Negative faculty role modelling - is it a reflection of deteriorating societal values?

BACKGROUND: Negative faculty role modelling is an area of growing concern especially due to its implications on medical professionalism. The study aims to explore the impacts of negative role modelling on professionalism of medical students in the context of Pakistan. METHODS: This qualitative study is part of a larger study exploring impacts of role modelling on professionalism of students. It is based on Constructivist Grounded Theory involving six semi-structured interviews with clinical faculty and three focus group discussions with 22 students. Initial, focused, selective coding and thematic analysis was used to find the core category. RESULTS: Three overarching categories were developed: traits observed with negative role models; impact of negative role modelling; factors promoting negative role modelling. Subcategories of impacts included negative impact on professionalism, emotional impact, and its paradoxical positive impact. Negative role modelling, a manifestation of declining professionalism, was attributed to deteriorating societal values; further compounded by the lack of required mechanisms by institutions and the regulatory authority at their respective levels. CONCLUSIONS: In the absence of a strong moral platform at societal level, the burden of responsibility rests with the faculty and more importantly with institutions and regulatory bodies to discourage negative role modelling and educate students to recognize, reflect on and avoid negative behaviours and adopt strong professional values.

Synthesis and characterization of pristine and strontium-doped zinc oxide nanoparticles for methyl green photo-degradation application.

Herein we describe an effective route for the degradation of methyl green (MG) dye under visible light illumination by pristine and strontium (Sr)-doped zinc oxide (ZnO) photocatalysts (synthesized by the simple chemical precipitation method). The x-ray diffraction structural analysis has confirmed that both photocatalysts exhibit the hexagonal wurtzite structure; without any additional phase formation in Sr-doped ZnO, in particular. The optical properties of the synthesized photocatalysts have been investigated using UV-vis absorption spectroscopy in the wavelength range of 250-800 nm. Through Tauc's plot, the slight decrease from 3.3 to 3.2 eV in band gap energy has been elucidated (in the case of Sr-doped ZnO), which has been further confirmed by the quenching in the intensity of Photoluminescence (PL) emission spectrum. This may be due to sub-band level formation between valence and conduction band, caused by the impregnation of Sr2+ions into ZnO host. The morphological study has also been performed using Field Emission Scanning Electron Microscope, which indicates nanoparticles (NPs) based surface texture for both photocatalysts. During the photocatalytic activity study, after 30 min irradiation of visible light, ∼65.7% and ∼84.8% photocatalytic degradation of MG dye has been achieved for pristine and Sr-doped (2 wt%) ZnO photocatalysts, respectively. The rate of photocatalytic reaction (K) has been observed to be âˆ¼0.06399 min-1for Sr-doped (2 wt%), whereas nearly half magnitude âˆ¼0.03403 min-1has been observed for pristine ZnO, respectively. The significantly improved photodegradation activity may be ascribed to the relatively broader optical absorption capability, surface defects and the enhanced charge separation efficiency of the Sr-doped ZnO photocatalyst.

Importance of faculty role modelling for teaching professionalism to medical students: Individual versus institutional responsibility.

OBJECTIVE: This study explores the perceptions of final year medical students and clinical faculty with regard to role modelling in teaching professionalism. METHODS: In this qualitative research design, we used the Constructivist Grounded Theory model. Six semi-structured interviews with faculty from six clinical specialties and three focus group discussions with 22 final year students were conducted. We applied initial, focused and selective coding along with a thematic analysis of the subject to develop a core category. This is the first part of a larger study that addresses the impact of positive role modelling on teaching professionalism. Findings relevant to negative role modelling are being reported in a subsequent paper. RESULTS: The results showed consensus that positive role modelling is the most important strategy for teaching professionalism to medical students. A disturbing finding was a perceived deteriorating level of inspirational positive role modelling. A lack of institutional support and weak regulatory control were pointed out as potential factors contributing towards this deterioration. CONCLUSION: Positive role modelling was found to be the most effective way to teach professionalism to medical students. However, it cannot be truly effective unless institutions play their role which is pivotal in promoting a culture of professionalism. This can be materialized by recognizing and facilitating conscientious and explicit role modelling by the medical faculty. In addition, an effective regulatory control by the concerned authorities could play an important role.

Perceptions Of Medical Students About The Educational Environment At The Start And End Of Obstetrics And Gynaecology Rotation And Its Impact On Career Choice.

BACKGROUND: The educational environment can influence students' learning and their attitudes towards various medical specialties, thus affecting their career choices. This study aimed to compare perceptions of medical students about educational environment at the start and end of Obstetrics and Gynaecology (O&G) rotation and to assess if these perceptions influenced their career choices. METHODS: This was a Comparative analytical study carried out in the Obstetrics and Gynaecology Department, Combined Military Hospital Lahore Medical College from 1st February to 30th July 2019. Eighty-eight final year MBBS students (60 females and 28 males; average age 22±1.2 years) completed validated Dundee Ready Education Environment Measure (DREEM) questionnaire at the start and end of three weeks of O&G clinical rotation. Two questions were added post rotation to assess impact of their perceptions on career choice. Data was analysed through SPSS version 21 using independent sample t-test. RESULTS: Mean total DREEM score was 126.68±14.17 and 127.49±15.31 out of a maximum of 200 pre and post rotation (p-value 0.001). The sub-scale which improved significantly (p-value 0.010) was Perception of Environment with average scores of 27.88±4.63 and 28.25±4.64 pre and post rotation. Majority of female students (78.7%) felt motivated for choosing O&G as a career after this rotation. CONCLUSION: Final-year medical students perceived the learning environment to be positive. Clinical rotation helped in improving their perception about O&G learning environment and helped female students get more inclined to choose this specialty as a career.

Comparison of prostaglandin E2 gel, prostaglandin E2 pessary and extra-amniotic saline infusion with oxytocin for induction of labour.

BACKGROUND: Induction of labour is the intentional initiation of cervical ripening and uterine contraction for the purpose of accomplishing delivery, prior to onset of spontaneous parturition. This study was conducted to compare maternal and neonatal outcome in women induced with Prostaglandin E2 gel, Prostaglandin E2 pessary and extra-amniotic saline infusion with oxytocin at Bishops score < 5. METHODS: It was a quasi-experimental which was conducted at the Department of Gynaecology and Obstetrics Unit-I, Mother and Child Health Care Centre, Pakistan Institute of Medical Sciences, Islamabad during one year of time. Eighty cases in each group (prostaglandin gel, prostaglandinE2 pessary and extra-amniotic saline infusion with oxytocin) were collected. Systematic sampling was done. First woman admitted was induced with prostaglandin gel, the second one with prostaglandin pessary and the third was induced with extra amniotic saline infusion and oxytocin. RESULTS: The most common indication for induction was post dates followed by PIH. The induction labour interval was less in EASI with oxytocin group (5.18 +/- 3.4) hours, as compared to prostaglandin pessary (8.81 +/- 5.60) hours and prostaglandin gel (8.32 +/- 5.18) hours. Induction delivery interval in EASI with oxytocin was (10 +/- 5.6) hours as compared to prostaglandin pessary (14 +/- 6.3) hours and prostaglandin gel (13 +/- 7.1) hours. This difference was statistically significant. The primigravidas had longer duration of labour than multigravidas. Induction labour interval in primigravidas was (8.2 +/- 5.1) hours while in multigravidas it was (6.7 +/- 5.02) hours. Induction delivery interval was also more in primigravidas (13.6 +/- 6.80) hours as compared to multigravidas (11.4 +/- 6.20) hours. Vaginal delivery rate was 89.2% while the caesarean section rate was 10.4%. The most common indication for caesarean section was foetal distress. There was no significant difference in perinatal morbidity and mortality in the three groups. CONCLUSION: EASI with oxytocin is a better method of induction than prostaglandin E2 gel and pessary. Moreover it is more economical in our country.

Frequency of placenta previa in women with history of previous caesarean and normal vaginal deliveries.

BACKGROUND: Placenta previa is known to be associated with previous caesarean deliveries, advanced maternal age, increasing parity, smoking, curettage and myomectomy. This study was carried out to compare the frequency of placenta previa, in women with previous caesareans versus those with normal vaginal deliveries. METHODS: It was one year study conducted at the Department of Obstetrics and Gynaecology Unit B, Ayub Teaching Hospital, Abbottabad. One hundred women were included in the study, 50 in Group A with previous caesarean deliveries, and 50 in Group B with previous normal vaginal deliveries. Frequency of placenta previa in both groups was analysed. RESULTS: Placenta previa was found in one (2%) woman in Group A, and in two women (4%) in Group B. It was not found in para 4 or less in both groups. One woman in Group A and two women in Group B with parity 4 or more had placenta previa (p < 0.05). None of the women with previous one scar had placenta previa, while with previous 2 scars one had placenta previa (p < 0.05). One woman with placenta previa in Group A and both women with placenta previa in Group B were more than 25 years old. Placenta previa was not found in women below 25 years of age. CONCLUSION: Previous one caesarean section did not increase the frequency of placenta previa. Increasing number of scars, increasing maternal age beyond 25 years and increasing parity beyond 4 were associated with placenta previa.