. Google search and replies from authors led us 36 STGs, totalling to 63 STGs. No STG mentioned any specific period of revision, eight STGs were not evidence-based, 55 had some Indian references, 48 STGs were for single disease and the remaining multi-disease, three STGs did not include diagnostic criteria, 16 STGs did not give prescribing information of recommended treatment and 16 STGs provide no referral criteria for patients. Fifty five STGs did not mention level of health care. While NICE is a single legal authority in England and guidelines are as per WHO recommendations for STGs, in India although Acts and rules do not vest authority, National Health Systems Resource Center is generally designated responsible for STGs. Interpretation & conclusions: In India, although there are multiple STGs developed by various authorities and professionals for the same conditions, these fulfil WHO recommendations only partially. Authority with statutory duty collaborating with professional organizations, a standard methodology for adopting international guidelines, Indian data for evidence base, attention to local needs will help in developing better STGs and their acceptance.