New approach to undergraduate quality improvement.

BACKGROUND: While quality improvement (QI) is an essential component to modern day clinical practice, some foundation doctors fail to engage. This is compounded by a lack of formalised undergraduate QI teaching. We trial an undergraduate active learning workshop and evaluate it using a concurrent triangulation mixed methods design. APPROACH: We constructed a 2-hour interactive QI workshop utilising near-peer educators for third year undergraduate medical students. Our workshop demonstrated an exemplary project and a template featuring evidenced-based QI tools to grasp key concepts. Informal support was provided for student QI projects, undertaken in small peer groups. Utility was assessed using linked pre-and-post event questionnaires with Likert scales, free text thematic analysis and project completion rates. EVALUATION: We recruited 74 students to attend our workshops delivered over 3 months. We achieved high event satisfaction and significant improvements on baseline confidence. Free text comments suggested students perceive QI as an important part of the undergraduate curriculum, described barriers to engagement and the value they place on project autonomy. The workshop eased student feelings of anxiety and intimidation regarding change ideas. Nine projects were completed with one winning a poster prize at a regional conference. IMPLICATIONS: We demonstrate a popular resource light model that can be scaled up to a variety of centres. Targeting QI teaching at the undergraduate level may be instrumental in developing QI culture in health care systems and address barriers to postgraduate involvement. Our study furthers the understanding of undergraduate students' perspectives of QI and demand for further sessions.

The prevalence of scabies, pyoderma and other communicable dermatoses in the Bijagos Archipelago, Guinea-Bissau.

INTRODUCTION: Skin diseases represent a significant public health problem in most low and middle income settings. Nevertheless, there is a relative paucity of high-quality epidemiological data on the prevalence of these conditions. MATERIALS/METHODS: We conducted two cross-sectional population-based skin-surveys of children (6 months to 9 years old) in the Bijagós Archipelago of Guinea-Bissau during the dry season (February-March 2018) and the wet season (June-July 2018). Following a period of training, a nurse performed a standardised examination for communicable dermatoses for each participant. We calculated the prevalence of each skin condition and investigated demographic associations. RESULTS: 1062 children were enrolled in the dry season survey of whom 318 (29.9%) had at least one skin diseases. The most common diagnosis was tinea capitis (154/1062, 14.5% - 95% CI 12.5-16.8%) followed by tinea corporis (84/1062, 7.9% - 95% CI 6.4-9.7%), pyoderma (82/1062, 7.7% - 95% CI 6.2-9.5%) and scabies (56/1062. 5.2% - 95%CI 4.0-6.8%). 320 children were enrolled in the wet season survey of whom 121 (37.8%) had at least one skin problem. Tinea capitis remained the most common diagnosis (79/320, 24.7% - 95% CI 20.1-29.9%), followed by pyoderma (38/320, 11.9% - 95% CI 8.6-16.1%), tinea corporis (23/320, 7.2% - 95% 4.7-10.7%) and scabies (6/320, 1.9% - 95% CI 0.8-4.2%). CONCLUSIONS: Our study, which utilised robust population-based cluster random sampling methodology, demonstrates the substantial disease burden caused by common communicable dermatoses in this setting. Given these findings, there is a need to consider common dermatoses as part of Universal Health Coverage to deliver 'skin-health for all'.