Teaching medical students hematopathology: a randomized crossover study comparing direct inspection by light microscope versus projected images.

Background: Students' ability to diagnose various blood disorders could be substantially improved by continuously reviewing approaches toward teaching hematology. This study aims to compare the effectiveness of light microscopes and projected images on students' learning and determine medical students' perception of these teaching methods. Methods: A randomized trial was conducted using a crossover design. Two groups, each with 30 students, were subjected to teaching methods based on light microscopes and projected images alternatively. Results: No differences were found in the two study groups' baseline characteristics, such as median age, sex, and prior academic performance, as well as in the pre-test scores. Post-test scores were significantly higher among students subjected to the projection method than in the control group (Mean ± SD = 9.8 ± 1.7 vs. 5.1 ± 1.3, p < 0.001). In the post-cross-over assessment, 85% (n = 51) of students reported their satisfaction for the projected images, and 78% (n = 47) of students were willing to be taught by projection. Students perceived that the projection method facilitated participation and better involvement in discussions, improved learning, provided greater motivation, and eventually increased comprehension and efficiency. Conclusion: The projection-based teaching method is more effective in improving knowledge and achieving intended learning outcomes. Students tend to prefer the projection method over the laboratory-based method and perceive it as an effective method to enhance their learning of hematology.

Enhancing Medical Students' Confidence and Knowledge in Antibiotic Prescription and Administration through Virtual Education: A Quasi-Experimental Study.

BACKGROUND: Antibiotic resistance is a worldwide health concern that necessitates antibiotic stewardship. Medical students significantly impact future healthcare practices; thus, their trust in antibiotic prescription and administration is crucial. This research aims to assess medical students' levels of confidence and knowledge in these areas before and after exposure to virtual antibiotic stewardship education. METHODS: A one-group pretest-posttest design was conducted with medical students from King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. Participants were enrolled in the WHO-online antibiotic stewardship course. RESULTS: The group's baseline confidence and background knowledge were reported to be lower than what was offered after introducing the virtual course. The McNemar-Bowker test showed a significant difference in students' confidence in pre-course and post-course scores (Z = 20, p < 0.002); the matched paired t-test revealed a significant difference in students' knowledge scores (M = 7.66 verses M = 5.36, Z = 3.54, p = 0.001). In the sample, 70% of the students were unfamiliar with antibiotic stewardship; thus, the analysis revealed a significant difference in their familiarity before and after enrolling in the online course (30 vs. 100, p < 0.001). CONCLUSION: Medical students experience low confidence in the safe practice of the antibiotic stewardship program. The WHO-online antibiotic stewardship course is considered a valuable resource that can be used in a formative medical curriculum. Thus, educators and the academic curriculum must promote practical strategies to minimize antibiotic stewardship literacy and increase antibiotic prescribing and administration quality. Introducing antibiotic stewardship across the medical curriculum and establishing educational courses are some strategies that can be undertaken to ensure that future doctors are well-educated in the principles and practices of the appropriate use of antibiotic stewardship.

Knowledge, Attitude, and Practice of Qualitative Research Among Health Sciences Faculty.

Background The importance of qualitative research in health sciences is rising. Qualitative research needs more attention from healthcare practitioners. Hence, some questions in the healthcare field may only be answered through qualitative research methodologies. In this study, we aimed to assess the knowledge, practice, and attitude among health sciences faculty about qualitative research. Methodology This cross-sectional study was conducted at King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS). A convenient sampling technique was used to collect data from health sciences faculty participants. Participants were included from five different colleges, i.e., College of Medicine, Applied Health Sciences, Nursing, Pharmacy, and College of Dentistry. A 20-question, self-made questionnaire was given to each participant. The questionnaire had five attitude questions, 10 knowledge questions, and five practice questions. Results A total of 236 participants completed the study questionnaire. The majority of the study participants (198, 84%) had an overall poor knowledge of qualitative research methodologies. Most participants (214, 91%) agreed that qualitative research is important in health sciences. More than half of the participants had never attended a qualitative methods workshop (140, 59%). About three-quarters of the participants (175, 74%) had never participated in a qualitative research project. Conclusions The overall knowledge and practice of qualitative research methodologies were poor among KSAU-HS health sciences faculty while they had a good attitude toward its importance in health sciences.

Establishing a Graduate Certificate in Health Informatics: Need Assessment and Competency-Based Framework.

Background: Health Informatics is an indispensable science in light of the massive reform healthcare has undertaken recently. Objective: Health Informatics is an indispensable science in light of the massive reform healthcare has undertaken recently. Methods: This descriptive multiphase study used a questionnaire to assess the need and applied a competency-based postgraduate curriculum to collect the required competencies as well as their proficiency levels. Results: Eighty percent of the respondents agreed that the current training should be advanced. 73.7% of the respondents agreed that this certificate would improve the level of knowledge, and it would impact on the delivery of healthcare positively (78.9%). For the required competencies, 10 competencies scored 1.75 and above, 22 scored between 1.5 and 1.75 and 22 scored below 1.50. The expert panel came to an agreement that the competencies with 1.5 and above should be included. Discussion: The findings emphasize the need to establish PG diploma in comply with previous studies that unveiled the need to provide education and training in Health Informatics. Only the required competencies were included as the program is one-year long. The selected competencies were validated and presented by the panel. Conclusion: A PG diploma in Health Informatics is a key element in the evolution of healthcare services, therefore, a competency-based framework was provided and validated by experts.

Knowledge and Awareness of Syncope Among the Population of Riyadh: A Cross-Sectional Study.

Background Although syncope is a common emergency in medical settings, no research has yet evaluated the general population's awareness regarding it. This study investigated the general population's knowledge and awareness of syncope and if they could differentiate syncopal and non-syncopal causes of transient loss of consciousness (TLOC). Methodology A cross-sectional study was conducted in Riyadh through a validated, self-administered Arabic questionnaire that was distributed to the general population through social media using Google Forms (convenience sampling). Participants younger than 18 or not from Riyadh were excluded from the study. Two cardiologists validated the questionnaire, following which forward and backward translation was done. The questionnaire contained three sections. The first section included demographic data and chronic conditions. In the second section, participants were asked if they or one of their relatives had ever experienced syncope. The third section had eight scenarios assessing the participants' syncope knowledge. Subjects with ≥five correct answers were considered to be aware. Results The number of total responses was 405 participants. Regarding demographic data, 53% of the participants were female, 33% had a medical background, and 76% had a university degree (n = 214, n = 134, and n = 306, respectively). The mean age of the participants was 33.2 ± 13.3 years. Participants who were aware of syncope represented 55% (n = 221). Among the syncope cases, orthostatic syncope had the highest number of correct answers (79%, n = 319), followed by vasovagal syncope (61%, n = 246). Males performed better in cases one (p = 0.001), two (p = 0.004), and seven (p = 0.01). Conclusions The results of this study showed that most participants were considered aware of syncope. Gender, marital status, and having a medical background had a significant influence on the results.

Association Between Asthmatic Patients' Asthma Control Test Score and the Number of Exacerbations per Year in King Abdulaziz Medical City, Riyadh.

Background Asthma is a reactive airway disease that has a high prevalence across the globe. Asthma exacerbations can occur due to various bacterial and viral infections that irritate nerve endings in the airways. With time, airway obstruction follows, and patients with asthma have various symptoms that occur intermittently. Asthma symptoms primarily include breathlessness, wheezing, coughing, and chest tightness. This research focused on the association between the Asthma Control Test (ACT) score and number of exacerbations per year. Methods  A questionnaire-based, cross-sectional study was conducted at the outpatient pulmonary clinic, King Abdulaziz Medical City, a tertiary hospital in Riyadh. The study included 227 adult patients who were diagnosed with asthma and had no other pulmonary diseases or other medical diseases that could mimic asthma exacerbation. Data was collected by direct interview with the patients and through the BESTCare system in King Abdulaziz Medical City. All the data were collected through Microsoft Excel 2010 (Microsoft, Redmond, WA, USA) and analyzed using Statistical Package for Social Sciences (SPSS) Statistics version 23 (IBM Corp., Armonk, NY, US). The categorical data we used were presented by percentages and frequencies such as gender, whereas the numerical data were prescribed as mean and standard deviation such as age and number of exacerbations. For inferential statistics, Chi square was used to find the association between the categorical variable while T-test and ANOVA test were used to find the relationship between asthma control test score of asthmatic patients, which was divided into three different groups based on their scores that include: well-controlled, partially controlled, or uncontrolled, and the number of exacerbations per year.  Results A total of 227 adult asthma patients were enrolled in this study, most of them were females (72.7%). Average age of the participants was 47.3 ± 13.8 years. The average ACT score was found to be 18.5 ± 4.9 out of 25. Uncontrolled asthma was present in 26% of the patients, 22.9% were partially controlled and 51.1% had well-controlled asthma; to relieve the exacerbation most of the patients used salbutamol (51.5%), 35.2% used oxygen and 30.4% did not use any medication. Gender and age were not associated with ACT score (P = 0.787 and 0.797, respectively), whereas number of exacerbations was significantly associated with ACT score (P = 0.000), as fewer exacerbations were reported with higher ACT scores. Conclusion About one-quarter of the patients had uncontrolled asthma, slightly less than one-quarter of the patients had partially controlled asthma while more than half of the patients had well-controlled asthma. Number of exacerbations was found to be significantly associated with asthma control test score as fewer exacerbations were reported in well-controlled asthmatic patients.

Knowledge and attitude of pregnant women in the Kingdom of Saudi Arabia toward Noninvasive prenatal testing: A single center study.

BACKGROUND: Noninvasive prenatal testing (NIPT) is a screening tool for chromosomal aneuploidies. Prior knowledge of NIPT is an inherent factor in the decision-making process. We assessed the knowledge and attitude of pregnant women related to prenatal testing with a particular focus on NIPT. METHODS: A prospective cross-sectional study, using a culturally validated questionnaire, was conducted with 342 pregnant women of whom 74.9% consented for prenatal screening. Mean age and gestational weeks ± standard deviation was 31 ± 5 and 26 ± 11, respectively. RESULTS: A positive/very positive attitude was observed to ultrasound, followed by FCT, NIPT, and lastly to CVS. More than half of the participants (56.1%) had no previous knowledge of NIPT. A reaching significance association was detected between education and knowledge of NIPT. Significant association was detected between risk for aneuploidy and knowledge of NIPT. The majority (74%) indicated their willingness to perform the test. The effect and value of society on the pregnant women to make a decision regarding NIPT was negligible. CONCLUSION: The pregnant women in the current study displayed a lack of knowledge and awareness regarding prenatal screening, particularly the NIPT. We recommend that pregnant women receive adequate counseling regarding prenatal screening to increase their awareness and knowledge of prenatal testing, including NIPT.

Frequency and Risk Factors of Diabetic Ketoacidosis in a Specialized Children's Hospital, Riyadh: A Cross-sectional Study.

Objectives: Diabetic ketoacidosis (DKA) is a life-threatening complication and a leading cause of hospitalization in patients with type 1 diabetes mellitus (T1DM). We aimed to assess the risk factors of admissions of children with DKA in a specialized children's hospital to reduce morbidity and inform appropriate prevention and intervention strategies. Methods: We conducted a retrospective review of all DKA admissions at King Abdullah Specialized Children's Hospital, Riyadh (March 2015-December 2017). Data were gathered from newly diagnosed patients with T1DM and known patients ≤ 14 years old with DKA criteria. The main variables were frequency, precipitating factors, and other characteristics of DKA admissions in both groups. Results: A total of 116/562 patients with T1DM (mean age 8.9±3.0 years) had 146 DKA episodes, of which 42/116 (36.2%) were newly diagnosed. The frequency of DKA admissions were 146/562 (26.0%), of which 42/141 (29.8%) were newly diagnosed versus 104/421 (24.7%) known T1DM patients. The majority were 10-14 years old (p ≤ 0.001), and 77.8% were females. Missing insulin was the main cause of DKA (p = 0.001) among known patients with T1DM. Recurrent episodes (n = 30/146, 20.5%) occurred in 15/116 patients and were more common in children ≥ 10 years of age (p = 0.024). The mean length of stay was 2.6±2.0 days and increased with DKA severity (p = 0.008). Conclusions: Most DKA episodes were in patients with known T1DM and missing insulin was the leading cause of DKA. In addition to awareness campaigns to prevent DKA as an initial presentation, intervention strategies should also target high-risk groups of known patients of T1DM such as adolescents and patients with recurrent episodes.

Hypothyroidism and the risk of coronary artery disease in Saudi patients.

BACKGROUND: Hypothyroidism has been described in the literature as a risk factor for coronary artery disease (CAD). An association between thyroid-stimulating hormone (TSH) levels and CAD has been confirmed. In Saudi Arabia, there has been no study on the relationship between hypothyroidism and CAD. Therefore, the aim of this study was to investigate the prevalence and risk factors of CAD in patients with hypothyroidism. MATERIALS AND METHODS: This cross-sectional study conducted at King Abdulaziz Medical City in Riyadh (KAMC-R), included 412 adult hypothyroid patients who were followed up between 2013 and 2018. The data was collected on demographics, CAD-related risk factors, and hypothyroidism. In addition, relevant laboratory tests, including thyroid function tests, lipid profile, and hemoglobin A1c, were collected. SPSS version 28.0 was used for data analysis. Categorical data were presented as frequencies and percentages, while mean and standard deviations were computed for the numerical data. Student's t-test used to test statistical significance for numerical variables and Chi- square test was performed to test the differences between categorical variables. Multivariate binary logistic regression was used to determine the effects of gender, BMI, family history (CAD), smoking, hypertension, and TSH on CAD. RESULTS: Of the 412 hypothyroid patients, 21.8% were diagnosed with CAD, with more prevalence in men (44.15%) than in women (15.4%). About 46% had hypertension, 2.2% were smokers, and 2.4% had family history of CAD. Older age was significantly associated with a higher prevalence of CAD compared to younger age groups. The mean of TSH was significantly higher in CAD patients than non-CAD patients before and at diagnosis with CAD (P < 0.001). For every 1mIU/L increase in the TSH level, the odds of developing CAD increased significantly by 4.8% (P = 0.014). The odds ratios for other CAD risk factors were 3.13 for males, 8.1 for smoking, 2.48 for hypertension, and 9.9 for family history of CAD (P < 0.05). CONCLUSION: The prevalence of CAD in hypothyroid patients was higher than in the general population. TSH level was significantly associated with CAD. Male gender, older age, smoking, hypertension, family history of CAD, and high TSH level increased the likelihood of developing CAD.

Factors and Determinants of Choosing Pathology as a Future Career: Results From a Multi-Institution Study.

Background Globally, less than 10% of graduating medical students select pathology as a future career. Many factors were reported from different settings to influence the choice of pathology. The aim of this study was to investigate the factors that determine medical students' preferences in choosing pathology as a future career. Methods This cross-sectional study surveyed students from three governmental medical schools in Riyadh, Saudi Arabia. A self-administered questionnaire that contained demographic questions and items that addressed perceived factors that affect the choice of pathology was distributed to medical students. Collected data were analyzed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). A chi-square test was used to determine the association between independent variables and interest in pathology. Results Out of the 400 questionnaires distributed, 338 students completed the survey with a response rate of 84.5%. Overall, surgery (24%) and internal medicine (20%) were the most favored, specialties with only 5% of the students selecting pathology as their first choice. Patient-doctor interaction (72.2%) was perceived as the most important factor in not choosing pathology as a future career. Taking an elective course, younger age groups, and year in medical school were all significantly associated (p<0.001) with an interest in pathology. Conclusion In this study, most of the students indicated surgery and internal medicine as their first specialty choices. Only 5% of the students chose pathology as their first choice. Two-thirds of medical students perceived pathologists do not interact with patients. A significant association was found between younger age groups, enrolling for a pathology course, and having an interest in pathology.

Trends in the Usage of Statistical Software and Their Associated Study Designs in Health Sciences Research: A Bibliometric Analysis.

Background The development of statistical software in research has transformed the way scientists and researchers conduct their statistical analysis. Despite these advancements, it was not clear which statistical software is mainly used for which research design thereby creating confusion and uncertainty in choosing the right statistical tools. Therefore, this study aimed to review the trend of statistical software usage and their associated study designs in articles published in health sciences research. Methods This bibliometric analysis study reviewed 10,596 articles published in PubMed in three 10-year intervals (1997, 2007, and 2017). The data were collected through Google sheet and were analyzed using SPSS software. This study described the trend and usage of currently available statistical tools and the different study designs that are associated with them. Results Of the statistical software mentioned in the retrieved articles, SPSS was the most common statistical tool used (52.1%) in the three-time periods followed by SAS (12.9%) and Stata (12.6%). WinBugs was the least used statistical software with only 40(0.6%) of the total articles. SPSS was mostly associated with observational (61.1%) and experimental (65.3%) study designs. On the other hand, Review Manager (43.7%) and Stata (38.3%) were the most statistical software associated with systematic reviews and meta-analyses. Conclusion In this study, SPSS was found to be the most widely used statistical software in the selected study periods. Observational studies were the most common health science research design. SPSS was associated with observational and experimental studies while Review Manager and Stata were mostly used for systematic reviews and meta-analysis.

Translation and cross-cultural validation of the non-invasive prenatal testing questionnaire in Arabic.

OBJECTIVES: To translate and cross-culturally adapt a Swedish questionnaire to Arabic to assess the awareness of pregnant women in Saudi Arabia regarding the availability of an accurate and safe prenatal screening procedure. METHODS: The study was conducted at the Obstetrics and Gynecology Clinic, King Abdulaziz Medical City, Riyadh, Saudi Arabia between December 2018 to April 2019. The non-invasive prenatal testing (NIPT) questionnaire, translated and validated in Arabic. Cronbach's alpha reliability testing was carried out to validate the Arabic version of the questionnaire. The sample size was 100 pregnant women, at any gestational period, from 20 to 44 years old. This is a prospective cross-sectional. RESULTS: An Arabic translated, and culturally validated questionnaire related to the attitudes, knowledge, and self-perceived probability of delivering a child with chromosomal abnormality.  Conclusion: We translated and validated the NIPT questionnaire to assess the attitude and awareness of pregnant women regarding the availability of the NIPT.

Attitudes towards depression among non-psychiatric physicians in four tertiary centres in Riyadh.

Depression is a common mental illness that has a profound impact on an estimated number of 300 million people worldwide. Depression is stigmatised in communities and even physicians, especially, non-psychiatric physicians, which affects depressed patients' care. This study aims to investigate non-psychiatric physicians' attitudes towards depression in Riyadh, Saudi Arabia. The study surveyed 380 participants using Revised Depression Attitude Questionnaire. Non-psychiatric physicians in Riyadh are optimistic and have a positive perspective towards depression. Yet, the majority preferred dealing with physical rather than mental illness. Understanding the attitudes of medical practitioners is important to shape service delivery and assess training needs.