Evaluation of the Effectiveness and Perceived Benefits of Interventional Structured Infection Prevention and Control Training Module Introduced in the Undergraduate Medical Curricula.

Introduction: Assessing and improving infection prevention and control (IPC) knowledge and practicing skills among medical students who are the future medical practitioners is crucial for reducing the burden of healthcare-associated infections (HAIs). In this study, we assessed the IPC knowledge of undergraduate clinical-year medical students before and after interventional IPC modular training and evaluated the effectiveness and students' perception on structured modular IPC training presented to them. Methods: This cross-sectional interventional study was conducted on single medical cohort comprising of 145 final-year undergraduate medical students of the academic year 2022-23 at COMHS. Pre-test, post-test, and feedback questionnaire were used as the assessing tools. The data were collected, entered into Excel sheet, and analyzed using SPSS software version 22. McNemar and Paired-T tests were carried out, and a p value<0.05 was considered significant. Feedback of the questionnaire was analyzed using 3 Point Likert Scale as agree, neutral, and disagree. Results: Overall, mean IPC knowledge scores after training (37.65±1.37) was significantly higher as compared to before training (25.13±4.51). Prior knowledge scores on certain aspects of IPC such as duration of hand washing, steps of hand washing, sequence of donning and doffing of PPE, use of N95 mask, and appropriate sharp and needle precautions, and biomedical waste management were varied from 13.6% to 65.6%. However, overall participants' knowledge (p value <0.001) on these aspects increased significantly after the training. The majority of the participants (>90%) perceived IPC training as an excellent tool to improve IPC knowledge and practicing skills. Conclusion: IPC training had a significant impact in gaining adequate IPC knowledge and practicing skills among our participants. Therefore, it is recommended that IPC training should be implemented in the undergraduate medical curriculum with greater emphasis on practicing skills.

Concept maps in immunology: A metacognitive tool to promote collaborative and meaningful learning among undergraduate medical students.

Introduction: Concept maps are graphical representations of knowledge that connect concepts, ideas, and relationships. The present study aims at assessing the perception of medical students in utilization of concept maps as a tool to foster their lifelong learning skills in immunology. Methods: The current study was approved by Institutional Ethics and Review Committee. Third-year undergraduate (MD3) medical students of the academic year 2021-22 were sensitized about the concept map study and included after obtaining their informed consent. The students worked in teams to find answers and link the different words or phrases of the concept maps. At the end of the immunology course, students' perception on concept map-based learning strategy was assessed. A pre-designed, self-administered questionnaire, pre-validated by subject experts for relevance and feasibility, was used for the study. The questionnaire included some quantitative questions assessed by using 3-point Likert Scale and an open-ended question to receive students' comments on concept map-based learning strategy. The responses were collected and analyzed using SPSS version 22. Descriptive statistics was used for the quantitative variables, tabulated as numbers and percentages while the qualitative data was analyzed by thematic analysis. The quantitative data results were prioritized but supported by students' comments on open ended question. Results: Out of 133 eligible participants, 109 students who volunteered and completed the study were included. Majority of our participants (>80%) welcomed the concept map-based learning strategy. Almost 4 out of 5 expressed that concept maps are interesting and enjoyable, encourage active participation, peer discussion, and enhance critical thinking and problem-solving skills. More than 80% of the students agreed that concept maps promoted deep understanding of the topic and lifelong learning. Nearly 3 out of 4 students suggested including concept maps in many immunology topics in future. Majority of students penned down positive comments indicating concept map tool facilitates metacognitive skills. Conclusion: From the study, it can be concluded that concept maps are effective active learning strategies to improve the metacognitive domain of medical students in immunology course, thus assisting them to become better lifelong learners.

Are Online Synchronous Team-Based-Learning (TBL) pedagogy effective?: Perspectives from a study on medical students in Oman.

INTRODUCTION: Team-based learning (TBL) is a highly structured, instructive, and student-focused pedagogy used by medical educators to foster the students' learning. The present study aimed to qualitatively explore the students' perception of the effectiveness of online synchronous TBL pedagogical strategy in promoting learning outcomes. METHODS: A cross-over interventional study was conducted on MD4 year medical students, using four modified TBL sessions on common immunological diseases on four different dates. 139 participants were divided into 4 groups [35 each in A, B, C, & 34 in D]. For TBL session 1, Group A and group B were the study and control groups, respectively. For the second session on different topics, the groups were reversed with group B and group A as the study and control groups, respectively. The same was followed for groups C and D. The means and standard deviations of the pre-test and post-test scores were compared after calculating the improvement in scores from pre- to post-tests. Repeated measures ANOVA suitably coded in SPSS for cross-over design was used to find out confounding by sequence of interventions with a p-value of <0.05 signifying the significance.  Students' feedback on online TBL sessions was collected through a predesigned questionnaire on a 3-point Likert scale. The data were analyzed using SPSS version 22 and expressed as number and percentage. RESULTS: The post-test scores of the students who participated in the TBL session were significantly higher when compared to the self-study (SS) arm. The overall improvement in scores was 4.98 (1.4) in TBL group, whereas in the SS arm it was only 2.29 (1.51). The new method was found far superior to the self-study method regardless of being applied before or after the comparison mode of self-study (P<0.0001). The scores of the self-study was marginally better when offered first rather than after a TBL session, indicating the negative effect of cross-over on SS mode (P=0.024). The overall response of our students toward the effectiveness of online TBL pedagogy was overwhelmingly positive in terms of an opinion survey which had a Cronbach's alpha of 0.932. The majority (>80%) perceived TBL as an enjoyable active session that promoted their active participation and engagement through student-led discussions. Many stated that TBL enhanced their critical thinking, problem-solving ability, communication skills, and knowledge. CONCLUSION: TBL is an instructive and highly structured teaching-learning strategy, welcomed by the majority of our participants. Online TBL sessions are effective in fostering the students' learning and can be used confidently when needed.

Encouraging students' engagement and promoting deep learning in immunology through an interactive clinical case problem-solving (CCPS) approach: Perception among cohort of medical students in Oman.

BACKGROUND: Modern competency-based medical education emphasizes student-centered teaching-learning strategies where students take responsibility of their own learning. Student-centered approaches facilitate multifaceted learning such as observation, critical evaluation, analysis, deeper understanding, and application of knowledge. The current study aims at assessing the students' perception on utilization of clinical case problem-solving approach (CCPS) to promote their lifelong learning. MATERIALS AND METHODS: The present cross-sectional study was conducted at College of Medicine and Health Sciences (CoMHS) during the year 2021-2022. MD3 students of the academic year 2021-2022 were the study participants. The study was approved by institutional Ethic and Review Committee. Students' performances were assessed through pre-test and post-test performances. Students' feedback was collected through a predesigned questionnaire on a 3-point Likert scale. Cronbach's alpha coefficient test was used to assess the reliability of the questionnaire. The data was entered to Microsoft Excel and analyzed using SPSS software version 22. Paired t-test was used to compare pre-test and post-test scores and the data was expressed as numbers and percentages. RESULTS: In total, 103 participants were included in the study. Post-test scores were significantly higher compared to pre-test scores (p < 0.05). Questionnaire results showed that CCPS approach was accepted as an effective learning strategy. Majority (>90%) of the students expressed CCPS approach was interesting, motivated to learn, encouraged peer discussion, enhanced knowledge, and clarified their topic-related doubts. More than 80% students opined that CCPS enhanced their critical thinking, problem-solving ability, deep learning, and lifelong learning skills. Nearly 90% of the students suggested for including such sessions for more topics in immunology course in future. CONCLUSION: From our study results, it can be concluded that CCPS is an effective learning strategy to encourage students' engagement and promote their deep learning skills.

Antibiotic Resistance Pattern of Acinetobacter baumannii Strains: A Retrospective Study from Oman.

BACKGROUND: Multidrug-resistant (MDR) Acinetobacter baumannii is of serious health concern and associated with high mortality. Data regarding the antibiotic resistance pattern of A. baumannii strains in Oman is limited. OBJECTIVES: To determine the antibiotic resistance pattern of A. baumannii from various clinical samples in a tertiary care hospital in the North-Batinah region of Oman. METHODS: A. baumannii isolates recovered from various clinical samples in the Microbiology laboratory of Sohar Hospital, Oman, during 2015-2019 were retrospectively analyzed. Organism identification and their antibiotic resistance patterns were performed as recommended by the Clinical and Laboratory Standards Institute. RESULTS: A total of 1890 A. baumannii nonduplicate isolates were found from clinical samples of 1326 patients. The isolates were more frequently isolated from elderly patients (40%) and in-patient department patients (67%). Infection/colonization was more common among patients treated in the medicine, intensive-care unit, and surgery departments. A. baumannii strains were highly resistant (50-83%) to most of the tested antibiotics, with the highest against ceftriaxone (83%) and ceftazidime (75%), and lowest against colistin (1%) and tigecycline (8%). Among the isolates, 67% (1265) were MDR strains. Of these, 22%, 32% and 16% were resistant to all six, five and four classes of the tested antibiotics. CONCLUSION: The study found that the frequency of isolation of MDR A. baumannii isolates in the northern region of Oman is high.

Stenotrophomonas maltophilia: An emerging opportunistic nosocomial pathogen in a tertiary care hospital in Al Batinah North Governorate, Oman.

OBJECTIVES: Stenotrophomonas maltophilia, a Gram-negative non-fermentative bacillus, has emerged as an important nosocomial pathogen in recent years. It is intrinsically resistant to many antibiotics and has the ability to acquire antibiotic resistance by multiple mechanisms. Treating Stenotrophomonas infections, therefore, is a serious challenge for physicians. This study aimed to investigate the antibiotic susceptibility patterns and risk factors contributing to S. maltophilia infections. METHODS: A retrospective cross-sectional study was conducted at Sohar Hospital in Sohar, Oman. The demographic, clinical and microbiological data of individuals from whom S. maltophilia was isolated between September 2016 and August 2019 were reviewed. Descriptive statistics were presented as frequencies and percentages. RESULTS: A total of 41 S. maltophilia isolates from clinical specimens of 41 patients were studied. Infection occurred predominantly in males (73%) and the majority of patients (88%) were either ≤5 years old or >60 years old. All inpatients had at least one comorbidity while 50% had more than one. All inpatients were exposed to various medical interventions such as intensive care (44%), mechanical ventilation (41%), haemodialysis (25%), Foley's catheterisation (13%) and central venous lines (6%). Most patients (81%) were in hospital longer than two weeks. The susceptibility rates of S. maltophilia to minocycline (97%), trimethoprim-sulfamethoxazole (93%) and levofloxacin (92%) were high; the rate was lowest for ceftazidime (50%). CONCLUSION: S. maltophilia was found to be an important nosocomial opportunistic pathogen. Prolonged hospital stay and exposure to various medical interventions were key factors contributing to the development of infection. Minocycline and ceftazidime were found to be the most and least susceptible drugs, respectively.

Hepatitis B: Knowledge and awareness among preclinical year medical students.

BACKGROUND AND OBJECTIVE: Hepatitis B is an occupational health hazard to health-care workers. The complete knowledge of hepatitis B virus (HBV) transmission and prevention is indispensable for medical students. This study was conducted to assess the knowledge and awareness of hepatitis B among preclinical year medical students. MATERIALS AND METHODS: This is a descriptive cross-sectional study. A predesigned self-administered questionnaire concerning hepatitis B knowledge and awareness was distributed to all the preclinical year medical students. The data were collected, tabulated, and analyzed by Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software, version 22. The results were expressed in numbers and percentages. RESULTS: Of 251 students, only 132 students voluntarily participated in the study. Majority of the students (84.8%) were aware of HBV infection. Many students knew that blood transfusion (81.1%) and use of contaminated needles and syringes (74.2%) are major modes of transmission. However, less than 30% of the students had knowledge about other modes of transmission. More than 50% of the students lacked in their knowledge about clinical features and complications of hepatitis B infection. Majority of students (72.7%) were aware of HBV vaccination. However, many students did not know their vaccination status, whereas only 23.5% of the students were fully immunized. CONCLUSION: This study revealed lack of complete knowledge regarding hepatitis B among preclinical year medical students. They are at high risk of acquiring HBV infection during their clinical practice, later in life. Hence, implementation of well-structured education program in the first year itself is needed to create complete awareness among medical students about hepatitis B.