Prevalence and Predictor of Impostor Phenomenon Among Medical Students at Jouf University, Saudi Arabia

BACKGROUND AND AIM

The impostor phenomenon (IP) was defined in 1978 as an "internal feeling of intellectual phoniness felt by people with outstanding academic and professional achievements." This study aims to estimate the prevalence and predictors of IP among medical students.

METHODS

A cross-sectional study was conducted from November 2022 to May 2023. A total of 200 medical students from years one to five participated in the survey; the response rate was 82.5% (165). A stratified random sampling technique was used to select groups of male and female Jouf University medical students from the 1st, 2nd, 3rd, 4th, and 5th batches of the 2022 to 2023 academic year. An e-mail with a self-administered questionnaire comprising the Clance IP scale and a consent form was sent to all participants. The identities of the students were kept anonymous to eliminate response bias. Participation was voluntary. Data were presented in terms of numbers and percentages; a chi-square test was used to compare categorical variables; and multivariable analysis was used to determine predictors of IP using SPSS Statistics version 20 (IBM Corp., Armonk, NY, USA).

RESULTS

A total of 165 students responded to the questionnaire, with a response rate of 82.531%; 47.30% were males, and 86 (52.10%) were females. The findings indicate that 12 (7.3%), 83 (50.30%), 59 (35.80%), and 11 (6.70%) medical students, respectively, suffered from few, moderate, frequent, and intense imposter features. Results also showed that 13 (56.50%) first-year students suffered from moderate IP experiences, and 10 (43.50%) had frequent IP experiences. It was observed that for students in the first year, the academic performance represented by a student's grade point average (GPA), monthly family income, father's educational level, mother's educational level, and marital status are predictors of impostor experience.

CONCLUSION

The study's findings show that impostor syndrome is a common problem among medical students and that being in the first year of medical school can increase the incidence of suffering from it. The problem-based learning system in medical school can contribute to impostor syndrome among medical students. Both low-achieving and high-achieving students suffer from impostorism.

Assessment of the Perception and Worries of Saudi Healthcare Providers About the Application of Artificial Intelligence in Saudi Health Facilities

Objective This study is aimed at assessing the perception and worries of Saudi healthcare providers about the application of artificial intelligence (AI) in Saudi healthcare facilities. Methods The study adopted a cross-sectional study involving 1026 Saudi healthcare providers between January 2023 and April 2023. The target population was healthcare providers across Saudi health facilities. Online questionnaires were administered through social media platforms. Data were analyzed using SPSS Statistics, version 26.0 (IBM Corp., Armonk, NY) to obtain important insights. Results The results of this study indicated that more than half (55.2%) of the respondents had good knowledge of AI, with (48.1%) of them being familiar with the application of AI in their specialty. A good proportion of the participants (57.9%) knew at least one term about the difference between machine learning and deep learning. More than half (69.9%) of the participants indicated that they had at one point in time used speech recognition or transcription application in their work. A large section (73.3%) of healthcare providers believed that AI would replace them at their job. A vast majority (84.9%) of the participants agreed that collaboration between medical schools with engineering and computer science faculties could be a game changer to provide a road for incorporating AI into medical curricula. The mean perception of AI in this study was 37.6 (SD=8.41; range 0-241). Age, level of health, health profession, and working experience all significantly impacted the positive perception score (p=0.021; p=0.031; p=0.041; p=0.026). However, there was no significant association between gender, nationality, and Saudi regions with a mean positive perception score. Conclusion There was a positive perception of AI among Saudi healthcare providers. Even though a substantial majority of Saudi healthcare providers were worried that AI would replace their jobs, the study revealed that AI serves as a crucial practitioner's tool rather than a physician's replacement.

Study of Gene Expression of Programmed Cell Death Ligand 1 (PD-L1) in Breast Cancer Patients

Introduction:

Breast cancer is the most frequently occurring cancer among females and the second most common cancer overall. Programmed Cell Death Ligand 1 (PD-L1) plays an important role in blocking ‘cancer-immunity cycle’ and is considered as a major inhibitory pathway. The aim of the present study was to clarify the alterations of expression of PD-L1 in peripheral blood mononuclear cytes (PBMCs) of female breast cancer patients and analyze its association with clinico-pathological criteria as well as therapeutic response.

Materials and Methods:

The study was conducted on 45 female breast cancer patients and 45 female controls. Blood samples were collected followed by PBMCs isolation, total RNA extraction, reverse transcription and finally, quantitative polymerase chain reaction (qPCR) using SYBR Green DNA binding dye. Expression levels of PD-L1 were calculated and then compared with clinicopathological parameters of the patients in addition to initial therapeutic response.

Results:

A significant difference was detected for PD-L1 expression levels in breast cancer patients compared to controls. A significant association with age, metastatic breast cancer, estrogen receptor (ER) negative status as well as high concentrations of cancer antigen 15-3 (CA15-3) was detected. On the other hand, no significant association was recognized with tumor size, lymph nodal status, histopathological type, grade, progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER-2) status, triple negative, among de novo and recurrent metastatic patients and for the number of metastatic sites as well as the therapeutic response.

Conclusions:

This study paves the way of the use of PD-L1 as a noninvasive prognostic and diagnostic biomarker for poor prognosis of breast cancer.

Effect of standard and high dose ranitidine on [13C]urea breath test results

OBJECTIVE

It has been suggested that standard dose H2 blockers will affect the [14-C]urea breath test. The aim of this study was to evaluate the effect of standard and high dose ranitidine on the [13C]urea breath test in a prospective cross-over study.

METHODS

Volunteers found to be positive for H. pylori by IgG serology and [13C]urea breath test were given either ranitidine 150 mg b.i.d. or 300 mg b.i.d. for 14 days. Repeat breath tests were completed on the last day of antisecretory dosing and study patients were immediately crossed over to the other ranitidine dose. The third breath test was performed at 14 days after initiation of the new dose.

RESULTS

A total of 20 volunteers were enrolled. Using the established cut-off of 2.4% for the commercial breath test, only one patient developed negative results on H2 blockers. This patient had negative breath tests on both ranitidine doses and remained test-negative off all medications 6 wk after study completion, suggesting either a false positive baseline test or an unexpected bacterial eradication. No specific trend in breath test results was observed for the group (p=NS). On ranitidine 300 mg, six of 19 patients elevated their breath results from 23% to 112% (mean 76%) above baseline.

CONCLUSION

Ranitidine at standard or high doses did not generate a reproducible decline in breath test results. Histamine 2 blockers do not need to be discontinued before urea breath testing.