ABSTRACT
BACKGROUND: International health electives prepare medical students during their student years of medical education in choosing, matching, and succeeding in the residency of their choice. They serve as a unique educational experience prior to residency training. OBJECTIVE: This study was conducted to explore 4th- and 5th-year medical students' perspective about international health electives and to evaluate their educational effects. METHODS: An anonymous online survey with 22 items concerning perceptions about the electives with a 5-point Likert scale was administered to medical students at the College of Medicine, King Saud University. RESULTS: For the majority of the students (81.6%) the elective course was arranged by the university and only 18.4% of students individually arranged their own. Most of the students (65.7%) agreed that the objective of the elective course was clear to them in advance. A total of 71.1% of students agreed that the program (elective) was responsive to their needs (both academically and socially). CONCLUSION: This is the first study looking at international electives in the context of the undergraduate medical curriculum in Saudi Arabia. The study showed that the international electives are a useful and unique experience for medical students (both academically and socially).
ABSTRACT
The determination of LV filling pressure is integral to the diagnosis of pulmonary arterial hypertension (PAH). The American Society of Echocardiography (ASE) has devised algorithms for their estimation. We aimed to test these algorithms in a population referred for suspected PAH. In our retrospective study, we evaluated the accuracy of the ASE Algorithms compared to right heart catheterization done within three months, in patients seen during 2006-2014. All echocardiograms were classified as showing normal, elevated or indeterminate filling pressures. Those with indeterminate pressures were excluded. We evaluated the diagnostic properties of this algorithm to predict a pulmonary artery wedge pressure (PAWP) and left ventricular end diastolic pressure (LVEDP) >15 mmHg. A total of 94 patients were included. The ASE algorithms yielded indeterminate results in 50 (53.2%) patients. This occurred more commonly in older patients and patients with cardiovascular comorbidities. The algorithm had a high sensitivity for predicting an elevated PAWP at 89.5% (95% confidence interval [CI] = 66.9-98.7) and an elevated LVEDP at 100% (95% CI = 76.8-100). The algorithm had a negative predictive value of 81.8% and 100% for predicting an elevated PAWP (95% CI = 52.4-94.8) and LVEDP, respectively, but a poor positive predictive value. The ASE algorithm for predicting LV filling pressures often cannot be applied in populations with suspected PAH. When they are interpretable, they have a high negative predictive value for elevated PAWP and LVEDP. We recommend caution when using these algorithms in populations with suspected PAH.
