Prevalence of the medical student syndrome among health professions students and its effects on their academic performance.

Medical student syndrome (MSS) is health-related anxiety while studying a specific disease that leads to stress and anxiety. The study aims to determine the prevalence of MSS among health professions students to identify its effect on the student academic performance and to recognize the awareness of MSS among health professions students. This is a descriptive cross-sectional study where 544 students from King Saud University health colleges were included and filled in a self-reported designed questionnaire. We used validated scale of short health anxiety inventory closed-ended items to measure the prevalence of MSS. All statistical analyses were performed using the statistical package for social sciences statistical software package. The results showed that 8.5% of the health colleges students were affected by MSS. The students with the medical syndrome had higher levels of anxiety (anxiety-odd ratio [OR] = 1.3, P = .35; anxiety-OR = 1.57, P = .27) and hypochondriac issues (hypochondria-OR = 2.93, P = .03; hypochondria-OR = 2.61, P = .14) than other students. Concerning to MSS negative consequences, students who experienced medical syndrome most of the time and always were 1.43 and 1.45 times more likely to experience anxiety. As a result of the medical syndrome, students with a grade point average decrease of <0.20 are 3.37 times more likely to develop a hypochondriac problem than students with no grade point average decrease (OR = 3.37; P = .04). Third-year students reported more anxiety and hypochondria symptoms than other-year students. In conclusion, MSS is a growing problem in health colleges. This study showed that, academic performance was affected for the students who have MSS. The prevention of this phenomenon may be greatly enhanced by reassurance and discussions about this syndrome.

The impact of COVID-19 pandemic on anxiety and depression among physical therapists in Saudi Arabia: a cross-sectional study.

BACKGROUNDS: A physical therapist may become infected while treating a patient since they are in direct contact with them or within a two-meter radius. In addition, physical therapists may feel that they are more susceptible to COVID-19 infection when applying rehabilitation practices, which often involve direct contact with patients. The physical therapist were surveyed on their level of anxiety and depression due to the Coronavirus disease pandemic (COVID-19). METHODS: The physical therapists were asked to complete two reliable and validated scales, the Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), to identify the presence of anxiety and depression in the participants. In addition, logistic regression models were used to determine the general characteristics of anxiety or depression. RESULTS: Among the 117 physical therapists who completed and participated in the study, 74 (63%) and 65 (55.5%) physical therapists reported having symptoms of anxiety and depression, respectively. The prevalence of overall anxiety levels was higher; mild (OR = 2.09; P = 0.08), moderate (OR = 2.26; P = 0.15), and severe levels six times as high (OR = 6.28; P = 0.1) in females compared to male physical therapists. Females, younger age, unmarried individuals, not having children, and not living with family showed a higher prevalence of anxiety and depression. Binary logistic regression analysis also revealed that the female gender, a single individual, and having no children were associated with anxiety and depression. CONCLUSIONS: A significant percentage of physical therapists reported symptoms of anxiety and depression, especially among females, younger age, single individuals, not having children, and not living with family. Thus, the mental health of physical therapists is suggested to be constantly and cautiously monitored, especially for those at high risk of developing psychological symptoms.

An insightful estimation of undergraduate medical students' experience about the Flipped Classroom.

BACKGROUND AND OBJECTIVE: The Flipped Classroom (FC) approach has become increasingly predominant and popular in medical education. This study aimed to explore the usefulness and the scope of FC based on medical students' experience, with their adaptation challenges. METHODS: The present study was a mixed-method accomplished during the academic years 2019-20, involving fourth-year students at the College of Medicine in Riyadh, Saudi Arabia. A self-administered questionnaire was used to seek their first experience and opinion of the FC. RESULTS: A total of 234 questionnaires were distributed to the students, and 214 students completed the survey (response rate of 91.45%). Out of this total, 68.2 % were males and 31.8% were females. Most of the students agreed 156 (72.9%) that the flipped classroom was more engaging than the traditional lecture, among them 100 (68.5%) males and 56 (82.3) females agreed. Almost ~79% of students liked FC as it enabled them knowing the material in advance, and the class time was spent clarifying the facts and principles with active interaction, as commented during focus group discussion "More chance for discussing with the doctors, and I got the chance to answer" (St. 6). CONCLUSION: The results showed that the students like the FC more than the conventional classroom. Suggestions were given by students to improve the active learning sessions within the FC modality.

Faculty development program assists the new faculty in constructing high-quality short answer questions; a quasi-experimental study.

Faculty development programs (FD) prepare the faculty for their educational role and career tasks. We aimed to evaluate the effectiveness of FDP in advancing the quality of short-answer questions (SAQs). This was a quasi-experimental study, comprising 37 new faculty. The SAQs were examined on psychometric analysis and Bloom's cognitive levels for the two educational blocks of 1st medical year (i.e. Musculoskeletal (MSK) and Renal blocks). We found substantial improvement in the discrimination index values of SAQs prepared after the workshop (p = 0.04). A higher number of SAQs with moderate difficulty and higher discrimination were also observed. Flaws within the post-workshop questions were reduced (3.0%) when compared with pre-workshop (12.5%). The major incline was also reported within Bloom's cognitive levels when pre-workshop K2 questions (30%) were compared with post-workshop (45.5%) with a p-value = 0.05. The SAQs constructed by the faculty member without participating in FDP are generally of unsatisfactory quality. After the FDP the assessment items of two blocks improved for various parameters of student assessment. The current study advocates that newly joined faculty shall be provided with the FDP to be guided, trained and supported for improving the quality of assessment through SAQs items writing.

Association of COVID-19 Pandemic with undergraduate Medical Students' Perceived Stress and Coping.

PURPOSE: The COVID-19 pandemic poses a major challenge for medical students' learning and has become a potential stressor, with a profound influence on their psychological well-being. We aimed to determine the effect of the current pandemic on undergraduate medical students' learning. We also explored the association of their stress level with coping strategies, educational, and psychological variables. MATERIALS AND METHODS: This is a cross-sectional design study, and participants were the 1st to 5th year medical students. A self-administered questionnaire (18 items) and a well-known Kessler 10 Psychological Distress questionnaire (10 items) were used to collect the data related to perceived stress with an association of educational, psychological, and coping variables. RESULTS: The prevalence of overall stress was significantly higher (χ 2= 16.3; P=0.000) in female medical students, ie, (40%) as compared to the male students (16.6%), and was highest (48.8%) during the 3rd medical year. It was also noted that the most effective strategy, embraced by students to cope with the severe stress, was "indulging in religious activities" (OR= 1.08; P=0.81). Furthermore, 22.3% of students had perceived severe stress as they did not prefer online learning. Similarly, those students who have not believed or refused the online learning or disagree in "there is pleasure in the study due to COVID" they have significantly higher stress (χ 2=39.7; P=0.000) 21.5% mild, 17.8% of moderate, and 21.2% severe. CONCLUSION: We found that the COVID-19 pandemic has induced stress and changes in medical students' educational attitudes and strategies. The results exhibited that the predominance of stress is higher in females than males, and also more stress was perceived by the students during their transitional year, ie, 3rd medical year (from pre-clinical to clinical) and also the respondents who regularly did religious meditation were at lower levels of stress. COVID-19's influence on medical education and students' well-being will be felt at an extended level, which necessitates an appropriate plan for preparedness.

Does self-esteem lead to high achievement of the science college's students? A study from the six health science colleges.

BACKGROUND AND OBJECTIVE: Self-esteem refers to a degree to which a person esteem himself or herself, the summation in light of cognizant self-evaluative considerations and feeling or in short as global emotional placement of self. This study investigates the relationship between self-esteem, social factors, and academic achievement in the form of grade point average (GPA) standing for academic achievement in the health science colleges. METHODS: This study is a quantitative cross-sectional design. The study was conducted at Princess Nourah bint Abdulrahman University (PNU), and the participants were health Science Colleges' undergraduate students. The questionnaire is composed of 24 questions in 4 main sections. The self-esteem was evaluated by using a validated Rosenberg Self-Esteem 7-questions Scale used only. RESULTS: A total of 551 questionnaires were distributed to the students, and 507 of them responded. Out of 507 responded, 7 were excluded due to a lack of the information. 47 (9.4%) were Foundation year students, 109 (21.8%) Medical students, 44 (8.8%) Dental students, 97 (19.4%) Pharmacy students, 101 (20.2%) Nursing students and 102 (20.4%) from Applied science. The students' overall responses demonstrated that most of the health science students agreed in a positive way of self-esteem (1.68 ±â€¯0.31). CONCLUSION: The findings from the current study contribute to the resources to better oversee projects to upgrade health sciences students' self-esteem, some short term courses (i.e. English, personality development and motivation) are requested to boost the academic career and confidence by lifting self-esteem; it indirectly helps to better academic performance. Students also need special counseling for how to deal with stress, anxiety and depression.

A critical review of obstetric and gynecological physical examination videos available on YouTube: Content analysis and user engagement evaluation.

BACKGROUND: Video-sharing website "YouTube" is a growing source of healthcare information. But, the videos uploaded on this open platform are not peer reviewed, therefore, the information available needs to be sufficiently evaluated. No studies have been conducted to evaluate the authenticity and utility of obstetrics and gynecology (Obs/Gyne) physical examination YouTube videos. This study was performed to analyze the sources, contents, and quality of videos about the Obs/Gyne clinical examination available on YouTube. METHODS: A systematic search was performed on YouTube website using the following key words: "OBSTETRIC," "GYNECOLOGICAL," "SPECULUM OBSTETRIC," "OBSTETRIC CLINICAL," "BIMANUAL PELVIC," and "EXAMINATION" to analyze the sources, contents, and the quality of YouTube videos about the Obs/Gyne clinical examination during the period between November 2015 and March 2017. The videos were classified into educationally useful and useless based on the content, accuracy of the knowledge, and the demonstration. RESULTS: Out of total 457 screened videos, 176 (38.51%) videos met the pre-set inclusion criteria. After review, out of 176 pertinent videos, 84 (47.7%) videos were found educationally useful, and out of these 84 useful videos, only 29 (34.5%) were highly educational in nature. CONCLUSION: YouTube videos showed variable educational value. Only, a small number of videos were identified as useful and can be used by the medical students for self-directed learning and by the clinical teachers for educational purposes or other academic activities.

Correction: Self-reported cheating among medical students: An alarming finding in a cross-sectional study from Saudi Arabia.

[This corrects the article DOI: 10.1371/journal.pone.0194963.].

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study.

BACKGROUND: Diabetes mellitus with comorbid complications constitute a major public health problem worldwide. The aim of this study was to evaluate the risk of comorbid complications with glycosylated hemoglobin levels and diabetes duration. Also assessed were patients' diabetic foot-care knowledge and practices. PATIENTS AND METHODS: This was a quasiexperimental study. A total of 360 type 2 diabetes mellitus patients were interviewed at a government health care center in Riyadh, Saudi Arabia. Diabetic complications and HbA1c-level data were collected from hospital records. A standard questionnaire was used to assess their diabetic foot-care knowledge and practice. RESULTS: Of the type 2 diabetes mellitus patients, 32.5% had highly uncontrolled glycosylated hemoglobin (HbA1c) levels (≥8.6%) and 62.8% had had diabetes >10 years. The patients had comorbid complications, such as hypertension (61.4%), dyslipidemia (58.6%), retinopathy (23.3%), heart disease (14.4%), and severe foot complications (3.9%). The majority of highly uncontrolled HbA1c-level patients had retinopathy (OR 8.90, P=0.0001), foot complications (OR 8.09, P=0.0001), dyslipidemia (OR 2.81, P=0.010), and hypertension (OR 2.0, P=0.028) compared to the controlled HbA1c-level (<7%) group. Patients with diabetes >10 years also had higher prevalence of foot complications (OR 2.92, P=0.0001), retinopathy (OR 2.17, P=0.011), and hypertension (OR 1.67, P=0.033). From patient responses, physicians examined only 34.2% of patient feet and 36.7% of patients received physicians advice for foot care. About 70% of patients had knowledge of diabetic foot care; however, only 41.7% of patients always examined their feet, 41.4% washed feet with warm water, 31.4% carefully dried between the toes, and 33.1% were using foot-moisturizing substances. CONCLUSION: The prevalence of comorbid complications was higher in the Saudi population compared to other international studies. Also, foot-care practice was not satisfactory. Therefore, there is need of improvement and increased awareness among physicians and patients to check regularly for proper care of the diabetic foot to avoid diabetic foot-related complications.

Undergraduate medical students' perspectives of skills, uses and preferences of information technology in medical education: A cross-sectional study in a Saudi Medical College.

BACKGROUND: Information technology (IT) is widely used in medical education. However, there are not enough studies about IT uses and preferences among traditional and problem-based learning (PBL) medical students. AIM: To compare IT skills, uses and preferences for education between traditional and PBL medical students'. METHOD: A cross-sectional study; a modified Educause Center for Analysis and Research online survey was sent to traditional curriculum 5th and PBL 4th year medical students of King Saud University. RESULTS: Most of the responding 176 students prefer mobile devices and moderate amount of IT in education. Fourth and fifth year students perceived high academic value of Google (94.2 vs. 86.7%, p = 0.34), YouTube (90.7 vs. 92.2%, p = 0.83) and PubMed (83.7 vs. 86.7%, p = 0.06). More 4th year than 5th year students rated themselves as skilled in learning management system (54.7 vs. 21.1%, p = 0.0001) and Smartboard use (40.7 vs. 23.3%, p = 0.04). Most students rated faculty IT skills as effective. Students agreed that technology helps working faster (95.5%) and make learning creative (85.9%). CONCLUSIONS: More integration of information literacy and IT training in medical curricula is needed to enhance better utilization of full features of IT resources available for learning and problem solving. National multi-institutional studies are recommended.

Self-reported cheating among medical students: An alarming finding in a cross-sectional study from Saudi Arabia.

Academic misconduct/dishonesty has become widespread behavior among many university students across the globe, and medical education is not an exception. Until recently, few efforts have been made to study the dishonest behavior in Middle-Eastern universities. This study examined the prevalence and predisposing factors of cheating among medical students in Saudi Arabia and suggests suitable preventive measures. A cross-sectional survey-based study was conducted at a government medical college during the 2014-2015 academic year. The response rate was 58.5% (421/720). The overall cheating behavior practiced by the participants was 29%, predominantly by male students. High GPA scoring students were the least likely to cheat. The participants living with their families were more likely to cheat compared to those who were living apart from their families. The reasons participants gave to justify their cheating behavior included getting better grades, passing the course, and lacking preparation while still recognizing that cheating is a 'mistake.' Overall, significant academic misconduct concerning cheating was found among the Saudi medical students; this misconduct is alarming in a reputable government institution. The implementation of strict punishments, requiring ethical courses and creating ethical awareness by exploiting the potential of Islamic religious belief might help to control this problem.

Effectiveness of longitudinal faculty development programs on MCQs items writing skills: A follow-up study.

This study examines the long-term impact of the faculty development programs on the multiple choice question (MCQ) items' quality leading to study its effect on the students' overall competency level during their yearly academic assessment. A series of longitudinal highly constructed faculty development workshops were conducted to improve the quality of the MCQs items writing skills. A total of 2207 MCQs were constructed by 58 participants for the assessment of 882 students' cognitive competency level during the academic years 2012-2015. The MCQs were analyzed for the difficulty index (P-value), discriminating index (DI), presence/absence of item writing flaws (IWFs), and non-functioning distractors (NFDs), Bloom's taxonomy cognitive levels, test reliability, and the rate of students' scoring. Significant improvement in the difficulty index and DI were noticed during each successive academic year. Easy and poor discriminating questions, NFDs and IWFs were decreased significantly, whereas distractor efficiency (DE) mean score and high cognitive level (K2) questions were increased substantially during the each successive academic year. Improved MCQs' quality leaded to increased competency level of the borderline students. Overall, the longitudinal faculty development workshops help in improving the quality of the MCQs items writing skills of the faculty that leads to students' high competency levels.

Principled physicians are not born-they are mentored: Medical students perception of the values and need of mentors at the College of Medicine, Saudi Arabia.

OBJECTIVE: To discuss the perception of medical students about mentoring at the medical school. METHODS: This cross-sectional descriptive study was conducted at the King Saud University, Riyadh, Saudi Arabia, from April 2015 to April 2016, and comprised medical students. A well-structured, bilingual (English and Arabic) quantitative questionnaire with 21 items was administered online via Google Docs to the students. SPSS 21 was used for data analysis. RESULTS: Of the 311 students who received the questionnaire, 296(95.17%) completed it. Of them, 257(86.8%) expressed an interest in having a mentor during their medical school career and 276(93.2%) selected the role of their mentor as a "guide". Moreover, 107(36.1%) students agreed that it was "not important at all" that their mentor should be of the same gender. CONCLUSIONS: Participants were interested in having a mentor during their medical school career.

Medical students' perception of the progress test as a quality-controlled assessment tool for improving learning and teaching, at a public sector medical college in Saudi Arabia.

Progress test's distinguishing characteristics make it pertinent worldwide. We explored medical students' perceptions and opinions about Progress Test (PT) with a view to identifying areas concomitant with it's execution. This cross-sectional study took place at College of Medicine, Saudi Arabia, during the academic year 2015-16. A questionnaire (14 items) was administered. Reason for majority n=96 (89.7%) of the total participants to take the PT was their keenness to compare their academic standing with their peers from other participating medical colleges. The majority of students were highly satisfied with PT implementation; i.e. its orientation (58.9%) and allocated time (90.7%). Students (76.6%) considered PT to offer academic support as future physicians. Students (75.7%) also agreed to participate in the future PT. Students being highly satisfied with the organization of PT. They found it to be a tool helping them to focus on improving the knowledge domain.

Students' perception and experience of intimate area examination and sexual history taking during undergraduate clinical skills training: A study from two Saudi medical colleges.

This study explores the experiences of Saudi undergraduate medical students about intimate-area examination (IAE) and sexual history taking (SHT) skills and assesses the barriers and their impacts on students' learning. This survey-based study was performed at 2 Saudi university medical colleges and revealed that most of the students never performed IAE, that is, female breast, male genital, female genital, female pelvic, male rectal, and female rectal. We found that 42.3% students had never taken any sexual history during their course. Both, male and female students reported barriers of patient refusal, mismatched sex, cultural background, ethical factors, lack of supervision, lack of training, and lack of skills. Among the currently used pedagogical techniques, majority of the students were satisfied with real patient-based learning, followed by video and manikin-based learning. The study indicates that Saudi students do not have sufficient experience of IAE and SHT because of above-mentioned barriers along with religious issues. This study suggests that teachers provide positive support to students and that they develop novel, competent teaching-and-learning techniques to meet the skills training of students without compromising on religious, sociocultural, and ethical values of the kingdom.

Stress and its association with working efficiency of junior doctors during three postgraduate residency training programs.

BACKGROUND: The residency training period in the medical profession is well known for physical and mental stress, which may affect cognitive function and practical life. The aims of this study were to assess prevalence of stress among the resident trainees of the three medical specialties of Saudi Commission for Health Specialties (SCHS) training programs, namely, Internal Medicine, Emergency Medicine, Family Medicine, and their association with training years, sex, and marital status. This study also aimed to correlate the stress levels with the working efficiency and self-perceived general health problems. PARTICIPANTS AND METHODS: Resident trainee physicians of SCHS were invited to complete a stress inventory Kessler 10, which is used for stress measurement. Pearson's chi-square test (χ (2)) and odds ratios (ORs) were used to quantify the associations between categorical variables. A P-value of <0.05 was considered statistically significant. RESULTS: A total of 318 (out of 389, with the response rate of 82%) resident trainees participated in this study. The mean (± standard deviation) age of the study population was 27.9 (±1.6) years. The results showed 70.4% of resident trainees had stressful conditions, which consisted of severe stress: 22.6%, moderate stress: 20.4%, and mild stress: 27.4%. During the 1st year (R-1), moderate stress (OR =5.87; 95% confidence interval =2.93-17.79; P=0.001) and severe stress (OR =11.15; 95% confidence interval =4.35-28.51; P=0.0001) levels were quite high. The highest stress level was found in Emergency Medicine (80.5%), followed by Internal Medicine (73.6%), and Family Medicine (63.2%) (χ (2)=6.42; P=0.04). The stress level decreased with the increase of years of training in Emergency Medicine (χ (2)=23.76; P<0.0001) and Internal Medicine (χ (2)=60.12; P<0.0001), whereas increased in Family Medicine (χ (2)=11.80; P=0.008). High stress level was significantly associated with absence from duty days (χ (2)=28.48, P<0.0001), inefficient day activities (χ (2)=39.15; P<0.0001), and general health problems (χ (2)=45.27; P<0.0001) of resident trainees. CONCLUSION: We found significantly high levels of stress among the resident trainees of SCHS. High levels of stress may have an effect on their working efficiency and general physical health. The high stress level decreased efficient day activity and made the trainees absent from the workplace.

A One-Day Dental Faculty Workshop in Writing Multiple-Choice Questions: An Impact Evaluation.

Long training workshops on the writing of exam questions have been shown to be effective; however, the effectiveness of short workshops needs to be demonstrated. The aim of this study was to evaluate the impact of a one-day, seven-hour faculty development workshop at the College of Dentistry, King Saud University, Saudi Arabia, on the quality of multiple-choice questions (MCQs). Kirkpatrick's four-level evaluation model was used. Participants' satisfaction (Kirkpatrick's Level 1) was evaluated with a post-workshop questionnaire. A quasi-experimental, randomized separate sample, pretest-posttest design was used to assess the learning effect (Kirkpatrick's Level 2). To evaluate transfer of learning to practice (Kirkpatrick's Level 3), MCQs created by ten faculty members as a result of the training were assessed. To assess Kirkpatrick's Level 4 regarding institutional change, interviews with three key leaders of the school were conducted, coded, and analyzed. A total of 72 course directors were invited to and attended some part of the workshop; all 52 who attended the entire workshop completed the satisfaction form; and 22 of the 36 participants in the experimental group completed the posttest. The results showed that all 52 participants were highly satisfied with the workshop, and significant positive changes were found in the faculty members' knowledge and the quality of their MCQs with effect sizes of 0.7 and 0.28, respectively. At the institutional level, the interviews demonstrated positive structural changes in the school's assessment system. Overall, this one-day item-writing faculty workshop resulted in positive changes at all four of Kirkpatrick's levels; these effects suggest that even a short training session can improve a dental school's assessment of its students.

No Evidence of Association of the Arg72Pro p53 Gene Polymorphism with Cancer Risk in the Saudi Population: a Meta-Analysis.

BACKGROUND: Earlier studies on the association between p53 codon 72 Arg>Pro polymorphism and cancer risk were inconclusive and conflicting for the Saudi population. Therefore, we performed a meta-analysis to investigate the relationship between the codon 72 Arg>Pro polymorphism and overall cancer risk in Saudi Arabia. MATERIALS AND METHODS: We searched all eligible published studies and data were pooled together to perform the meta-analysis. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for homozygous, heterozygous, dominant and recessive genetic models. RESULTS: A total of five eligible published studies covering 502 cancer cases and 784 healthy controls were included in the meta-analysis. No publication bias was detected in this study. The results suggested that the variant (Pro vs Arg: p=0.960; OR=1.004, 95% CI=0.852-1.183), homozygous (Pro.Pro vs Arg.Arg: p=0.970; OR=1.006, 95% CI=0.729-1.390), heterozygous (Arg.Pro vs Arg.Arg: p=0.473; OR=0.783, 95% CI=0.402-1.527) carriers were not associated with overall cancer risk. Similarly, dominant (Pro.Pro+Pro.Arg vs Arg.Arg: p=0.632; OR=0.886, 95% CI=0.540-1.454) and recessive (Pro.Pro vs Pro.Arg+Arg.Arg: p=0.269; OR=1.163, 95%CI=0.890-1.521) models also did not indicate increased risk of cancer. CONCLUSIONS: The current meta-analysis suggests that the codon 72 Arg>Pro polymorphism of the p53 gene might not contribute to cancer susceptibility in Saudi population. Future well designed large case control studies are needed to validate our findings.

Faculty development programs improve the quality of Multiple Choice Questions items' writing.

The aim of this study was to assess the utility of long term faculty development programs (FDPs) in order to improve the quality of multiple choice questions (MCQs) items' writing. This was a quasi-experimental study, conducted with newly joined faculty members. The MCQ items were analyzed for difficulty index, discriminating index, reliability, Bloom's cognitive levels, item writing flaws (IWFs) and MCQs' nonfunctioning distractors (NFDs) based test courses of respiratory, cardiovascular and renal blocks. Significant improvement was found in the difficulty index values of pre- to post-training (p = 0.003). MCQs with moderate difficulty and higher discrimination were found to be more in the post-training tests in all three courses. Easy questions were decreased from 36.7 to 22.5%. Significant improvement was also reported in the discriminating indices from 92.1 to 95.4% after training (p = 0.132). More number of higher cognitive level of Bloom's taxonomy was reported in the post-training test items (p<0.0001). Also, NFDs and IWFs were reported less in the post-training items (p<0.02). The MCQs written by the faculties without participating in FDPs are usually of low quality. This study suggests that newly joined faculties need active participation in FDPs as these programs are supportive in improving the quality of MCQs' items writing.