Teaching Hospital In Karachi Research Articles

Experience of Saving Limbs With Free Fibula Osteocutaneous Flaps.

BackgroundComplex wounds of hands and feet have always been a challenge for reconstructive surgeon. We aim to share our experience of reconstruction of such defects using free fibula osteocutaneous flaps.Materials and methodsThis is a retrospective study over a period of six years which was conducted at a tertiary care teaching hospital in Karachi. All patients, who were included and had reconstruction with this flap, agreed to participate in this study. Hospital records were retrieved for patient’s demographic details, mode of injury, size of the defect, number of bone loss in the defect, dimensions of flap, size and number of bony segments in each flap. Outcomes were recorded in terms of flap survival and secondary procedures, with post-operative radiographs.ResultsIn 14 patients, 25 (80.5%) metacarpals and 6 (19.5%) metatarsals defects were reconstructed. K-wires were used for bony stabilization and were removed at 8 weeks post-operatively. Only two flaps were re-explored due to venous congestion. Minor wound dehiscence was noted in two flaps which were managed conservatively.ConclusionProper planning and meticulous flap dissection and inset using free fibula flap can save many hand and foot from amputations

Parental perception on screen time and psychological distress among young children.

Objective:We aimed to assess the parent-reported screen time of children, identify the perceived risk factors for increased screen time and its relationship to psychological distress in children.Materials and Method:A cross sectional study was conducted at a teaching hospital in Karachi, Pakistan. A total of 230 employees from medical and non-medical departments were included. Participants were employees with child/children ages 4-12 year who consented to participate in the study, we included 135 fathers and 91 mothers. The questionnaire included (i) demographic data (ii) Media history exam form and (iii) parent reported strength and difficult questionnaire (SDQ).Result:The average daily screen time reported was 2.5 (1.5-5) hour for boys and 2 (1-4) hour for girls. Preschoolers had greater screen time as compared to school-aged children (Median (IQR): 3 (1.5-5.6) vs 2 (1-4), P = 0.46). The children owned devices with approximately equal distribution of preschoolers and school-aged children (19 (27.1%) and 48 (30%), P = 0.661 respectively). Emotional score was found higher in school-aged group in comparison to preschoolers (p = 0.036). Moreover, mother screen time and number of devices owned by a child were found to be positively associated with child's screen time.Conclusion:We conclude that as we are embracing the digital age providing a tech free zone to children is virtually impossible. Children screen time related activities in our part of the world exceeds the limitation. Parental awareness and co-viewing screen with their children are essential to avoid media related behavior problems.

Knowledge of standard precautions among healthcare professionals at a Teaching Hospital in Karachi, Pakistan.

Background and Aim:Hospital-acquired infections (HAIs) are infections acquired by patients during their hospital stay which they did not have previously. This also includes infections acquired by healthcare professionals while managing infected patients. Since both healthcare professionals and patients can be a source of spreading infections across there is a need of practicing standard precautions religiously, to minimize this risk. This study aimed to assess the knowledge of healthcare professionals working at The Indus Hospital, a tertiary care hospital of Karachi, Pakistan.Material and Methods:This cross-sectional study was conducted between March 2017 and July 2018. 205 employees working at The Indus Hospital, Karachi were recruited in this study. A self-made questionnaire based on CDC guidelines was administered to the participants and their responses were recorded.Results:Among all participants, nearly two-thirds (70%) had a very good knowledge of the use of standard precautions, 19.5% had good knowledge, and 12.2% had average/below average knowledge. Of those having very good knowledge, most of them were doctors (60%). Older age groups had more knowledge than the younger age groups.Conclusion:Our study concluded that among different healthcare workers, the nurses had less knowledge as compared to doctors. There was a significant association found between the age of the healthcare professionals and the information he/she has on the standard precautions. Improving the knowledge of doctors and nurses would help in breaking the chain of nosocomial infections and will decrease the burden of infectious diseases on our society.

Prevalence of Different Hepatobiliary Tree Variants on Magnetic Resonance Cholangiopancreatography in Patients Visiting a Tertiary Care Teaching Hospital in Karachi.

IntroductionHepatobiliary tree variant anatomy is crucial to understand the preoperative planning of hepatobiliary surgeries. Although the presence of variant anatomy is not an absolute contraindication for liver transplantation, inadvertent mapping can lead to postoperative biliary complications. These variants are also important to be recognized in various hepatobiliary surgeries and interventional procedures. Magnetic resonance cholangiopancreatography (MRCP) is an excellent non-invasive imaging tool that can identify biliary anatomy. The purpose of the current study is focused on determining anatomical variants of the biliary tree on MRCP in our population visiting a teaching hospital in Karachi.MethodsThis cross-sectional study was conducted on patients referred to Dr. Ziauddin Hospital for MRCP. MRCP was performed on MAGNETOM Avanto, SIEMENS, Belgium, Germany. Images were analyzed on a workstation by two radiologists and a postgraduate trainee. A senior radiologist reviewed equivocal cases. SPSS 22.0 (SPSS Inc., Chicago, IL) was used for statistical analysis. Chi-square test was used to see the link between anatomical variants of biliary tree and gender. P-value of ≤0.05 was considered as statistically significant.ResultsWe recruited 369 patients undergoing MRCP consecutively for our study. Out of 369, 342 patients were eligible for analysis (139 males and 203 females). Standard anatomy was found to be prevalent in 65.8%. Type 3 was the leading variant. A statistically significant difference was recorded for the type 2 anatomic variant which was more frequent in males than females (p-value <0.001), while types 1, 3, and 4 anatomic variants were found to be more in females than males but this difference was not statistically significant. Few other variants were also recorded.ConclusionThis study is robust evidence regarding biliary variants in Pakistan. It is important to consider these variants in our region, owing to an increased trend of liver transplants and other hepatobiliary procedures.

The Frequency of Neurological Symptoms in COVID-19 Patients at a Tertiary Care Hospital in Pakistan.

IntroductionCoronavirus disease 2019 (COVID-19) primarily affects the pulmonary system and presents itself as shortness of breath, fever, and cough. However, it may affect other systems as well, including the nervous system. This study aimed to determine the frequency of neurological symptoms in COVID-19 patients and its association with the severity of the disease.MethodsThis cross-sectional study was conducted at a public sector tertiary care teaching hospital in Karachi, Pakistan, from April to July 2020. All patients with positive polymerase chain reaction (PCR) tests were included, except those with pre-existing neurological and psychiatric conditions.ResultsThe most common neurological symptom was dizziness (17.5%), followed by headache (15.7%). Three (2.6%) patients had a stroke. Nine (7.8%) participants had a taste impairment, and another nine (7.8%) had a smell impairment. There was no significant difference in the frequency of neurological symptoms when severe and non-severe disease was compared.ConclusionNeurological symptoms are frequent in COVID-19. Care should be taken to identify them early. COVID-19 should be suspected in patients presenting with neurological abnormalities and should be included in the differential diagnosis to prevent further virus transmission.

The Perceptions and Experiences of Health-Care Providers During&amp;nbsp;COVID-19 Pandemic in Karachi, Pakistan: An Exploratory Qualitative Study

Background: The rapidly evolving pandemic has stretched the healthcare system of Pakistan and outpaced the capacity of hospitals to meet demand for vital medical resources. As the numbers are increasing, healthcare providers are playing a central role in tackling this issue in the face of several challenges. This crises situation necessitates investigating frontline healthcare workers experiences of the barriers and enablers to manage Covid-19 cases. Methods: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Key-informant interviews were conducted with senior management and hospital leadership and in-depth interviews were conducted with front line healthcare providers. Study data was analysed manually using the conventional content analysis technique. Findings: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was ‘challenges faced by frontline healthcare providers working in Covid-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to exhaustive donning and doffing process, intense work, and stigmatization. The second theme was ‘enablers supporting healthcare providers to deal with Covid-19 pandemic’. Front-liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate trainings, strong system of information sharing and supportive management. The third theme was ‘recommendations to support healthcare workforce during the Covid-19 crisis’. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-liners, preparing backup health workforce and establishing a platform to address the mental health needs of the frontliners. The study emphasises on the factors that are necessary to improve overall experiences of health-care providers dealing with Covid-19 pandemic. Interpretation: This study provides initial evidence base of healthcare providers’ experiences of managing Covid-19 patients in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in LMICs to ensure a safe working environment for front line workers in their fight against Covid-19. Funding Statement: None. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Ethical approval for this study was obtained from the Aga Khan University Ethical Review Committee (AKUERC) – [2020-3694-9056].

Effectiveness of training on de-escalation of violence and management of aggressive behavior faced by health care providers in a public sector hospital of Karachi.

Background & Objective:Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings.Methods:A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology and obstetrics departments of two teaching hospitals in Karachi. Quantitative assessment was done through structured interviews and qualitative through Focus Group Discussions. Healthcare providers` confidence in coping with patient aggression was also measured using a standard validated tool”.Results:The overall self-perceived mean score of Confidence in Coping with Patient Aggression Instrument “(CCPAI)” scale was significantly higher in intervention group (Mean= 27.49, SD=3.53) as compared to control group (Mean= 23.92, SD=4.52) (p<0.001). No statistically significant difference was observed between intervention and control groups with regard to frequency of violence faced by HCPs post training and major perpetrators of violence..Conclusion:De-escalation of violence training was effective in improving confidence of healthcare providers in coping with patient aggression.

Spiritual Care and its Impact Among Care Givers: Results of Survey from Teaching Hospital in Karachi, Pakistan

Objective: Spiritual needs have been of great importance in care giving both religiously and culturally in our society. The aim of this study was to investigate the importance of spiritual needs of care givers and role of spiritual support in care giving.Methods: A cross sectional study was conducted during July to September, 2015 at a tertiary care teaching hospital in Karachi, Pakistan. Participants 18 years old and above, involved in care giving to a family member were consecutively recruited. A pre-tested questionnaire was used to assess information and SPSS was used for data analysis.Results: A total of 400 participants were recruited. About 54% of the participants were males. Most of the participants (80%) feel that care giving gets easy with spiritual support.Conclusion: Spiritual care has favorable impact on psychological and spiritual well being of care givers. Physicians need to be aware of the value held for religious beliefs and spiritual implementation by patients and their care givers

Knowledge, behavior and attitudes of dental practitioners towards photodynamic therapy use in dental practice

BackgroundThe aim of the present study was to assess knowledge, behavior and attitudes of dental practitioners (DPs) towards photodynamic therapy (PDT) in dental clinical practice. MethodsA cross-sectional study was performed and a 13-item survey questionnaire was given to DPs practicing in 13 different teaching hospitals in Karachi, Pakistan. Questions were aimed at exploring the knowledge of DPs regarding PDT and their attitude towards PDT and perceptions that may influence clinical practices. Chi-square and spearman coefficient were conducted to compare subgroups and correlate factors with the knowledge score of DPs. ResultsA total of 509 questionnaires were completed (response rate=82%). Median age of participants was 34 years and 70% were females. Most DPs demonstrated good knowledge related to PDT, and nearly 77%, 69% and 62% were aware of the mechanism of action and the role of photosensitizers in PDT respectively. It was reported that 74% of the respondents expressed that they are comfortable to know about PDT in detail for their clinical practice. A cumulative 54% disagreed that discussing the option for PDT with their patients was peripheral to their role as clinicians. A striking 82% would like to attend seminars and workshops on PDT. Significant difference was found among senior lecturers and assistant professors for the knowledge items (p <0.05). No statistical correlation was found between the knowledge items score of DPs and their behavior (r=0.18; p=0.762), attitude (r=0.04; p=0.594) and self-rated knowledge (r=0.42; p=0.854). ConclusionDental practitioners showed adequate knowledge regarding PDT and its use in dentistry. However, expertise with regards to handling and training is warranted so that DPs could use PDT in their dental practice.

Impact of Caregiving on Various Aspects of the Lives of Caregivers.

ObjectiveThis study was designed to assess the impact of caregiving on the lives of the caregivers.MethodsA cross-sectional study was conducted between July and September 2015 at a teaching hospital in Karachi, Pakistan. Participants who were more than 18 years old and were involved in caregiving (former or current) of a family member were invited to participate in the study. The participants were recruited through consecutive sampling technique. A total of 400 caregivers were interviewed. Written informed consent was obtained from all the participants. A pretest structured questionnaire was used for data collection and included sections on demographic details and impact of caregiving on various aspects of the lives of caregivers. The data was analyzed using SPSS version 19 (IBM, NY, USA).ResultsInformation about a total of 400 caregivers (215 men and 185 women) was included in the final analysis. The majority (57.0%) of the participants were aged between 18 and 30 years. About three-fifths (60%) of the participants were single and the majority of the participants were students. Approximately 64% of the participants were currently involved in caregiving and about 48% of the participants responded that caregiving has an overall negative impact on various aspects, such as physical (40.8%), psychological (47.8%), and professional aspects (51.8%) of their lives.ConclusionNegative impact of caregiving was observed among caregivers due to extensive demands of caregiving and limited resources. Therefore, it is imperative for health care providers to explore, identify and support caregivers to cope in a better way to the challenging task of caregiving.

Determinants of Job Satisfaction among Dentists Working in Teaching Hospitals in Karachi, Hyderabad and Islamabad

Background: The scarcity of healthcare professionals is one of the burning issues in almost every part of the world. Each health care personnel are crucial for the healthcare system and its insufficiency produce troubles for the working of the system. This dearth’s construct an unfavorable environment for others to retain in an organization. Job satisfaction is one of the leading concerns for all mangers around the world. Job satisfaction among professionals would actually have impact on their work. Objective: To evaluate the determinants of job satisfaction among Dentists in teaching hospitals in few cities of Pakistan. Method: A quantitative approach was used by using probability sampling. A self-administered questionnaire was distributed at five teaching hospitals of Karachi and two teachings hospitals outside Karachi. A sample size of hundred respondents were identified and selected for this study. Study questionnaire consists of two sections. Section A comprised the socio-demographic characteristics consisting of seven items; while Section B was on evaluation of job satisfaction consists of 15 questions. Data were then confining in Statistical Package for Social Sciences SPSS 21 for the purpose of analysis. Results: The study found that Dentist were more satisfied with their job advantages, sufficient job opportunities, work mentally stimulating, status in the community and entrusted with responsibility. Majority of the sample (71%) were agreed to the point that they are satisfied with their job. Results also suggest that there is no association between socio-demographic variables and job satisfaction. Conclusion: Dissatisfaction with one’s job cannot affect only motivation at work but also career decisions, personal growth and level of cooperation. Given the pivotal role that healthcare professionals play in determining the effectiveness, efficiency and sustainability of health care systems, it is imperative to understand what motivates them and the extent to which contextual variables and the organization satisfy them.

Attitude and knowledge of family medicine practitioners towards the association between periodontal disease and obesity.

To assess the attitude and knowledge of family medicine practitioners (FMPs) towards the association between periodontal disease and obesity. A cross-sectional study was performed and a 13-item survey questionnaire was given to FMPs practicing in 12 different teaching hospitals in Karachi, Pakistan. The questions were aimed at exploring the knowledge of FMP's regarding the association of obesity and periodontal disease and their attitude towards the association of obesity and periodontal disease. Chi-square and Spearman co-efficient were conducted to compare subgroups and correlate factors with the knowledge score of FMPs. A total of 314 questionnaires were completed (response rate = 92%). Median age of participants was 41 years and 57% were females. Almost 61% of FMPs answered all the knowledge questions correctly and 64% reported moderate understanding of the association between periodontal health and obesity. Nearly 73% FMPs inquired from obese patients regarding the periodontal disease and more than half (58%) refer patients to a dentist for evaluation. More than half of FMPs perform periodontal disease screening. Nearly all FMPs considered informing obese patients regarding periodontal disease as one of their roles. FMP's play an important role in the early diagnosis, prevention and treatment of periodontal conditions in obese patients. More than two thirds of FMPs showed good knowledge of the association of obesity and periodontal disease. The attitudes of FMPs towards assessing and referring obese patients at a risk of having periodontal disease were reassuring.

Impact of Cable Television on Lives of Patients Visiting a Teaching Hospital in Karachi, Pakistan

A cross-sectional survey was conducted during August 2014 to October 2014, to identify the impact of cable television channels on lives of the people, in Karachi, Pakistan. Three hundred participants were selected through convenience sampling and a pre-tested structured questionnaire was used for data collection. Data was analyzed in SPSS version 19.0. About 15% of participants were more than 40 years. About 62% were females in the study sample. Regression analysis showed that viewing television at night impacts work performance (OR: 1.39; 95% CI: 0.81-2.37), sleep (OR: 1.07; 95% CI: 0.63-1.81), family life (OR: 1.52; 95% CI: 0.89-2.60) and social life (OR: 1.38; 95% CI: 0.78-2.42). To minimize the adverse impact of the cable television it is imperative to monitor and control individual screen time, to avoid its adverse impact work performance, sleep, social life and overall health.

Occupational Stress among Nurses of Tertiary Care Hospitals in Karachi, Pakistan

Objectives: Stress is physiological and psychological response towards any occurrences. It is very much vital to learn about occupational stress because as it deters health and decreases the quality of work of nurses. The main objective was to determine prevalence, intensity and causes of occupational stress among nurses. Materials & Methods: Hospital-based analytical cross-sectional study was conducted from January to November 2015 at two tertiary care teaching hospitals of Karachi. The study was carried out on 265 registered nurses, having valid license by Pakistan Nursing Council. Convenient nonprobability method was used to access subjects. After taking consent, semi-structured and pre-tested occupational stress questionnaire was used to obtain the data. Data was entered and analyzed in SPSS version 21. Results: The study results revealed that majority of nurses 125 (47.2%) were between 25 to 30 years of age. Maximum ratio of nurses were female 160(60.4%) and out of them 148(55.8%) were married. Two hundred and one (75.8%) were diploma holders in nursing, while only 2(0.8%) had done their master in nursing. The study participants reported to suffer with job-related stress; mild stress 2.0%, moderate stress 36.5% and severe 61.5%. Conclusion: The current research paper gave an awareness of problem-related to occupational stress among Nurses at tertiary care hospitals. The study outcomes established conclusively that an overwhelming portion of nurses population, setting their demographic characteristic aside faced moderate or severe job stress that may cause damaging effect on their professional, interpersonal skills, and social accountabilities.

Guilt and Its Impact among Care Givers : Results of Survey from Teaching Hospital in Karachi , Pakistan

Guilt and Its Impact among Care Givers : Results of Survey from Teaching Hospital in Karachi , Pakistan

Psychosocial Risk Factors for Acute Myocardial Infarction: Results of a Case-Control Study in a Teaching Hospital at Karachi, Pakistan

Objective: To determine psychosocial risk factors for acute myocardial infarction at a teaching hospital in Karachi. Methods: One hundred and fifty three cases were recruited from cardiology clinics and 153 controls from internal medicine and family medicine clinics of Aga Khan University Hospital, Karachi, through non-probability sampling using a structured questionnaire. Cases were those who were diagnosed with acute myocardial infarction for the first time in past month. Controls were selected from family medicine and internal medicine clinics of the same hospital and included patients above the age of 40 years without acute myocardial infarction. Associations between psychosocial risk factors and acute myocardial infarction were investigated using multiple logistic regressions. Results: The psychosocial risk factors associated with acute myocardial infarction were irritability at home (OR: 4.86, 95% CI: 3.24-7.53), self-illness (OR: 3.33, 95% CI: 2.86-5.23), illness in family (OR: 8.44, 95% CI: 6.21-10.1), loss of job (OR: 3.71, 95% CI: 1.16-8.86) and death in family (OR: 7.42, 95% CI: 3.98-10.12) in fully adjusted models. Conclusions: Psychosocial risk factors are associated with acute myocardial infarction. Therefore, regular screening for these risk factors should be undertaken by physicians to identify high risk patients.

Factors associated with intimate partner violence against women in a mega city of South-Asia: multi-centre cross-sectional study.

OBJECTIVES. To assess the proportion of women subjected to intimate partner violence and the associated factors, and to identify the attitudes of women towards the use of violence by their husbands. DESIGN. Cross-sectional study. SETTING. Family practice clinics at a teaching hospital in Karachi, Pakistan. PARTICIPANTS. A total of 520 women aged between 16 and 60 years were consecutively approached to participate in the study and interviewed by trained data collectors. Overall, 401 completed questionnaires were available for analysis. Multivariate logistic regression analysis was used to identify the association of various factors of interest. RESULTS. In all, 35% of the women reported being physically abused by their husbands in the last 12 months. Multivariate analysis showed that experiences of violence were independently associated with women's illiteracy (adjusted odds ratio=5.9; 95% confidence interval, 1.8-19.6), husband's illiteracy (3.9; 1.4-10.7), smoking habit of husbands (3.3; 1.9-5.8), and substance use (3.1; 1.7-5.7). CONCLUSION. It is imperative that intimate partner violence be considered a major public health concern. It can be prevented through comprehensive, multifaceted, and integrated approaches. The role of education is greatly emphasised in changing the perspectives of individuals and societies against intimate partner violence.

Knowledge Attitudes and Practices of Shisha Smoking Among Medical Practitioners in Karachi, Pakistan

Background: It is well established that tobacco use in the form of shisha has adverse effects similar to cigarette smoking. Medical-practitioners can play an important role in spreading awareness regarding health hazards associated with shisha smoking. Misconception about shisha is an important factor responsible for its increasing use, the need to evaluate medical practitioner's knowledge about shisha is an important step in controlling the growing epidemic.Objectives:To investigate the knowledge, attitudes and practices of shisha smoking among different designations of medical practitioners in Karachi.Methodology:A self-administered questionnaire was distributed to interns, postgraduate-trainees, medical-officers and consultants in various teaching hospitals of Karachi, Pakistan.Results:A total of 343 medical practitioners participated in the study including 38.2% interns, 43.1% postgraduate trainees, 12% medical-officers and 6.7% consultants. Of the total study population 29.5% of the medical practitioners admitted using shisha at some point in their life. Significant results were obtained when knowledge of medical practioners regarding shisha containing tobacco and its harmful effects on health were judged with p-values of 0.001 and &lt;0.003 respectively. Knowledge regarding hazards of passive shisha exposure was found to be varying with 25.2% interns, 40.5% postgraduates, 34.1% medical-officers and 69.6% consultants being aware of association of neonatal deaths with passive shisha exposure (p-value &lt;0.001) while 51.9% house physicians, 64.2% postgraduates, 53.7% medical officers and 87% consultants believed that shisha exposure during pregnancy can lead to Sudden Infant Death Syndrome (p value 0.001).Conclusions:There is a lack of knowledge among medical practitioners, especially house physicians, regarding contents used in shisha and its hazards.

Patients’ receptiveness for Medical students during consultation in out patient department of a teaching hospital

Patients' attitude towards medical students' presence during treatment depends on the cultural values of the society. This study was conducted to find out the patients' receptiveness in our society to be involved in teaching process for medical students during consultation in out patient department of a teaching hospital in Karachi Pakistan. This cross sectional study was conducted in the surgical Out Patient Department (OPD) at Dow University Hospital from May 2012 to June 2012. Four hundred and eleven patients consented for participation through non probability purposive sampling, in which 279 patients were from morning clinics in the presence of students for clinical teaching, while 132 patients participated through evening clinics of surgery, when students were not present for comparison in specific dimensions of care for patients' satisfaction. Majority of patients 293 (71%) agreed with the teaching of students during consultation and they feel they are contributing in future doctor's teaching, only 24% patients disagreed. Fifty two percent of patients who disagreed reported interference in privacy, 34% reported interference in consultation and 43% felt it resulted in prolong waiting time due to teaching. Majority of the patients agree to be part of teaching for medical students and this study can be used to assess the educational interventions designed to improve the patient based teaching.

Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards

BackgroundIn an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan.MethodsA survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants.ResultsThe overall response rate was 78.51% (95/121). All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76%) agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%). Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%). The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and problem-based learning sessions were less favored by radiologists than by residents. Teaching via radiology films (86%) was the most frequent mode of instruction. Salary (59%) was the most commonly cited teaching reward. The majority of respondents (88%) were not satisfied with their current level of teaching rewards.ConclusionAll radiologists and residents working in an academic radiology department are involved in teaching undergraduate students at multiple levels. The most valued teaching methodology involves use of images, with one-on-one interaction between the trainer and trainee. The monetary reward for teaching is inbuilt into the salary. The methodology adopted for teaching purposes was significantly different between respondents from private hospitals and those from public teaching hospitals. Because of low satisfaction among the respondents, efforts should be made to provide satisfying teaching rewards.