Medical Students' Perceptions Of Their Learning Environment At Lahore Medical And Dental College Lahore.

BACKGROUND: The present study was designed to assess medical students' perceptions of their learning environment at Lahore Medical and Dental College, Lahore. METHODS: It was a crosssectional descriptive study conducted at Lahore Medical and Dental College, Lahore. Five hundred and thirty-three students participated in this study. A questionnaire was used as a study tool, comprising of demographic information and the 'Dundee Ready Education Environment Measure' (DREEM) inventory. Data was entered and analyzed using SPSS 21 package. A comparison of scores between different MBBS classes was done by using ANOVA. Comparison of scores between gender and high school education was done by using Mann-Whitney U tests. RESULTS: Study population included 62% females and 32% males. About 58% of the participants were between 18-21 years and 42% were between 22-25 years of age. The mean total DREEM score was 120.27/200. The mean score of the domains: 'Students' perceptions of learning' was 28.31/48, 'Students' perceptions of teaching' was 26.92/44, 'Students' academic self- perceptions' was 21.37/32, 'Students' perceptions of atmosphere' was 27.72/48, and 'Students' social selfperceptions' was 16.40/28. Total DREEM and its subclasses score was significantly higher in F. Sc. students than the students with A level/American board (p-value <0.001). When DREEM scores were analyzed according to gender, perceptions of both male and female were positive. Age had no significant bearing on the total DREEM scores or scores in its subclasses. CONCLUSIONS: Overall perceptions or experiences of the MBBS students of their learning environment at Lahore medical and Dental College, Lahore were more positive.

Lectures in medical educaton: what students think?

BACKGROUND: The volume of medical knowledge has increased exponentially and so has the need to improve the efficiency of current teaching practices.With increasing emphasis on interactive and problem based learning, the place of lectures in modern medical education has become a questionable issue. Objectives were to assess the perspective of undergraduate medical students regarding the role and effectiveness of lectures as a mode of instruction as well as the ways and means that can be employed to enhance the effectiveness of lectures. METHODS: A cross sectional study was carried out among 2nd to final year medical students from five medical colleges including both private and public sector institutions. A total of 347 students participated by completing a structured questionnaire. Data was analyzed using SPSS-17. RESULTS: Sixty seven percent students considered lectures as a useful mode of instruction (47% males and 77% females), whereas 83% of the students reported that clinical sessions were superior to lectures because of small number of students in clinical sessions, active student participation, enhanced clinical orientation, and interaction with patients. About 64% responded that lectures should be replaced by clinical sessions. Majority of the students (92%) reported not being able to concentrate during a lecture beyond 30 minutes, whereas 70% skipped lectures as they were boring. A significantly greater proportion of male respondents, students from clinical years, and those who skipped lectures, considered lectures to be boring, a poor utilization of time and resources, and could not concentrate for the full duration of a lecture compared to females, students from preclinical years, and those who do not skip lectures, respectively. CONCLUSION: Lecturing techniques need to be improvised. The traditional passive mode of instruction has to be replaced with active learning and inquiry based approach to adequately utilize the time and resources spent on lectures.

Bedside manners: do we care?

BACKGROUND: Teaching bedside manner might prove to be one of the most challenging tasks in medical education as it is not easy to structure or formalise such training. Besides, the rigorous training process for acquiring clinical and technical skills often overshadows the humanistic aspect of medical care. The aim of this study was to assess the perception of final year medical students as well as the faculty regarding the teaching and practice of bedside manner including a brief evaluation of students' bedside manner. METHODS: A cross-sectional study was conducted involving final year medical students from five medical colleges (n = 193) and faculty from a single institution (n=29). Sample was selected using systematic random or convenient sampling techniques. Data was collected using self administered, anonymous, structured questionnaire. Data were analysed using SPSS-17. RESULTS: While evaluating students' bedside manner, 85% of the students reported they always take consent while interacting with a patient whereas, only 17% of the faculty members agreed with this. Only 3% of the faculty members reported that students take care of privacy of patients and none of them thought that students reassure a patient during an encounter whereas the percentages among students were 76% and 48%, respectively. Though students thought they need to improve, majority (56%) of them was confident of their bedside manner. On the other hand, 83% of the faculty members rated students' bedside manner from fair to poor. A large proportion (69%) of the faculty members were not satisfied with the quality of teaching regarding bedside manner, reporting lack of focus on this particular aspect of medical care as the most important cause. Majority of the students (87%) believed doctors have a better bedside manner in private as compared to public hospitals. CONCLUSION: Students have an inflated evaluation of their bedside manner but majority felt a need to improve. A sharp contrast exists between students' and faculty's opinion regarding the practice of bedside manner by students. An outright lack of focus on bedside manner was reported as the most important cause for inadequate emphasis on teaching this particular aspect of medical care.

Injuries to the duodenum--prognosis correlates with body Injury Severity Score: a prospective study.

BACKGROUND: Duodenal injury is an important hollow viscus injury in the abdomen. The study analysed the factors related to the outcome of duodenal injuries presenting to the unit. PATIENTS AND METHODS: Prospectively collected data on a case series involving 23 patients over three years. It involved demographic details, Injury Severity Score, Revised Trauma Score, part of duodenum injured, duodenal injury severity according to the AAST, injury-operation time lag, mode of repair, and the extent of significant associated injuries. Patients with non-perforating injury were excluded. RESULTS: M:F ratio was 9:2. Median age was 33 years. All were operated by a senior registrar or senior. Seven out of 23 were blunt, 13/23 firearm and 3/23 stab injuries. D2 was involved in 87%. Duodenal injury severity was graded according to American Association for Surgery of Trauma-Organ Injury Scale (AAST-OIS). Seventeen/23 were Grade II/III, 3 Grade IV and 3 Grade V injuries. Four had injury-operation lag of >18 h. Two injuries were missed. All injuries up to Grade IV had simple repair. Two of them had T-tube duodenostomy. None had pyloric exclusion. Complex repairs were required for 3/23 patients. Five patients died. Duodenum-related mortality was zero. The mortality was related to body Injury Severity Score >45. One delayed repair developed duodenal fistula. Intra-abdominal abscess, septicaemia and wound dehiscence were seen in two patients each. Adverse prognostic factors towards morbidity was injury-operation lag >18 h.