House Officers Research Articles

The Impact of the Covid-19 Pandemic on the Mental Health of Healthcare Professionals and Paramedical Staff Working in Peshawar, KP

Background: COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Therefore, it is extremely important to identify the healthcare workers who are at increased risk of psychological stress.Objectives: To determine mental health issues due to COVID-19 among health care workers during the pandemic. To determine the factors behind mental health issues among healthcare workers during COVID-19Material and Methods: A cross-sectional study, carried out at two major tertiary hospitals in Peshawar Khyber teaching hospital (KTH) and Hayatabad Medical Complex (HMC). The participants included house officers, trainees, consultants and nurses. Data was collected through questionnaires. Survey tools such as Patient Health questionnaire -9 (PHQ-9) scale for depression and Generalized anxiety disorder (GAD-7) scale for anxiety were used. Chi -square test was applied to find association between mental health issues and COVID-19.Results: About 230 HCWs participated having equal number of males and females. Most of the participants were in age group 25-30 and were composed of trainee medical officers. We found that 61.2% of the participants screened positive for depression while 52.6% of the participants screened positive for anxiety and it was due to dissatisfaction towards facilities provided by their respective hospitals. Conclusion: Anxiety and depression were prevalent among the health care workers especially younger and un married individuals during COVID -19. To foster supportive work environment effective strategies are needed.Keywords: Anxiety, Covid -19, Depression, Pandemic

Preparedness for the transition to medical registrar from senior house officer-What's the problem?

Transitions in clinical training are a hallmark in medical trainee's careers. The transition from senior house officer (SHO) to the role of medical registrar is often viewed as one of the most challenging, but to date, there is little research exploring why the transition is proving problematic for so many learners. The aim of this study was to explore the experiences of trainees preparing to make this transition. Using an interpretative phenomenological analysis (IPA) approach, this qualitative study employed semi-structured interviews to explore the lived experiences of transition in a purposive sample of trainees on the cusp of transition from SHO to registrar or who were in their first year of being a medical registrar. Interviews were recorded, transcribed verbatim and analysed using an IPA approach. Six trainees participated in this study, four of whom were currently in SHO positions, with the remaining two in their first year of medical registrar. Two main themes emerged from data-perception of the medical registrar and barriers in transition. The role of the medical registrar was perceived to represent a strong leadership role, with barriers created due to increasing expectations, lack of support and uncertainties regarding the job. The role of the medical registrar is a challenging one, representing periods of uncertainty, increased expectations and reduced supports. Within this, there is potential to further support SHOs in transitioning to the role of medical registrar.

Inter-observer Variability in the Analysis of CO-RADS Classification for COVID-19 Patients.

During the early stages of the pandemic, computed tomography (CT) of the chest, along with serological and clinical data, was frequently utilized in diagnosing COVID-19, particularly in regions facing challenges such as shortages of PCR kits. In these circumstances, CT scans played a crucial role in diagnosing COVID-19 and guiding patient management. The COVID-19 Reporting and Data System (CO-RADS) was established as a standardized reporting system for cases of COVID-19 pneumonia. Its implementation necessitates a high level of agreement among observers to prevent any potential confusion. This study aimed to assess the inter-observer agreement between physicians from different specialties with variable levels of experience in their CO-RADS scoring of CT chests for confirmed COVID-19 patients, and to assess the feasibility of applying this reporting system to those having little experience with it. All chest CT images of patients with positive RT-PCR tests for COVID-19 were retrospectively reviewed by seven observers. The observers were divided into three groups according to their type of specialty (three radiologists, three house officers, and one pulmonologist). The observers assessed each image and categorized the patients into five CO-RADS groups. A total of 630 participants were included in this study. The inter-observer agreement was almost perfect among the radiologists, substantial among a pulmonologist and the house officers, and moderate-to-substantial among the radiologists, the pulmonologist, and the house officers. There was substantial to almost perfect inter-observer agreement when reporting using the CO-RADS among observers with different experience levels. Although the inter-observer variability among the radiologists was high, it decreased compared to the pulmonologist and house officers. Radiologists, house officers, and pulmonologists applying the CO-RADS can accurately and promptly identify typical CT imaging features of lung involvement in COVID-19.

Survey on the Perceptions of Pregnancy and Parenthood in Trainees: Advances, Obstacles, and Growth Opportunities

IntroductionDespite national policy changes, perspective changes on pregnancy and parenting in training are often lacking. We evaluated current viewpoints regarding pregnancy, parenthood, leave needs, and perceptions of support across trainees at our institution. MethodsA cross-sectional survey was sent to all residents and fellows at a tertiary care academic center with >700 trainees. Demographic information, opinions on maternity and paternity leave, and opinions on institutional support and career goals were collected. The survey was sent via the Graduate Medical Education Office listserv -- 66 Accreditation Council for Graduate Medical Education (ACGME) programs and 40 non-ACGME programs. ResultsSeven hundred and forty-seven house officers received the survey with a response rate of 21.9% (n = 164). Of respondents, 81% were residents and 99 respondents were female (representing 31% of female trainees at our institution). Thirty-seven point two percent of respondents reported being parents. Twenty-five point three percent of respondents had been pregnant while a trainee with no statistical difference by specialty type (P = 0.0817). Statistically significant difference was noted in having children based on sex with men becoming parents at twice the rate of women (56% vs 26%, P < 0.001). No difference was noted between specialties on perceived support while pregnant and peripartum. Thirty percent of parent respondents reported thinking about leaving medical training after having children given family stressors. Statistical difference in thoughts of leaving medicine overall between females (46%) and males (17.6%; P = 0.0238). ConclusionsMen and women need support as they navigate becoming parents at a naturally stressful transition period. Females consider leaving medicine at twice the rate of males after becoming parents. Our institution and other ACGME programs need greater transparency and consistent leave practices that reflect changing times.

Endodontic file separation and its management among dentists in Punjab, Pakistan

The study aimed to find the incidence and awareness of endodontic instrument separation and its management among dental house officers, postgraduate trainees, demonstrators, consultants, and general dentists. Methods: This online questionnaire-based cross-sectional study was conducted with the approval of the IRB in private and public dental hospitals and dental clinics in Punjab. The authors developed the survey tool, which comprises 24 closed-ended items regarding demographics, the incidence of file separation, and awareness about its management. The data were analyzed using IBM SPSS version 24. The Chi-Square Test was used to compare percentages of categorical variables. Results: Postgraduate trainees experienced the most instrument separations (43.6%), made the most retrieval attempts (49.2%), and experienced the most secondary errors during retrieval (52.1%) (p&lt;0.001). Around four out of ten respondents always informed the patients (39.6%) and department (41.6%) about errors. Manual files (69.8%), stainless steel files (75.8%), and short files (60.4%) were more frequently separated, and the most frequent cause was older fatigue files (57.7%). Manual files were more frequently broken in public dental institutes (p=0.003). Two-thirds of the file separations (72.5%) occurred during cleaning and shaping in the apical third of molars (65.1%), especially in mesiolingual canal (56.4%). Bypass attempt was the most common in symptomatic teeth (47.7%). Conclusions: Preventive approaches such as limiting file reuse and constructing a glide path can reduce the occurrence of file separation. Operators should be familiar with the number of uses of the instrument before fatigue and should be trained through workshops and refresher courses.

Evaluation of the Occupational Hazards among Clinical Dental Students and House Officers in Napata College in 2022

Evaluation of the Occupational Hazards among Clinical Dental Students and House Officers in Napata College in 2022

Abstract IA008: Weaving university and community-based partnership

Abstract Introduction/Background Including Hypothesis/Objectives: University investigators affiliated with the Partnership for Native American Cancer Prevention (NACP) and Navajo Nation partners worked together with a goal to estimate the prevalence of Helicobacter pylori infection and its specific subtypes and factors associated with infection. Methods: This partnership required multiple strategies to promote awareness and individual participation in this study. The team started with tribal resolutions and communication network with local Chapter House officers, Community Health Representatives (CHRs), local Navajo translators, Diné Haatalii Association (Navajo Medicine Man), social network outreach, and community healthcare providers. Results: Our population-based study weaved together various networks with local leaders, social media, and the Navajo Healthy Stomach website. Participant follow-up after testing found that local hospitals were overwhelmed with requests for appointments and immediate treatment. Participants reported side-effects of prescribed medications. The Monroy lab revealed enough biopsies to test for Helicobacter pylori infection. Conclusions: Successful studies must utilize both Navajo Nation Human Research and Review Board approvals with university Institutional Review Boards (IRBs). Local, in-person, radio, and social media-based weaving of culturally sensitive communications develops strong partnerships between university and community-based local people, programs, and hospitals. Future Directions (Opportunities and Challenges): The team continues to study the role of Helicobacter pylori on the gastrointestinal microbiome in the development of gastric disease in infected Navajo patients. Further outreach is ongoing with local community and providers. Funding Support: Partnership for Native American Cancer Prevention, U54 NCI grant. Citation Format: Priscilla R. Sanderson, Fernando Monroy, Heidi Brown, Robin Harris. Weaving university and community-based partnership [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr IA008.

IMPROVING WORK PERFORMANCE WITH THE INFLUENCE OF ROTATION THROUGH WORK ENTHUSIASM AND MOTIVATION IN THE HOUSING, RESIDENTIAL AND DEFENSE AREA SERVICES OF BULELENG REGENCY

This study aims to determine the increase in work performance with the influence of rotation through work enthusiasm and motivation in the housing, settlement and defense areas of Buleleng Regency. The population and sample in this study were 92 employees at the Housing, Settlement and Defense Areas Office of Buleleng Regency. The data analysis technique used in this research is Structural Equation Modeling (SEM) based on variance SEM, which is well known as Partial Least Square (PLS) visual version 3.0. The results of this study indicate that rotation has a direct influence on morale at the Housing, Settlement and Defense Areas Services in Buleleng Regency. Rotation has a direct influence on motivation in the Housing, Residential Areas and Defense Services of Buleleng Regency. Rotation has a direct influence on work performance at the Housing, Settlement and Defense Areas Office of Buleleng Regency. Morale has a direct influence on work performance at the Housing, Settlement and Defense Areas Office of Buleleng Regency. Motivation has a direct influence on work performance at the Housing, Settlement and Defense Areas Office of Buleleng Regency. Rotation has a direct influence on work performance with work enthusiasm as an intervening variable at the Housing, Residential and Defense Areas Office of Buleleng Regency. Rotation has a direct influence on work performance with motivation as an intervening variable at the Housing, Residential and Defense Areas Office of Buleleng Regency.

Ophthalmology: a dwindling specialty in Pakistan

Madam Editor, Ophthalmology is a branch of medical science that deals with diagnosing and treating eye disorders. It comprises both the medicinal and surgical aspects of eye care. Medical students choose a specific field of their interest as their future speciality. It is the dream of every medical student to go far in his or her field of study and to make good progress. Some students choose Medicine while others opt Surgery. Even in surgery, some students choose General surgery, while others choose other surgical interests, such as Cardiac surgery, Gynaecology, Neurosurgery, etc. The same thing happens in the field of medicine i.e., they want to become Internists, Pediatricians, Dermatologists, Neurologists and Cardiologists. But the tendency of students to opt Ophthalmology is observed to be less in Pakistan (1). According to Aslam M, et al. (2011), only 1.7% of medical students in the .public sector and 3.3% of medical students in private sector medical colleges preferred Ophthalmology.(2). Another study by Hamid S et al., in 2019 conducted on the fourth and final year medical students, and house officers showed that only 3.8% of the participants were interested in Ophthalmology as a future subject of speciality, with a male to female ratio being 1:3 ,which is alarming as well (3). The main factors influencing medical students not to choose Ophthalmology include, fewer chances of residency, prolonged duration of residency, and limited opportunities in the private sector (4). Besides this, students often perceived Ophthalmology as a ‘dry subject’ by students. The basics of the eye i.e., anatomy, histology, embryology, and physiology are also extensive and difficult to be retained for a prolonged period. Poor retention of concepts can also affect the specialty preference concerning Ophthalmology among medical students. Though there are many benefits of choosing the field as a speciality, some being high income, less working hours and no duties in the night (4). Almost all cases in Ophthalmology are treated in daycare settings and the surgeries are also mainly elective procedures as there are fewer emergency calls. Moreover, sub-specialties are offered including Paediatric Ophthalmology, Orbit and Oculoplastics, and Vitreoretinal Ophthalmology (5). According to the International Council of Ophthalmology, there are 1860 ophthalmologists in Pakistan with 11 ophthalmologists per million of the population (1). There is a dire need for ophthalmologists in the country. ---Continue

Evaluation of Learners’ attitude towards Medical Professionalism (LAMPS) in a Private Medical &amp; Dental College in Lahore, Pakistan

Introduction: Investing in medical professionalism is investing in the future of healthcare if we want next generation to be equipped with values, behaviours, and attitudes that define the relationship between healthcare professionals and patients and also provide compassionate care.Objective: To conduct a survey among faculty, post-graduate residents, house officers, and students to assess their perceptions of medical professionalism and identify gaps where additional training and support are required within the next three months.Methods: A descriptive correlational study was conducted among a sample size of 300, including faculty, post-graduate residents, house officers, and students of a private medical college, through convenient sampling. Duration of 3 months was accustomed to collecting prescribed data through a validated self-assessment tool” LAMPS” was used after getting permission. This questionnaire consisted of five attributes: accountability, autonomy, integrity, altruism, and respect. The data was analysed using SPSS version 25.Results: The comparison of data showed that faculty and house officers have high values of professionalism when compared to postgraduate trainees and medical students.Conclusion: There are multiple reasons for this attitude. The most probable reason is that faculty and house officers are highly paid among these job titles, and therefore they are more accountable for their actions to the paying body.Keywords: Health, Professionalism, Dental Students, Faculty

Mental Health Training for Health Care Workers at Eradah and Mental Health Complex in Jeddah City

Aims: This study aims to implement the impact of a mental health training program designed for health workers at Eradah Complex in Jeddah City, Saudi Arabia.&#x0D; Study Design: A quasi-study in addition to qualitative designs.&#x0D; Place and Duration of Study: A mixed method was made at Eradah Complex for the program took 4 months.&#x0D; Methodology: A mixed-methods research design was employed with A quasi-experimental design employing a single group pre-test/post-test approach utilized to assess the impact of training on knowledge and attitude and using semi-structured interviews. Additionally, qualitative feedback from both the health workers and patients was gathered to gauge the program's impact on the quality of mental health care provided at the Eradah Complex.&#x0D; Results: A total of 100 participants with different healthcare specialities were selected on quasi-experimental design with nearly equality of males and females’ gender and majority of ages more than 25 years old or less and house officers (physicians). Assessing the knowledge revealed that the group showed a significant difference before assessing the program and after it (p=0.00) with a mean difference of more than 5±1.07 for each type of mental health, also, assessing the attitude revealed that the group showed a significant difference between before assessing the program and after it (p=0.00) except for epilepsy (p= 0.17) with mean difference more than 6±1.06 for each type of mental health.&#x0D; Conclusion: The findings of this case study highlight the positive outcomes of the mental health training program. Health workers demonstrated significant improvements in their understanding of mental health disorders, communication skills, and ability to support patients experiencing mental health crises. Moreover, the program contributed to a noticeable reduction in the stigma surrounding mental illness among both staff members and patients, fostering a more supportive and compassionate healthcare environment. This case study provides valuable insights into the importance of mental health training for healthcare professionals and offers practical recommendations for other healthcare facilities aiming to enhance the mental health competencies of their staff. The study concludes with a discussion of the implications of the findings and suggestions for future research and improvements in mental health training programs for healthcare workers in similar contexts.

Improving Quality Care and Patient Safety With Implementation of an Oversew Stitch in Lumbar Drains.

The lumbar drain exit site purse string oversew stitch is a well-described bedside intervention to stop or prevent cerebrospinal fluid (CSF) leak. It is not routinely placed at the time of lumbar drain placement. Via four plan-do-study-act (PDSA) cycles, we test the effect of prophylactic utilization of the lumbar drain exit site oversew stitch on house officers' paging burden, need to redress the drain, need to oversew the drain to stop a CSF leak, and need to replace the drain. We found that the simple act of placing an oversew stitch at the time of lumbar drain placement significantly reduced paging burden and reduced the frequency at which an oversew stitch was required to stop a CSF leak. Subjectively, during PDSA cycles during which overstitches were placed prophylactically, in-house residents perceived that there were less lumbar drains on service, although objectively, the overall number was unchanged. We conclude that prophylactic lumbar drain exit site stitch placement reduces risk and bedside interventions for patients and also reduces overall call burden on house officers. This simple intervention may therefore provide a more widespread improvement in care quality beyond lumbar drain care because house officers experience less burnout during their call shifts.

Audit on the Adequacy of Consenting Practices for Neck of Femur Fracture Surgeries.

Doctors are bound to obtain informed written consent prior to any form of surgical procedure on a patient. The General Medical Council (GMC) and the Royal College of Surgeons of England (RCS) provide guidance on what constitutes valid consent. Failure to obtain valid and adequate consent can have legal ramifications. All relevant material risks associated with the surgery must be discussed with the patient during the consenting process. This was a retrospective cross-sectional study of the consenting practices for neck of femur fracture surgeries, covering a period of three months, from the 15thof April to the 15thof July 2023. We evaluated the consent forms of 100 patients, of which 63 were consent form-1 and were included in the study. The British Orthopaedics Association (BOA)-endorsed consent forms, together with the RCS and GMC guidance on consent, which were used as the standard for the audit. The majority of the consents were obtained by senior house officers (SHO) and core surgical trainees who did not have prior formal orthopaedic training (52.4%). The risks that were most frequently documented were infection, blood clots (deep vein thrombosis and pulmonary embolism), and bleeding, with documentation rates of over 90%. Prosthetic joint dislocation following hemiarthroplasty or total hip replacement was not mentioned in 22.2% of the forms. Neurovascular injury was not documented in 20.6% of the consent forms. Less than 75% documentation rates were observed for postoperative pain (74.6%), anesthetic complications (73%), failure (malunion/non-union/loosening of prosthesis) (68.3%), leg length discrepancy (60.3%), bone damage/fracture (50.8%), death (49.2%), wound-related complications/scars (42.9%), and hip stiffness (14.3%). None of the patients had been advised about the probable need for catheterization following surgery. We also noted that 22.2% (n=14) of the consent forms did not contain the diagnosis or the indication for surgery, 12.7% (n=8) did not mention the intended benefits, and 28.6% (n=18) of the consent forms had no mention of the responsible consultant.We also noted that in 25.4% (n=16) of the cases, the possible requirement of a blood transfusion had not been mentioned. The audit revealed several deficiencies in the consenting of patients for neck and femur fracture surgeries. There were poor documentation rates for risks associated with surgery, especially the less common and rare ones. We also identified several deficiencies in the remaining aspects of the consent forms that were not in keeping with the GMC and RCS guidance on consent. The lack of orthopaedic training and knowledge among the senior house officers and core trainees may be a contributing factor.

Priority Recommendations for Residential Road Improvement Using the SMART Analysis Method

Roads are infrastructure for organizing transportation, which are places for traffic to flow both for people and goods to reach destinations safely, securely, comfortably, quickly, smoothly, orderly, and efficiently, especially roads in residential areas. Setting priorities for the road improvement program is the responsibility of the Public Housing, Settlement Areas, and Land Affairs Office, which handles technical planning, development, arrangement, supervision, and control of development in residential areas. Recommendations for road proposals for the currently running improvement program, based on an assessment of their physical condition, are carried out by experts. This prioritization certainly takes a long time because experts have to compare the physical conditions of the roads one by one to make a decision. A decision support system is specifically designed for the decision-making process that can be applied in various aspects of the decision-making field. Recommendations for alternative roads in the road improvement program were analyzed using the SMART method to find alternatives with the highest preference value and the advantage that they can be used for all weighting techniques. Accuracy testing shows that the priority recommendation output presented by the application has an accuracy rate of 80%. This value is obtained by comparing the results of recommendations from experts.

Peran Ombudsman RI Perwakilan Provinsi Bali Dalam Pengawasan Pelayanan Publik Di Dinas PUPR Kota Denpasar

Public services in Indonesia are often in the spotlight in society, especially in maladministration actions carried out by public service providers. Such as an increase in reports of alleged maladministration received by the Ombudsman of the Republic of Indonesia in Bali Province. Where in this report the agency that received the highest report was the Department Public Works Service in Denpasar City. With reports of alleged maladministration from the public, it is felt that there is a need for a role from an institution authorized to supervise public services, such as the Ombudsman Institute of the Republic of Indonesia. The purpose of this study is to conduct an analysis regarding the role of the Indonesian Ombudsman Representative of the Province of Bali in supervising public services at the Department Public Works Service in Denpasar City. This study uses a post-positivism approach with descriptive qualitative analysis. The results obtained are the role of the Indonesian Ombudsman Representative for the Province of Bali which is divided into 2 dimensions, namely prevention of maladministration with the sub-dimensional assessment of compliance with public service standards and community participation as well as the report completion dimension with the report completion procedure sub- dimension and the number of completed reports. The Ombudsman of the Republic of Indonesia for the Province of Bali succeeded in carrying out all of these dimensions in the supervision carried out by the Public Works and Public Housing Office of the City of Denpasar

Covid-19 Pandemic and Dentistry: Perception of Dental Trainees Regarding their Professional Skills and Career Change How Covid-19 Impacted Professional Skills and Career Plans

Objective: The aim of this study was to find out the impact of COVID-19 pandemic on professional skills and career plans of House Officers (HO) and Postgraduates (PG) dental trainees. Methodology: A cross sectional study was conducted on 380 participants. A total number of 194 HO’s and 186 PG trainees from all the teaching dental hospitals of Peshawar, Khyber Pakhtunkhwa. The time duration of this study was December 2020 till March 2021. A self-administered questionnaire was developed to assess the psychological impact of COVID-19 on the HO and PG dental trainees. The questionnaire comprised of closed ended questions on perceptions of trainees regarding their mental health. The data was recorded and analyzed using SPSS statistical package 26.0. Results: A total number of 380 Trainee dentists participated in the study and half of them (48%) reported to be tested positive for COVID-19 at some point. During the peak of the pandemic, 90.8 % of the participants' reported that their mental health was compromised, with the most common reasons being financial issues (58.9%) and psychomotor skills (52.1%). The Postgraduate Trainees were more concerned about their dental practice and impact on their mental health as compared to the HO’s and the difference was statistically significant, financial issue being the major reason. Conclusion: This study shows that the COVID-19 pandemic affected the mental health, professional skills and financial issues of the house officers and postgraduate dental trainees.

Quality of Counseling About Lifestyle Modifications and Complications of Hypertensive Patients, Sudan

Hypertension is a common chronic disease and an important public health problem. Effective hypertension control depends on patients being aware of the necessary lifestyle modifications. This study aimed to assess the quality of counseling received by hypertensive patients, the influence of blood pressure control and complications of hypertension. This cross-sectional study was conducted on hypertensive patients attending a private medical facility, a governmental facility and a PHC (Primary Health Care) center in Sudan. The patients were randomly selected, and their waist circumference, height and weight were recorded. The participants received counseling from family physicians and SHOs (Senior House Officers) about diet, mental relaxation, weight loss, exercise, smoking, and alcohol. The follow-up doctor vs. counseling showed a significant difference in counseling about diet, salt, fat intake, and smoking. The quality of counseling depended on the doctor rather than the follow-up location. The quality of counseling offered to hypertensive patients depends on the doctor rather than the location; almost half of the participants had to follow up with SHOs, including half of the participants with complications, and only a quarter received counseling about complications. For hypertensive patients, the quality of counseling depends on the doctor rather than the location. Recommendations include prioritizing lifestyle modifications and ensuring doctors are sensitive and aware of their counseling tactics with patients.

Assessment of prescription writing skills among dental house officers: A multi-center study.

To assess the knowledge and skills of prescription writing among dental house officers from different hospitals. This cross-sectional study was conducted from July to September, 2022. A self-administered, structured questionnaire was used to collect data from 180 house officers from four teaching dental hospitals (n=45 each). The participants were asked to write a prescription for an adult and a pediatric patient. The prescription was evaluated according to WHO criteria. Analysis was done using SPSS v.20. Data was presented as frequencies and percentages. Among the 180 participants, 42.9% were males and 57.1% were females. 33.9% participants reported prescription writing to be a difficult task. Only 36.7% participants reported to be trained in prescribing pediatric medications. None of the prescriptions completely fulfilled the WHO criteria. Doctor related information (name, address and contact no) was written by only 3.8% of the participants while 10% of the participants mentioned the patient related information (name, address and age). Dosage of the prescribed drugs was the most commonly drug-related missing parameter which was mentioned in 30% of the pediatric prescriptions and 21% of the adult prescriptions. There is a general lack of knowledge among the dental house officers regarding prescription writing as they were found to be unaware of the essential elements of a prescription. The findings call for an urgent change in the undergraduate teaching of prescription writing skills with special emphasis on pediatric drugs and dosage.

Microlearning and online simulation-based virtual consultation training module for the undergraduate medical curriculum – a preliminary evaluation

BackgroundVirtual consultation is a synchronous mode of telemedicine provided remotely via information and communication technology. The projected growth of digitalization in healthcare delivery, however, necessitates medical student training in virtual consultation (VC) to ensure safe and effective patient care. This study describes the implementation and preliminary evaluation of a competency-based VC training module for undergraduate medical students.MethodsA newly developed six-week VC module was implemented online through asynchronous microlearning and synchronous simulation-based experiential learning modalities. Clinical students in years 4 and 5 and fresh graduates, who had not started pre-registration house officer or residency programmes, were invited to participate. Training outcomes using checklist-based video-recorded assessments of VC encounters between medical students and simulated patients were compared. Each video was independently assessed by two facilitators trained in VC teaching and assessment, using a direct observed virtual consultation skills checklist derived from established VC competencies. The participants completed course evaluations electronically as additional outcome measures.ResultsFifty-two clinical phase medical students and alumni completed both the instructional and practical phases of this module. Altogether, 45 (95.7%) students found the module beneficial, and 46 (95.9%) reported increased self-efficacy for conducting VC. In total, 46 (95.9%) students would recommend the course to others. Post-test results showed a significant increase in the students’ abilities to conduct a VC (t-test = 16.33, p < 0.05).ConclusionMicrolearning and simulation-based sessions were effective instructional delivery modalities for undergraduate medical students in their attainment of VC competencies.

Healthcare Workers’ Knowledge and Use of Safe Childbirth Checklist Tool in Tertiary Hospitals in Rivers State

Globally, maternal mortality is an indicator to monitor maternal health services. In 2010, the WHO indicated that maternal deaths in Nigeria contributed to 14% of global maternal deaths. In 2018 Nigeria’s maternal mortality rate was 512 deaths per 100,000 live births. The WHO and other key partners developed the Safe Childbirth Checklist (SCC) as a facility-based tool to serve as reminder to help health workers adhere to evidence-based practices to ensure safety of the mother and baby. SCC has reportedly been adopted for use in other countries like Brazil and Cameroon. The objective of this study was to assess the Doctors and Nurses’ Knowledge and Use of SCC in public tertiary hospitals in Rivers State. Descriptive cross-sectional study was used. Structured questionnaires were self-administered to 207 respondents (35 nurses and 67 doctors at RSUTH, 49 nurses and 56 doctors at UPTH) working in obstetrics and gynaecology department. Chi-square was used to test the hypothesis. Descriptive statistics was used to assess the responses of the respondents. Responses obtained at Teaching Hospital A showed that 80% of the Nurses/Midwives have no knowledge of SCC tool, 100% of the House Officers have not seen the tool; 90% of the Resident Doctors have not also used SCC tool. At Teaching Hospital B, 80% of the Nurses have no knowledge of SCC tool; 20% of the Nurses had seen it earlier. The study showed evidence that SCC tool is not in use in the two tertiary hospitals in Rivers State. Null hypothesis was accepted.