Corridor and real-time 6-minute walk tests in healthy young adults: A randomized cross-over study.

Objective: Cardiopulmonary endurance is important for comfortably participating in activities of daily living. Exercise tests, such as the 6-minute walk test (6MWT), are commonly used to evaluate cardiopulmonary endurance. We investigated the effects of the Gait Real-Time Analysis Interactive Lab (GRAIL)- and corridor-based 6MWTs on functional performance. Methods: Thirty healthy men were randomly divided into two groups. Group A participants performed a corridor-based 6MWT, followed by a washout period (1 h). Subsequently, they performed the GRAIL-based 6MWT. Group B participants performed the tests in the reverse order of that performed by Group A participants. Results: The corridor-based 6MWT resulted in significantly higher 6MW distance and 6MW speed than the GRAIL-based 6MWT. No significant differences were observed between the two groups in any of the following secondary outcomes: systolic blood pressure, diastolic blood pressure, oxygen saturation, heart rate, dyspnea, and overall fatigue. A strong positive correlation was observed between the 6MW distance and 6MW speed. Conclusion: The corridor- and GRAIL-based 6MWT should not be used interchangeably.

Shared clinical decision making. A Saudi Arabian perspective.

OBJECTIVES: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia.   METHODS: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences.  RESULTS: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic  (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio  (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008).  CONCLUSION: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes.

Problem-based learning in undergraduate medical education in Saudi Arabia: time has come to reflect on the experience.

BACKGROUND: Problem-based learning (PBL) is being increasingly used in many undergraduate medical schools worldwide due to its recognized advantages. OBJECTIVES: To explore views of medical students in the Kingdom of Saudi Arabia (KSA) about the appropriateness of the PBL concepts and process. Differences in students' views were examined as well. METHODS: This is a cross-sectional, questionnaire-based study conducted in two medical colleges in Riyadh, Saudi Arabia, during the period from April to June 2012. RESULTS: One hundred seventy four undergraduate medical students participated in the study. Majority of the participants supported the concept of PBL and thought it is a beneficial learning strategy. However, only about half of them consider the problems used in tutorials are relevant for the local setting. Significant differences have been identified between the gender, schools, and study level of participants and their views on the process of PBL tutorials. About 35% of participants either undecided or will not recommend medical schools that adopt PBL curriculums for their friends. CONCLUSIONS: The majority of participants were satisfied with PBL approach and valued its importance in their learning process. Specific concerns have been expressed about relevance of some aspects of PBL. Underlying factors should be further explored in order to improve the outcomes of PBL curriculum in the local Saudi setting.