Participation of medical students in patient care: How do patients perceive it?

INTRODUCTION: Clinical teaching helps students develop clinical reasoning, decision-making, professionalism, empathy, and patient management. These benefits can only be obtained if patients show reasonable acceptance towards medical students. The aim of this study was to assess patients' perceptions regarding their level of acceptance towards students' participation in their healthcare. METHODS: This descriptive cross-sectional study was conducted at King Fahd University hospital between December 2018 and March 2019. The data were collected via face-to-face interviews with patients from four clinical departments using a self-administered questionnaire. A total of 196 patients were approached for an interview, of whom 187 agreed to participate (a response rate of 95.4%). RESULTS: Overall, patients showed a positive attitude towards students' participation in their care. The acceptance rate was higher in cases where there was minimal or no student-patient physical contact, such as reading patient's medical records (88.8%) and attending outpatient clinics (83.3%). On the other hand, the refusal rate increased dramatically (from 11% to 43.3%) when permission was sought from patients to perform diagnostic procedures. In a comparison of specialties, the highest refusal rate was observed in the obstetrics/gynecology department, whereas the lowest refusal rate was observed in the pediatrics department. CONCLUSIONS: Patients seeking healthcare services in a tertiary care teaching hospital have an overall positive attitude towards the involvement of undergraduate students in their medical care. The higher refusal rate with regard to students performing a physical examination and diagnostic procedures is alarming and demands alternative clinical teaching solutions, such as simulation-based training.

"Cable Suturing Technique" a Dural Obliteration Method for the Prevention of Cerebellar Herniation through a Large Occipital Meningocele.

The authors present a patient who had a large occipital meningocele, which was transformed into an encephalocele after primary closure due to a large skull defect. Thus, the technical importance of classifying patients with occipital meningocele with a large skull defect and a tight dural obliteration is crucial, not to leave a wide dead space with a potential risk of cerebellar herniation. Encephalocele and meningocele are embryological anomalies, which result in intracranial structures herniation due to inborn skull defect. Acquired encephalocele may develop through the same defect with normal cerebellar tissues; since the prognosis of occipital encephalocele may worsen as the size of herniation increases, the patient underwent a modified dural obliteration technique (Cable Suturing Technique) to adjust the size of the dura and to strengthen it to prevent the risk of future herniation followed by cranioplasty and the cerebellar herniation regressed significantly after the procedure.