evolving educational environment in a medical school undergoing curricular change in the United Arab Emirates

College of Medicine, Gulf Medical University, United Arab Emirates, underwent a curricular change from a discipline-based to an organ system-based integrated curriculum. The long term effect of this change on the educational environment was unknown. Hence we aimed to compare perceptions of three consecutive batches of second year students about their educational environment [EE] in the new curriculum. The Dundee Ready Education Environment Measure [DREEM] questionnaire was distributed to a total of 140 second year students of Batches 2008, 2009 and 2010 at the beginning of their academic year. Collected data was transferred to SPSS 21 version and the total, domain and individual statement scores were assessed with Kruskal-Wallis and Wilcoxon rank sum tests. The mean DREEM score for all the three batches was 123/200 with significantly higher scores [p < 0.001] for Batch 2008 [135/200] than for Batch 2009[116/200] or Batch 2010 [120/200]. Significantly higher scores in all domains [excepting the domain Students' academic self-perceptions] and certain individual statement scores were also observed for Batch 2008 compared to the other two batches. There was hardly any difference in all the scores between the genders. The curricular overload, the authoritarian leaning of the teachers, a lack of a support system for students who experienced stress, and diminishing interest levels of the students, which had been rated low by Batches 2009 and 2010, emerged as areas that warranted remedial development. Some improvements detected in 2010 were the assessment strategies, the student-centered teaching and the students' social interactions. The mean DREEM score for all the three batches [123/200] signified a positive EE over the previous three years. There was no difference between the genders in their perceptions of the EE over the three years. Individual item analyses identified the areas of strengths and remedial interventions for the institution

Prescribing patterns in the orthopedics outpatient department in GMC hospital, Ajman, United Arab Emirates

Information on the utilization patterns of drugs in the Orthopedics outpatient department [OPD] were lacking in Gulf Medical College Hospital [GMCH]. Hence, we aimed to investigate the prescribing patterns in the Orthopedics outpatient department [OPD] of GMCH. The study was a hospital based observational [record based] study carried out over one year period. The prescriptions of all new patients visiting the Orthopedic OPD of GMCH hospital were critically analyzed using a predetermined criterion. Prescriptions of 623 patients were randomly selected for analysis. The majority patients were South -East Asians or Arab males, aged between 26-35 years and had insurance coverage. The median number of drugs per prescription was 3 [range 5]. Low backache was the most common reason for attending the OPD. Non-steroidal anti-inflammatory drugs [NSAIDs] and muscle relaxants were the most commonly prescribed drug group. Fixed dose combinations accounted for around 17% of the prescriptions. All the drugs were prescribed by their brand names Absence of department name on the prescriptions were also observed. The prescribing pattern in the orthopedic outpatient department in GMC Hospital was generally rational. The most commonly prescribed drugs included were Nonsteroidal anti-inflammatory drugs and fixed dose combinations were observed in many of the prescription

Does curricular change improve faculty perceptions of student experiences with the educational environment? A preliminary study in an institution undergoing curricular change / 보건의료교육평가

PURPOSE: College of Medicine, Gulf Medical University, United Arab Emirates, underwent a major curriculum change from a discipline-based to an organ system-based integrated curriculum. However, it was not known how the faculty perceived the changes in the educational environment as experienced by the students. In this context, we aimed to compare the faculty perceptions of the student experiences in the discipline-based curriculum with those in the organ system-based integrated curriculum. METHODS: The Dundee Ready Education Environment Measure (DREEM) questionnaire was modified to assess faculty perceptions of the student experiences, pilot-tested, and administered to all faculty members (n=28) involved in the discipline-based curriculum (FDC) in January 2009. In the subsequent year, data were collected from the same faculty involved in the new integrated curriculum (FIC). Collected data were transferred to Predictive Analytics Software version 18. Total, domain, and individual statement scores were assessed with the Wilcoxon signed rank test. Percentage agreement, disagreement, and uncertainty were assessed by the McNemar's test for proportion. RESULTS: The mean total DREEM score was significantly higher (P<0.001) for FIC (139/200) as compared to FDC (119/200). The FIC perceived significantly more positive student experiences with the educational environment as indicated by the domain scores and statement scores. The differences in proportions of agreement between FIC and FDC also reinforced that the FIC perceived more positive student experiences with the educational environment. CONCLUSION: The study showed that the faculty perceived the organ system-based integrated curriculum as providing a better educational environment for the students than the discipline based curriculum.

Development of the AMEET questionnaire, an instrument measuring faculty members' perceptions of their educational environment

The educational environment experienced by teachers involves all conditions affecting teaching and learning activities. Faculty perceptions of their educational environment are important not only for themselves but also for students. As no instrument exists to assess viewpoints of faculty, we aimed to develop and validate the Assessment of Medical Education Environment by Teachers [AMEET] questionnaire. A modified Delphi technique was used to generate items for the inventory. A small group of experts [a medical education expert and four teaching faculty] assisted in defining a preliminary list of items through literature review and group discussions. Sixteen international consenting panel members graded [0 - not necessary, 1- desirable, 2- important, 3- absolutely essential] and modified the initial statements or suggested new statements [Round 1], In Round 2, the panel graded the new statements and reconsidered their previous responses. Subsequently, statements with median scores < /= 1 were excluded. Responses for new statements were reconsidered and final inclusion of each statement was indicated through agreement in Round 3. A pilot test enabled evaluation of validity and reliability of the instrument. Fifty statements were generated initially for the preliminary inventory. The panel members modified and graded the fifty statements and suggested five new statements via Round 1. The new statements were graded; responses to previous fifty statements were reconsidered and three statements with median scores < 1 were removed following Round 2. Agreement was finally sought for inclusion of 52 statements and two statements were subsequently deleted as panel agreement was < 75% for each of them. The 50-item questionnaire was refined to its final version with six domains and piloted with 62 faculties. A Cronbach's Alpha of 0.94 was obtained. The AMEET questionnaire is a valid, highly reliable and practically useful instrument to assess faculty members' perceptions of educational environment

Effects of PUPA on lipid level in patients with diabetes: hospital based study

Diabetes mellitus is a metabolic disease that is associated with dyslipidemia; manifested by high levels of triglyceride, LDL and low HDL which increase the risk of cardiovascular disease. This study investigates the effect of polyunsaturated fat [PUFA] on the glycemic state and the lipid profile of diabetic patients. A 3 months observational study of 63 type 2 diabetic patients, divided the patients in to PUFA group n. =31 given Omacor [omega-3] 1 capsule /day as a source of n-3 PUFA and control group n. = 32 continued on their routine anti-diabetic medication. Subjects took their routine diet and usual diabetic medication. Fasting blood glucose and lipid profile of the two groups were assessed pre and post enrolment in the study. 3 months of n-3 PUFA consumption lowered the levels of fasting blood glucose, triglycerides, total cholesterol, and LDL in diabetic patients with an increase in HDL level. Although n-3 PUFA improved the lipid profile and the blood glucose level in type 2 diabetic patients yet were of no statistical significance when compared to the initial values of the patients or with the diabetic group who did not have n-3 PUFA. 3 months n-3 PUFA supplementation for type 2 diabetes decreases fasting blood glucose, total cholesterol, triglyceride, LDL with an increase in HDL level. Non-statistical significant findings suggest that a longer term clinical trials and /or large sample size are required to conclusively establish the effect of n-3 PUFA on cardiovascular risk, lipid profile and outcomes in type 2 diabetic patients

Prevalence and practice of self-medication among medical students

The use and misuse of drugs amongst university students is quite rampant. As information about the self-medication[SM] practices among medical students of Gulf Medical University [GMU] was not available, we aimed to identify the prevalence and practice of SM among the students and to assess the associating factors. A cross-sectional survey including 247 medical students was conducted using a self-administered questionnaire. Students from first to fifth year were included in the study. Data was analyzed using SPSS version 19.0 and the association between SM and different variables was tested with Chi square test. The majority of participating students were females with mean age of 21 +/- 2.4 years. The one year period prevalence rate of SM with both prescribed and non-prescribed medications was 65%.The prevalence of SM in students from first to fifth year was 48.3%; 57.7%; 88.9%; 73.3% and 63.8% respectively. An association with age and SM was also observed. The most common sources of drugs were private pharmacies and stocks at home. The students mostly relied on self and parents for drug recommendation. The dependence on parents reduced and self-reliance increased significantly as the students' age progressed. Majority of the self-medicating students [92.5%] read package inserts before using the drugs. Headache and flu symptoms were common Self-Medicated conditions and correspondingly, analgesics and antipyretics were most commonly used. Mild illness and previous experiences with the medicines were quoted as most common reasons for SM. Though 36% students reported that their knowledge about medicines was sufficient, high risk practices like altering dosage [59%]; stopping medication [58.7%] were found to be prevalent. The prevalence of SM among medical students of GMU is associated with age and year of study. In view of the high risk practices followed, there is a need to emphasize responsible self-medication practices among the medical students

Knowledge of cardiovascular disease risk factors among the non-medical staff of a medical university in UAE

Cardiovascular diseases [CVD], a group of disorders of heart and blood vessels [Coronary Heart Diseases; CHD and stroke], are the most common causes of premature morbidity and mortality worldwide. To study the level of knowledge about CVD risk factors and prevention among non-medical staff of Gulf Medical University. A cross - sectional questionnaire - based survey was used to collect data from 77 participants. Questions enquiring about the definitions of CHD and stroke [closed ended statements]; steps to be taken to reduce the risk of getting CHD/stroke [Open ended sections] and identification of factors that increase risk of CVD [from a list] formed parts of the questionnaire. Majority of the participants were South Asians, educated males [74%]. Around 76.6% and 57.1% knew definitions of CHD and stroke respectively. Exercise [76.6% and 45.5%], healthy food habits [68.8% and 35.1%] and smoking cessation [28.6% and 20.8%] were indicated as steps to be taken to reduce the risk of CHD and stroke respectively. From the listed factors, high blood cholesterol [87%], high blood pressure [84.4%], family history [75.3%], obesity/ overweight [65.7%], and diabetes mellitus [58.4%] were identified as factors that increase the risk for CVD. Very few participants identified male gender [30%] and South Asian ethnicity [18.2%] as risk factors. Though 84.4% identified tobacco smoking as a risk factor of CVD, only half of them knew that regular exposure to second-hand smoke can also lead to CVD. Moreover, few [36.4%] knew about high risk in females who smoke and use oral contraceptives and that the risk increases after menopause [23.4%]. The knowledge about CVD risk factors and prevention among the participants is high which may have been influenced by their working environment. However, it is far from [deal as they belong to a high risk ethnic population

Faculty perceptions of the educational environment at the college of medicine, Gulf Medical University

College of Medicine, Gulf Medical University [C0M] underwent a curricular change from a discipline-based to an organ system-based integrated curriculum. As information about the viewpoints of faculty regarding this change was not available, we aimed to ascertain the faculty members' perceptions of the educational environment at CoM and investigate any differences in perceptions based on socio-demographic characteristics. Following a pilot test, the self-administered Assessment of Medical Education Environment by Teachers [AMEET] questionnaire was answered by teaching faculty of MBBS 2012-2013. The total, domain and individual statement scores were expressed as Median [range]. Scores were compared among groups using Wilcoxon Rank sum test. The median total score of the sample was 136 [range: 108] out of a possible maximum of 200. The highest median domain scores were for Teachers' Perceptions of Teaching and Teachers' Professional Self-Perceptions, whereas the lowest domain scores were for Teachers' Perceptions of Students. The individual item analyses identified the teaching- learning activities, learning atmosphere, collaborative atmosphere and professional self-perceptions as strengths of our college while the preparedness of students, levels of student stress, learning atmosphere in the hospital and support system for stressed faculty were areas necessitating improvement. The median total, domain and individual item scores of the non-clinical faculty were found to be significantly higher than those of the clinical faculty. The female faculty also gave significantly higher scores to the domain Teachers' Perceptions of Teaching [p < 0.05]. There were no significant differences in the median total and domain scores based on teaching experience and faculty positions. The educational environment in the organ system-based integrated curriculum was generally perceived positively by the faculty although a few areas of concern were highlighted. The results of our study give important feedback to curriculum planners and administrative leaders for necessary remedial actions

Diabetes Mellitus related knowledge of entry-level students of a medical university in UAE

The aim of this study was to assess diabetes mellitus [DMI]- related knowledge among the entry-level students of Gulf Medical University. A pre-tested questionnaire assessing the knowledge of DM was administered to students in the first semesters of the different programs of GMU. Data collected were transferred to PASW Statistics [Chicago, IL, USA, Version 18] and analyzed. Data collected from 119 students [25% males and 75% males] were included in the analysis. The students demonstrated a very high general knowledge about DM. 72% mentioned that DM is a disease affecting the pancreas, 90% recognized it as a condition of inadequate insulin action, 96% knew that there are several types of DM and insulin is required for the treatment of some diabetic patients and 93% knew that family history is a major risk factor. Knowledge about common symptoms and complications was also high. 92% of the students had the knowledge that DM is a chronic disease related to lifestyle and perceived DM. This level of knowledge was found to be much higher than that of students in a non-healthcare university where only 46% knew about the involvement of the pancreas and 54% related it to inadequate insulin action. Additionally, only 57% knew that there are several types of DM and 67% linked DM to lifestyle. Entry level students [high school level education] from biological stream have a high DM-related knowledge. Their level of knowledge is much higher compared to similar students from a non-healthcare university

Perceptions of Gulf Medical University medical graduates regarding nutrition education in the undergraduate medical curriculum

To assess perceptions of GMU medical graduates nutrition education in the undergraduate medical curriculum. 75 GMU medical graduates [years of graduation 2005-2009] were invited to participate in an anonymous online survey in May 2012. The questionnaire was designed with the help of medical education experts, faculty involved in nutrition education and IT experts, validated and pilot-tested. Data was collected in MS Excel and results expressed as percentages. 42 medical graduates responded to the survey. 62% were females, 11 are working in the UAE while others are based in other countries including India, USA, UK and other GCC countries. 31% were working as general physicians while the rest were specialists/ specializing in various medical disciplines. The respondents mentioned receiving nutrition-related instruction in the pre-clinical years [80%] and clinical years [50%]. Courses in which Nutrition-related topics were learnt were identified as Community Medicine [59%], Biochemistry [47%], Physiology [23.5%], Pediatrics [35%] and Internal Medicine [29%]. The main teaching- learning methods adopted were lectures and case-based discussions. Nutrition education for the doctors was perceived as "very important" by 73.8% and "fairly important" by 23.8% of the respondents. 39% mentioned using nutrition-related knowledge daily. However 73.5% felt they had not received adequate nutrition instruction in relation to their past or present professional work. Areas requiring more instruction were identified as Clinical Nutrition [73%], Nutrition in primary case settings [57%] and Evidence-based nutrition [50%]. GMU medical graduates perceive Nutrition education to be very important for doctors and feel that more nutrition education is needed in the undergraduate medical curriculum, especially in the areas of clinical nutrition, nutrition in primary care settings and evidence-based nutrition

Diabetes mellitus-related knowledge among university students in Ajman, United Arab Emirates

The aim of this study was to assess diabetes mellitus [DM]-related knowledge and practices among university students enrolled in non-health care related professional courses in the United Arab Emirates. A pre-tested questionnaire assessing the knowledge of DM was administered to the above-mentioned students. Data collected were transferred to PASW Statistics [Chicago, IL, USA, Version 18] and analysed. Data on 168 university students [47 males and 121 females] were included in the analysis. Of the participants, 25% were overweight or obese and only 27% exercised regularly. Regarding their knowledge of DM, 70% knew that it is characterised by high blood sugar levels and identified family history as a major risk factor. Surprisingly, only just over half could link obesity and physical inactivity as risk factors for developing DM, or could identify an excessive feeling of thirst, frequent urination, and weight loss as symptoms. Knowledge of the complications of diabetes, including gangrene, loss of sensation in limbs, oral and dental complications, recurrent infections, and risk for cardiovascular disease got a moderate response. Knowledge of diabetes was found to be higher in females compared to males. No significant differences were observed in the health behaviour of participants with or without a family history of DM. Our study revealed that in spite of exposure to various sources of information, the participants' level of DM-related knowledge was not adequate. We recommend the engagement of health professionals in educational settings in order to enhance health-related knowledge and inculcate healthy lifestyle practices in students

Faculty and students' perceptions of student experiences in a medical school undergoing curricular transition in United Arab Emirates

Gulf Medical College, United Arab Emirates, underwent a major curriculum change from a discipline-based to an organ system-based integrated curriculum. However, it was not known whether the faculty perceptions of the student experiences in the new integrated curriculum actually align with those of the students. In this context, the study compared the perceptions of faculty and students of the student experiences in the newly introduced integrated curriculum. Data were collected from the faculty and second year students in the integrated curriculum using the Dundee Ready Education Environment Measure [DREEM]. As the DREEM Questionnaire was originally developed to give only the students' perceptions of the educational environment, the faculty DREEM Questionnaire was modified in our study to assess the perceptions of the faculty about the student experiences in our institution. Data collected were transferred to PASW-18. Global and domain scores were assessed with Wilcoxon Rank Sum test. Percentage agreement, disagreement and uncertainly were assessed by z test for proportion. There were no significant differences between the total DREEM scores of faculty [139/200] and students [135/200]. The faculty perceived that the students were experiencing significantly more positive learning as indicated by the domain score of "Students' Perceptions of Learning". Proportions of agreement between faculty and students showed that more faculty members than students perceived increased to students and a greater emphasis on long term learning. The study showed that the faculty and students' perceptions were similar about the student experiences in the integrated curriculum. Areas necessitating remedial measures were learning constructive feedback techniques by the faculty and emphasis on long term learning in the new curriculum

Does the curricular change at Gulf medical college, United Arab Emirates improve the faculty perceptions of student experiences with the educational environment?

Gulf Medical College, United Arab Emirates, underwent a major curriculum change from a discipline-based to an organ system-based integrated curriculum. However, it was not known how the faculty perceived the educational environment as experienced by the students in the new curriculum. In this context, the present study compared faculty perceptions of the student experiences in the discipline-based curriculum with those in the organ systems-based integrated curriculum. The Dundee Ready Education Environment Measure [DREEM] questionnaire was modified, pilot-tested and administered to all faculty members [n=28] involved in the discipline-based curriculum [FDC]. In the subsequent year, data were collected from the same faculty involved in the integrated curriculum [FIC]. The data collected were transferred to PASW-18. Global, domain and individual item scores were assessed with Wilcoxon Signed Rank test. Percentage agreement, disagreement and uncertainty were assessed by z test for proportion. The total DREEM score was significantly higher [p<0.001] for FIC [139/200] as compared to FDC [119/200]. FIC perceived significantly more positive student experiences with the educational environment as indicated by the domain scores and item scores. The differences in proportions of agreement between FIC and FDC also reinforced that the FIC perceived more positive student experiences with the educational environment. The study showed that the faculty perceived the organ systems-based integrated curriculum was providing a better educational environment for the students than the discipline based curriculum

Does the curricular change of GMU improve the students' perceptions of educational environment?

Gulf Medical College, United Arab Emirates, underwent a major curriculum change from a discipline-based to an organ system-based integrated curriculum. There was no knowledge about the educational environment in the institution, both before and after the change. In this context, the present study compared students' perception of the educational environment in the discipline - based curriculum with that in the organ system-based integrated curriculum. Data was collected from second year students [Group 1] in discipline-based curriculum and in the subsequent year from second year students in integrated curriculum [Group 2]. The instrument used was the Dundee Ready Education Environment Measure [DREEM] questionnaire. Collected data was transferred to PASW-17 for analysis. Global, domain and individual item scores were assessed with Wilcoxon Rank Sum test. In addition, data from second, third and fourth year students in the discipline- based curriculum gave the global DREEM score for the school. The global DREEM score was significantly higher [p<0.001] for Group 2 [135/200] when compared to Group 1 [116/ 200]. Both groups unanimously perceived a positive educational as indicated by the domain scores. Although Group 2 showed significantly more satisfaction, they perceived an over-emphasis of factual learning and a problem of cheating. The global DREEM score for the school before the curricular change was 120/200. The study shows that the organ system- based integrated curriculum is perceived to provide a better educational environment than the discipline based curriculum. The DREEM questionnaire identified the weakness and strengths of our newly introduced integrated curriculum. Analysis of individual items identified the teachers' medical knowledge and competence as our strength. Reduction of core curriculum and introduction of new assessment strategies have emerged as areas of remedial interventions

Perceptions of faculty at Indian medical schools about animal use in undergraduate medical education

Traditionally, animal experiments have played an integral role in Indian medical education in disciplines like Pharmacology and Physiology. These experiments reinforce knowledge which is well documented or redundant in current clinical practice. The present study aims to measure and compare the perceptions of the medical faculty about animal use in undergraduate medical education with respect to gender, duration of teaching experience academic position and educational qualifications. Data was collected from Indian medical faculty who were using animals in undergraduate medical education. The instrument used was 35 item, structured, validated and pre-tested questionnaire with 4 domains: Advantages [18 items], Disadvantages [5 items], Conduct of animal experiments [8 items] and Alternatives to existing animal experiments [4 items]. The global score for all domains was 140. Each item was scored from 0-4 with 4= Strongly Agree; 3=Agree; 2=Unsure; 1=Disagree; 0=Strongly Disagree. Collected data was transferred to PASW-17 for analysis. Global, domain and individual item scores were assessed with Mann Whitney test. Fifty nine faculty participated in the study. Majority of the faculty were females [68%], with more than eight years of teaching experience [66%] and had terminal degrees -MD/Ph. D[78%]. Mean + SD global score was 72 + 20.8 Mean + SD scores for domains were 40.5 + 13.9; 8.8 + 3.2; 17.6 +4.6 and 5.3 +3.4 respectively. There was no statistically significant difference in the mean global, domain and individual item scores with respect to gender and educational qualifications. However, significant differences were observed in domain scores and individual item scores with respect to teaching experience. Indian medical faculty supported animal use in undergraduate medical education in spite of being aware of the drawbacks of animal experiments and the availability of alternatives