Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital.

Context: Simulation based teaching is effective strategy to allow trainees to acquire skills, develop clinical judgment and to become competent in order to manage the patients in a safe environment. The Case-based simulation improves the assessment and management skills of the trainees to prepare them as a competent physician. Aim: Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital. Setting and Design: An Interventional study (Pre and post design) was conducted on the residents of the Family Medicine department of the Aga Khan University hospital Karachi. Methodology: After getting their consent, pre intervention Objectively structured clinical examination (OSCE) was conducted at the Center for Innovation in medical education, AKUH. The scenarios were based on urgent care problems presenting in the Family Medicine setting. It was followed by the case based simulation teaching intervention by the facilitators and debriefing. The post intervention OSCE was conducted in order to assess the resident's performance. Statistical Analysis: The data was analyzed in Stata version15 software in two stages; descriptive and inferential. In descriptive analysis frequency and proportion were calculated for categorical variables. Median and inter quartile range were reported for continuous variable. Paired T-tests were applied to compare the pre and post test results. Results: The resident's scores significantly improved after case based simulation in majority of the post intervention OSCE stations proving the effectiveness of the intervention. Conclusion: Case based simulation is an effective teaching strategy for the learning process of the Family Medicine residents regarding the urgent care management skills. It is advised to use this strategy in the teaching and learning process of other Family medicine residency programs.

Online Flipped Classroom (E-Fcr): Way Forward In Covid 19 Era.

Online teaching and learning have been in place for the last two decades. COVID-19 pandemic has intensely augmented institutions towards implementation of online teaching. Literature reported benefits of online learning including flexibility and self-direction. In addition, researchers reported that virtual learning pedagogy is encouraging, as it mainly inspires lifelong learning due to its self-paced and self-directed instruction. Flipped classroom is an active pedagogical instructional strategy that uses online resources external to the classroom, and then employs small group pedagogies within the classroom. Flipped classroom strategy allows use of lecture time for active learning activities. This active model restructures the traditional lecture paradigm, in that students acquire basic course content before coming to the classroom, while class time is dedicated for problem solving learning activities. Flipped classroom utilizes time in student interaction sometimes one to one, addressing to their concerns and queries regarding the content. This strategy gives opportunity to the teachers to share their relevant real-life experiences and design small group problem solving activities.

The "new-normal" OSCE examination: Executing in the COVID-19 era.

In this unprecedented situation of COVID-19 era, the educational institutions have to attune not only the teaching strategies but also the assessment. Similarly, just as COVID precautions have become the "new normal" practice, hence implementation changes during face-to-face examinations may become standard practice in the Post- COVID era. The Objective structured clinical exams (OSCEs) which usually require a face-to-face assessment of skills, posed a special challenge to health professionals in COVID 19. This commentary paper is written on shared experiences of the examination cell principal resource faculty for OSCE and exam coordinators. It addresses how to plan and implement objective, valid, feasible and reliable clinical skills examinations (OSCEs) keeping in place COVID precautions to ensure the utmost wellbeing of all stakeholders involved.

Medical Students' Research Mentoring Program At Central Park Medical College, Lahore, Pakistan.

BACKGROUND: Postgraduation programs, including clinical specialties, have inculcated a mandatory research component, yet no initiatives are taken for the promotion of research at the undergraduate MBBS programs across Pakistan. This study has highlighted a research mentoring program at undergraduate level conducted at Central Park Medical College (CPMC), Lahore, which developed research interest from the start of MBBS. The objective of the study was to explore the perception of mentees and mentors regarding the research mentoring program at CPMC. METHODS: This observational cross-sectional study, conducted from April-December 2019, included 500 MBBS students, along with their 50 research mentors. After institutional ethical approval and written informed consent, a survey questionnaire was circulated in November, amongst mentors and mentees, to explore their perspective regarding research program. The data was entered in SPSS version 21. Frequency and Reliability analysis by Cronbachs Alpha was done. RESULTS: The reliability of the questionnaire was 0.82. Around 80-90 percent of the mentors believed that it developed intellectual skills of both mentors and mentees, but the students had a mixed response. After 7 months, there was one article published, four were accepted for publication, ten were under peer review in HEC recognized journals, and majority was observational cross-sectional studies/case reports. CONCLUSIONS: It proved to be a mutually beneficial program and facilitated research activities of both mentors and mentees. It is suggested to introduce structured research mentoring program into the undergraduate curriculum of other medical institutions too.

Making lectures memorable: A cognitive perspective.

Lectures have been a cornerstone of medical education since the introduction of a discipline based curricular model more than two hundred years ago. Recently this instructional strategy has come under criticism because of its reliance on passive learning. There are still many medical schools that cover content predominantly through lectures due to its feasibility. With the introduction of the flipped classrooms, lectures have been given a new lease of life. Improving cognitive imprinting during lectures would enhance retrieval and promote long term storage. Simplifying the content reduces the cognitive load of the information being received and makes it more meaningful hence more memorable. To make learning memorable, rehearsal should be built into the sessions. With the exponential increase in online learning, the need for online learning technologies will require a generation of a large amount of asynchronous video content which should ideally be truly meaningful and memorable, and inspirational to our students.

Study guide usability survey: perception of students and teachers of an undergraduate medical college.

OBJECTIVES: To explore the perception about usability of study guide from students and teachers of an undergraduate medical college. METHODS: The cross-sectional study was done at Bahria University Medical and Dental College, Karachi, in May 2012 and comprised 2nd, 3rd and 4th year medical students and faculty members. Data was analysed on SPSS 16. Analysis of variance was used for looking at differences in perceptions of the three groups of students and among different cadres of faculty, while tukeys test was used for individual differences. RESULTS: Of the 300 students initially enrolled, 257 (85.6%) represented the final study sample. There were 147 (57.2%) females and 110 (42.8%) males. Reliability of the questionnaire by Cronbach's alpha was 0.889. Besides, 150 (58.3%) students agreed that layout and content of the study guide helped in self-directed learning, while 128 (50%) said that information about books and resources was not mentioned in it. The faculty overall appreciated the study guide except on information about identification of resources in it. CONCLUSION: The perception about the usability of study guide was well appreciated by both students and teachers Their content will be reviewed and improved based on the results of this study.

Comparison of students and facilitators' perception of implementing problem based learning.

OBJECTIVE: To evaluate the perception of facilitators and students on the implementation of PBL, based on their experience. METHOD: A questionnaire based survey was conducted on 186 first and second year students and 25 faculty members. RESULT: The responses of faculty members and students were analyzed using Chi-square and a P-value < 0.05 was considered significant. Comparison between faculty members and students for implementation of PBL showed that in the faculty (both junior and senior) 26.27% disagreed, 27.09% were neutral and 46.22% agreed with implementation of PBL whereas in the students group 9.87% disagreed, 10.94% were neutral and 79.17% agreed (p = 0.000). When senior and junior faculty was compared the seniors showed that 36.8% disagreed, 32.2% were neutral and 30.98% agreed whereas in the junior faculty 18.2% disagreed, 22.8% were neutral and 58.97% agreed (p = 0.000). CONCLUSION: For implementing this strategy there is support from the academic administration (principal and faculty responsible for implementation of the PBL-based curriculum). Junior faculty members (instructors) give encouraging results. Students are supportive of this strategy and learning attained by this method. However senior faculty is not very enthusiastic about implementation of this strategy.