Development and Validation of a Questionnaire to Measure a Medical Student's Interest in the Subject of Community Medicine.

Background: Lack of interest has been cited by many studies as the predominant cause for students undervaluing the subject of Community Medicine. However, there are few valid and reliable tools that could measure this interest. To develop and validate a questionnaire to measure a medical student's interest in the subject of Community Medicine. Material and Methods: Cross-sectional study conducted at MTMC Jamshedpur. The Community Medicine Interest Questionnaire (CMIQ) was developed in two phases: item generation and item reduction. Items were generated through a review of the literature, focused group discussions, and in-depth interviews. In the item reduction phase, the content and construct validity of the questionnaire were ascertained. Content validity was carried out by a group of experts based on three parameters: the interrater agreement on the representativeness of the item, the interrater agreement on the clarity of the items, and the content validity index. The construct validity was ascertained through pilot testing of 480 responses from undergraduate medical students. Exploratory factor analysis through principal axis factoring and Promax rotation. Results: Twenty-five items were generated. Three of these items were removed following expert validation. Furthermore, three items were removed after pilot testing. The resulting CMIQ consisted of 19 items distributed over three dimensions: feeling, value, and predisposition to reengage toward the subject. The internal consistency of each of the subscales was ascertained. Conclusions: CMIQ is a valid and reliable tool that can be used to measure such interest for providing educational interventions.

Family Adoption Program for Undergraduate Medical Students at a New Medical School of Jharkhand: An Experience and SWOC Analysis.

Introduction: Family adoption program (FAP) incorporated into the undergraduate medical education curriculum is beneficial to all stakeholders involved. Many medical colleges have started FAP at different times and various levels based on resources availability, feasibility, and accessibility. This article is intended to cover the process of FAP implementation, the strength, weakness, opportunities, and challenges at various levels, and its scope in future. Methodology: FAP was launched by adopting a hamlet 17 km away from the college. During the foundation course, orientation lessons and logbook discussions were conducted online before the actual field visit. During the initial visit, families were assigned, which was followed by collecting sociodemographic information, a plantation drive, and organizing medical camp/ door to door screening in the last visits for phase one students. Observations: The strengths perceived were early community exposure of students and leadership skills, and the weaknesses were allocating adequate number of slots in the curriculum, adopting families far away, etc., Similarly, FAP has an opportunity to achieve the larger goal of Heath for All in terms of identifying, following up, and managing various socio clinical cases in the adopted families. However, few challenges can pose as it progresses across other phases, such as language problem, allotment of problem families, existing social pathology in family, cultural taboos, etc. Conclusion: The article suggests that once a student leaves, another student should continue the cycle of adoption and provide continuum care of services to prevent the family from being orphaned.

Sputnik V vaccine perception and hesitancy in a tertiary health care centre transformed to Covid-19 vaccine centre: A case study.

BACKGROUND: Sputnik V vaccine was approved in India in April 2021 to tackle the pandemic situation. However, there was lack of information on the effects, side effects, and peoples' perception toward it. The present case study aims to evaluate the vaccine coverage, the awareness, and perception toward it and compare the adverse effects after each dose. MATERIALS AND METHODS: A unique case study was conducted in a sample of 200 participants comparing 2 groups of population who took first and second dose of Sputnik V vaccine during June to November 2021. The data were collected by a prevalidated questionnaire, follow-up telephonic interviews focused on knowledge, awareness, side effects of vaccine, and analyzed using descriptive statistics such as frequency, percentages, mean, and standard deviation. RESULTS: The vaccine coverage for first and second doses were 98.3% and 96.5%, respectively. The mean age of the participant was 29 + 9.5 years and majority 68.5% were males. Seventeen percent experienced the S/E for the vaccine with 9.5% from second dose. There were usual side effects; however, it was more after second dose of vaccination. Friends and healthcare workers were the main source of information (33.5%) and motivation (43%). Majority (73.5%) were aware of the side effects. Forty three point five percent took vaccine attributed to its protective role, availability, and peer pressure. There was no significant association between type of doses and side effects of the respective doses of vaccine. CONCLUSION: The vaccine coverage was >90%. Participants were well aware of the vaccine and side effects which were more in second dose. However, there was no significant difference between the two doses of vaccine.

Validated checklist for assessing communication skills in undergraduate medical students: bridging the gap for effective doctor-patient interactions.

Communication skills are fundamental in healthcare, but assessing them among medical students presents challenges. In the Indian context, the lack of a specific assessment tool further compounds the issue. Thus this study aimed to develop and validate an observation-based communication skills checklist tailored to Phase I Bachelor of Medicine and Bachelor of Surgery (MBBS) students. The checklist was developed using both inductive and deductive approaches and underwent rigorous testing to ensure its reliability and validity. After piloting, the finalized version was administered to 84 Phase I MBBS students. Results indicated a critical content validity ratio of 0.78, face validity of 0.80, and an impressive Cronbach's alpha of 0.91, indicating good internal consistency and reliability of the checklist. The students scored over 80% in all checklist domains, except for empathy (73%) and support (74%), highlighting areas for potential improvement. Nonetheless, about 75% of students expressed satisfaction with the checklist's communication skills assessment. The feedback from faculty members was positive, as they found the checklist was easy to use, quick, and effective for evaluating communication skills. Consequently, the checklist's introduction has been well received by both students and faculty. In conclusion, the developed checklist proves to be an effective and valid instrument for assessing communication skills in Phase I MBBS students. By integrating this tool into observed station clinical examinations, medical educators can comprehensively evaluate students' communication behaviors. Moreover, the checklist serves as a valuable resource for bridging the gap between theoretical knowledge and practical application, enabling future physicians to excel in doctor-patient interactions, a crucial aspect of patient-centered care.NEW & NOTEWORTHY This article presents a highly unique and novel approach by introducing a structured checklist for communication skill assessment in medical students. Its rigorous validation process ensures reliability and effectiveness, while its adaptation to sociocultural norms highlights its relevance and applicability. The user-friendly design with a single-page layout and dichotomous scale further enhances its practicality in objective structured clinical examinations. The developed checklist equips educators with a valuable resource to assess and improve students' communication abilities.

Participatory cooking demonstrations: A distinctive learning approach towards positive health.

Background: Participatory cooking demonstration is a unique and effective way to teach nutritional concepts and basic cooking skills in a community setting. The present study attempted to develop the same in 4th-year nursing students through the intervention for a better nutritional health outcome. The objectives are to introduce and train nursing students on participatory cooking demonstrations in community households, evaluate the improvement of knowledge and self-efficacy of the participants, and assess the feedback of the study participants towards the intervention. Methodology: An educational intervention was carried out among BSc Nursing students in a tertiary healthcare institute from April to June 2019. A sample of 66 students were subjected to pre- and post-tests along with a self-efficacy evaluation and feedback survey. Results: Out of all, 91.1% were between 21 and 30 years, 77.8% belonged to rural areas, and 82% were in the lower-middle socioeconomic class. The knowledge was improved, and it was found to be statistically significant (P < 0.0001). The self-efficacy evaluation showed an enhancement of knowledge and awareness. The majority either strongly agreed or agreed that participatory cooking demonstrations helped them learn healthy cooking practices (80%), analyze specific nutritional problems (95.6%), and get hands-on experience in nutritional care (86.4%). The themes that emerged from qualitative data were discussed under liked, disliked aspects, challenges faced, and solutions offered. Conclusion: The hands-on sessions on participatory cooking demonstrations were successfully introduced and the knowledge and self-efficacy of the participants was improved. All participants were satisfied with the intervention as perceived by the participants.

Evaluation of Factors Affecting Thyroid Levels and its Relationship with Salt Iodine to Suggest the Way Forward!

BACKGROUND: In India, 42 million people suffer from thyroid diseases. One in 10 adults suffer from hypothyroidism. Although coverage of iodized salt utilization has increased after universal salt iodization, we are yet to achieve the goals of NIDDCP for which the present study was planned to identify the hidden factors. The aim is to identify the factors affecting thyroid hormone levels, their association with salt iodine content and suggest strategies for improvement based on patient perceptions. METHODS: A hospital based prospective follow up study was conducted among 140 patients, with an in depth interview and testing of salt iodine content. Data were analyzed using the SPSS software. RESULTS: 96 (69%) patients were of age 18-35 years. 129 (92%) were females, 120 (86%) were from rural areas, 95 (68%) were literate, 116 (83%) were unemployed, and 115 (82%) were of low socioeconomic status. Most of them had poor cooking practices and dietary habits. The T3, T4, and TSH levels were within the normal range in 84 (60%) patients. Only in 28 (20%) salt samples, the iodine content was adequate. The association between factors like intake of inadequately iodized salt (P < 0.01), rural distribution (P < 0.05), illiteracy, presence of the comorbid conditions (P < 0.0001), and thyroid hormone abnormality was found to be statistically significant. CONCLUSION: The factors that adversely affect thyroid levels were higher age, female gender, rural distribution, comorbid conditions and patients with low salt iodine were prone to abnormal levels. Monitoring salt iodine content, training of health care workers to create awareness were the key strategies proposed for improvement.

Evaluation of participatory learning approach for developing competency of human immunodeficiency virus risk assessment skills among MBBS undergraduate students.

BACKGROUND: An Indian medical graduate needs to be competent in the diagnosis and management of human immunodeficiency virus (HIV) patients. This is crucial in terms of occupational safety. A participatory learning approach could be a possible way to change behavior and improve HIV risk assessment skills among medical students for better occupational safety and health care. The present study was planned to identify the need, provide different learning experiences for acquiring competency, and compare the effectiveness of participatory learning over traditional in developing HIV risk assessment skills. MATERIALS AND METHODS: An educational interventional (randomized controlled trial) was carried out at GEMS and Hospital. Needs assessment survey was conducted, which identified HIV risk assessment as a key competency. For which the outcome-specific learning objectives were defined, two different learning experiences were employed. A pretest was conducted to assess the baseline knowledge and attitude (n = 92); they were then divided into two equal groups (A and B). "A" group was taught by participatory approach, whereas "B" by traditional techniques followed by posttest and objective structured clinical examination (OSCE) to assess their HIV risk assessment skills. Statistical analysis: Paired t-test for assessing knowledge and attitude within the same group and unpaired t-test for assessing skills between the two groups were used in this study. RESULTS: Statistically significant improvement (P < 0.001) in knowledge and attitude scores was noticed that OSCE scores were significantly higher in the intervention group "A" (P < 0.001) as compared to "B" taught by traditional techniques. CONCLUSION: Participatory learning effectively builds upon existing knowledge and attitude to develop better HIV risk assessment skills.

Introduction of Interactive Teaching for Undergraduate Students in Community Medicine.

BACKGROUND: There is lack of interest in the subject of community medicine among undergraduate MBBS students leading to poor understanding of community problems and drastic fall in preventive, promotive component of health care. AIM: To evaluate effectiveness of interactive teaching learning (ITL) over traditional teaching learning (TTL) methods in creating interest in the subject. OBJECTIVES: 1. To identify the need of interactive teaching among students. 2. To know the perception of students towards it.3. To know the views and opinion of faculties towards it. MATERIALS AND METHODS: An interventional study at NRIIMS, Vishakhapatnam. After need assessment survey, under graduate MBBS students were randomly allocated to study (A) and control groups (B). 2 topics were taught using ITL 1& 2 in group A and TTL in group B. After a washout period of 15 days, 2 other topics were taught using ITL3 & 4 in group B and TTL in group A, which was followed by assessment. Feedback from students and faculties were taken at the end of session. RESULTS: 82% of students felt significant need of interaction in classroom. There was an increase in performance of students in the intervention group in terms of better scores (>75% score) which was found to be statistical significant in all the four sessions (P value are 0.0230, 0.0058, 0.0075, 0.0034 for TPS, BS, CBS, PTP respectively). Students were satisfied, so as the faculties with the implementation of ITL module. CONCLUSIONS: Student performance was increased. Overall satisfaction was good among students and faculties.

Utilisation of nutritional support scheme among the patients of tuberculosis: A myth or a truth.

INTRODUCTION: Under-nutrition increases the susceptibility to active tuberculosis and delays recovery. Nikshay Poshan Yojana provides a financial incentive of Rs. 500/month for each notified TB patient for a duration until the patient is on anti-TB treatment. OBJECTIVES: 1. To find out the utilization of the nutritional support scheme among TB patients. 2. To give evidence-based recommendations. METHODS: It is a retrospective cross-sectional study conducted among TB patients. 2 DMC's in each of the 2TU (randomly selected from 12 TUs) were chosen. 83 patients responded to telephonic interview out of all patients registered in the last six months. The demographic details were collected from TB treatment cards and registers and other information by telephonic interview of 10-15 min each conducted over a period of 15-20 days. The quantitative data thus collected was analysed in terms of frequency, percentage and Chi-square test and qualitative data from patients and providers were analysed by thematic analysis. RESULTS: Majority were of 40-60 years of age and were males. A total of 76 patients were aware of the scheme but only 17 patients had received their first instalment after two months in their account. Among the 17 who faced difficulty while getting the money, 13 TB patients spent it on nutrition. Lack of communication, stigma, unawareness, ignorance, illiteracy, multistep approval process and technical issues were few themes that emerged as difficulties encountered while utilisation. CONCLUSION: There is a large gap between demand and supply chain of services. A majority were unsatisfied and thus the administrative scale up for proper implementation of services and measures to bring down the stigma attached with the disease was recommended.

Evaluation of Antenatal to Neonatal Continuum Care Services Affecting Neonatal Health in a Tertiary Health-Care Setup.

BACKGROUND: Maternal and child mortality and morbidity continue to be high despite existence of various national health programmes in India. Annually 41% of all Under 5 mortality is comprised of neonates, 3/4 of who die within the first week of life. Even though effective programmes are existing, optimum utilization is still a question. So the present study was planned to assess utilisation of maternal and neonatal health services and its influence on neonatal health. OBJECTIVES: 1. To assess the utilization of MCH services before admission to SNCU. 2. To analyse the process of implementation of IMNCI before referral and during the admission. 3. To observe the impact on neonatal health and give necessary recommendations. METHODOLOGY: The information regarding utilization of MCH services was obtained by conducting in depth interviews with the responsible adults accompanying the sick neonate. The Pre-treatment and referral slips were verified and compared with that of the prescribed guidelines laid down by the IMNCI for young infants (0-2 months) at SNCU. RESULTS AND DISCUSSION: Some of the important observations were mentioned here. 100% women had TT immunization whereas 72% had the full ANC, 58.7% had full course of IFA, 76% had utilized JSY benefits and 48.34% had their PNC. 84% neonates had required immunization, 59.01% were on exclusive breast feeding. 38.9% were paid home visits, only 42% had an idea about the danger signs of neonatal period. 23% sick babies were treated under IMNCI guideline. Among them 98% given initial treatment, only 34% given proper diagnosis/classification, 56% were given adequate advice.