The Relation Between Theoretical and Practical Exams for Health Sciences Students at King Saud Bin Abdulaziz University for Health Sciences- Jeddah

Introduction

A comprehensive approach to assessment is essential to ensure that all students' learning competencies are measured accurately. Therefore, multiple methods of assessment have been developed to address this matter. This Study aims to assess the correlation between health sciences students' performance on theoretical and practical exams.

Methods

A correlational study design was conducted. The academic performance of 352 students across theoretical/practical courses was tested. SPSS version 29.0 was used for analysis. Spearman's rho correlation (Rs), Wilcoxon, and Mann Whitney were computed at p<0.05.

Results

The theoretical performance was strongly correlated with the practical performance of all programs pooled together (Rs (352) = 0.67, p<0.001). Also, there was a strong correlation between theoretical and practical performance for male students (Rs (181) = 0.72, p<0.001), while a moderate correlation for female students (Rs (171) = 0.53, p<0.001). Mann-Whitney test revealed significant mean performance difference by gender both at theoretical (U = 9284, p<0.0001) and practical (U = 11,373, p < 0.0001) levels.

Conclusion

There were significant correlations between theoretical knowledge and practical skills across the selected four programs.; The mean student's performance was better in the practical skills than in the theoretical knowledge assessment, and female students surpassed male students in both practical and theoretical assessments in the four programs offered to both genders.

Overconfidence, Time-on-Task, and Medical Errors: Is There a Relationship?

Background

Literature suggest that physicians' high level of confidence has a negative impact on medical decisions, and this may lead to medical errors. Experimental research is lacking; however, this study investigated the effects of high confidence on diagnostic accuracy.

Methods

Forty internal medicine residents from different hospitals in Saudi Arabia were divided randomly into two groups: A high-confidence group as an experimental and a low-confidence group acting as a control. Both groups solved each of eight written complex clinical vignettes. Before diagnosing these cases, the high-confidence group was led to believe that the task was easy, while the low-confidence group was presented with information from which it could deduce that the diagnostic task was difficult. Level of confidence, response time, and diagnostic accuracy were recorded.

Results

The participants in the high-confidence group had a significantly higher confidence level than those in the control group: 0.75 compared to 0.61 (maximum 1.00). However, neither time on task nor diagnostic accuracy significantly differed between the two groups.

Conclusion

In the literature, high confidence as one of common cognitive biases has a strong association with medical error. Even though the high-confidence group spent somewhat less time on the cases, suggesting potential premature decision-making, we failed to find differences in diagnostic accuracy. It is suggested that overconfidence should be studied as a personality trait rather than as a malleable characteristic.

Family Medicine Resident Experience Toward Workplace-Based Assessment Form in Improving Clinical Teaching: An Exploratory Qualitative Study

Background

Workplace-Based Assessment (WPBA) has been widely utilized for assessing performance in training sites for both formative and summative purposes. Currently, with the recently updated duration of the family medicine (FM) training program in Saudi Arabia from four years to three years, the possible impact of such a change on assessment would need to be investigated. This objective was to explore the experiences of FM residents regarding the usage of WPBA as an assessment tool for improving clinical teaching at King Abdulaziz Hospital (KAH), Al Ahsa, Saudi Arabia.

Methods

The study involves an exploratory qualitative phenomenological approach targeting family medicine resident in KAH was used. Purposive sampling techniques were used. In this descriptive study, data was collected through the utilization of 1:1 semi-structured interviews guided by directive prompts. All recorded interviews were transcribed verbatim. An inductive analytical approach was applied for thematic analysis of transcripts.

Results

Fifteen participants were individually interviewed until data saturation was reached. The themes that emerged were organized into the categories of underlying principles of WPBA, the impact of the learning environment, associated opportunities and challenges, and making WPBA more effective. Participants expressed that the orientation provided by the program was insufficient, although the core principles were clear to them. They valued the senior peers' support and encouragement for the creation of a positive learning environment. However, time limit, workload, and a lack of optimum ideal implementation reduced the educational value and effectiveness of WPBA among senior residents.

Conclusion

The study examined residents' experiences with WPBA and concluded that low levels of satisfaction were attributed to implementation-related problems. Improvements should be made primarily in two areas: better use of available resources and more systematic prior planning. Revision and assignment of the selection process were suggested, in addition to the implementation of the new curriculum. The research will assist stakeholders in selecting and carrying out evaluation techniques that will enhance residents' abilities.

The Use of Vaping Among Male Health Sciences Students Compared to Other Male Students in Riyadh

Background Vaping has become widely used by teenagers due to its accessibility, variety of flavors, peer influence, and the thought that it is a less harmful alternative to tobacco smoking. This study aimed to compare the prevalence of vaping among health sciences students compared to other college students in Riyadh and identify reasons for its usage. Methods A cross-sectional study was conducted in three major universities of Riyadh: King Saud bin Abdulaziz University, King Saud bin Abdulaziz University for Health Sciences, and Al-Imam Mohammad Ibn Saud Islamic University. A self-administered online questionnaire related to the use of e-cigarettes and conventional cigarettes was utilized. It included questions about the use of conventional cigarettes and e-cigarettes and the reasons for using them. Responses were compared between health sciences and non-health sciences students in Riyadh. Results An electronic survey was distributed online, and 442 students responded, but two of them did not agree to participate, so they were removed from the sample. Out of 440 students, 312 (71%) were health sciences students, and 128 (29%) were non-health sciences students. Smoking conventional cigarettes was found among 38 (12%) health sciences students, and 22 (17%) non-health college students smoked conventional cigarettes (p=0.16). Regarding vaping, 117 (38%) health sciences students smoked e-cigarettes. On the other hand, 47 (39%) non-health college students smoked e-cigarettes (p=0.99). Anxiety/stress relief (54%) and peer influence (46%) were the most common reasons for those who smoked conventional cigarettes. Regarding the most common reasons behind using e-cigarettes, the majority (55%) considered e-cigarettes less harmful than conventional cigarettes. The second most common reason was having no distinctive odor (36%). Conclusion The study found that there was a high prevalence of the self-reported use of e-cigarettes. It appears that the use of conventional cigarette smoking is not as common as e-cigarettes among university students. This study found that university students tend to use e-cigarettes more than conventional cigarettes due to the belief that e-cigarettes are less harmful than conventional cigarettes.

Enhancing Medical Students' Confidence and Knowledge in Antibiotic Prescription and Administration through Virtual Education: A Quasi-Experimental Study

BACKGROUND

Antibiotic resistance is a worldwide health concern that necessitates antibiotic stewardship. Medical students significantly impact future healthcare practices; thus, their trust in antibiotic prescription and administration is crucial. This research aims to assess medical students' levels of confidence and knowledge in these areas before and after exposure to virtual antibiotic stewardship education.

METHODS

A one-group pretest-posttest design was conducted with medical students from King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. Participants were enrolled in the WHO-online antibiotic stewardship course.

RESULTS

The group's baseline confidence and background knowledge were reported to be lower than what was offered after introducing the virtual course. The McNemar-Bowker test showed a significant difference in students' confidence in pre-course and post-course scores (Z = 20, p < 0.002); the matched paired t-test revealed a significant difference in students' knowledge scores (M = 7.66 verses M = 5.36, Z = 3.54, p = 0.001). In the sample, 70% of the students were unfamiliar with antibiotic stewardship; thus, the analysis revealed a significant difference in their familiarity before and after enrolling in the online course (30 vs. 100, p < 0.001).

CONCLUSION

Medical students experience low confidence in the safe practice of the antibiotic stewardship program. The WHO-online antibiotic stewardship course is considered a valuable resource that can be used in a formative medical curriculum. Thus, educators and the academic curriculum must promote practical strategies to minimize antibiotic stewardship literacy and increase antibiotic prescribing and administration quality. Introducing antibiotic stewardship across the medical curriculum and establishing educational courses are some strategies that can be undertaken to ensure that future doctors are well-educated in the principles and practices of the appropriate use of antibiotic stewardship.

Evaluating Gaps in Otolaryngology Training: An In-Depth Needs Assessment in Saudi Arabia

BACKGROUND

The landscape of otolaryngology training in Saudi Arabia is undergoing transformation due to the expansion of medical colleges and increased overseas medical scholarships. However, concerns persist regarding the satisfaction and adequacy of surgical education. This study aims to assess gaps in otolaryngology training through an in-depth needs assessment.

METHODS

A cross-sectional study was conducted among 85 otolaryngology-head and neck surgery residency graduates in Saudi Arabia between 2019 and 2021. Participants completed a validated questionnaire assessing deficiencies, importance, and competence in different subspecialty areas. Data were analyzed using descriptive statistics, median comparisons, and Kruskal-Wallis tests.

RESULTS

Participants identified deficiencies in training across domains, with significant variations in specific subspecialties among different regions. Dissatisfaction with clinical discussions, research training, access to simulation labs, and training in emerging subspecialties was evident.

CONCLUSION

The study highlights challenges within otolaryngology training, emphasizing the need for continuous evaluation and adaptation to ensure high-quality and comprehensive training. Addressing these gaps is essential to produce well-rounded otolaryngologists capable of meeting the evolving demands of modern healthcare.

Experience of emergency medicine residents toward an implemented modified teaching approach

Lecturing has always been one of the traditional instructional methods in medical education. It is cost-effective, especially when it comes to conveying a large amount of information to many students at once. However, disadvantages are plenteous, one of which is its passive way of knowledge delivery and learning. Active learning, on the contrary, has better students' engagement and longer retention, and it results in better students' achievement. The emergency medicine residency training program at KAMC-Jeddah has modified the educational activity to become more aligned with the end-of-year assessment in the form of active learning. This study aimed to explore the experience of the residents regarding the implementation of the new educational approach. An exploratory-qualitative study utilizing constructive grounded theory was conducted, collecting our data through an in-depth 1:1 interview using semi-structured open-ended questions. Purposeful sampling was used, and saturation was reached after interviewing 24 residents. The general perception of residents toward the new teaching modes slightly varied, highlighting the positivity of the new educational environment, the desired impact on their learning, the challenges they encountered, and finally their high satisfaction level and support for this new experience. It was asserted that such experience could be permanently implemented to increase the efficacy of teaching and learning.

Developing Leadership Among Dental Residents: An Exploratory Study

INTRODUCTION

Today's healthcare requires leaders to lead and improve the healthcare sector. CanMEDS framework is the one defining the competencies required for all Saudi residency programs, including dental specialty. Senior residents should demonstrate readiness to transition to practice as a leader. It is imperative to understand the notion of medical education and its influence on the training of future dentists. The major significance of this study is exploring the current leadership development and the integrated training into the Saudi Board Dental Residency Program that has not been systematically studied.

METHODS

This was a qualitative study employing the phenomenological approach. The theoretical saturation point determined the sample size using a purposeful sampling technique. Semi-structured interviews were used for data collection using a semi-structured interview guide. A descript platform was used for the recordings' transcription. Ongoing thematic data analysis was done using Nvivo computer software by QSR International. Themes were generated, and the data were interpreted within supported with the most relevant quotations.

RESULTS

Sixteen senior residents were required to serve the study purpose. Three themes emerged: awareness of leadership, educational experience, and factors that impacted leadership development. Awareness of residents about the leader's role was limited. Residents developed leadership under the training program with inconsistency and lack of structure. Summative reports were received as part of the assessment, whereas no integral protocol for formative feedback. Specialties, training centers, and coaching were identified as factors that impacted leadership development.

CONCLUSION

This study highlighted leadership development during the residency period. The residents struggled and varied in developing leadership skills relying on their educational experience and learning environment. Residency programs may verify equivalent "leader role" education for all specialties and training centers in residency training in Saudi Arabia. Dovetailing leadership coaching with daily teaching workflow and implementing faculty development initiatives to allow for appropriate feedback and assessment of these skills are advised.

Exploring the Attitudes and Perceptions of Master of Medical Education Graduates Towards Research Publication in Saudi Arabia

INTRODUCTION

Evidence is lacking to identify what encourages students to conduct research and publish. This study aimed to understand the barriers and facilitators of research and publications from Master of Medical Education student research projects as 15-20% have published their research while 75-80% did not.

METHODS

This study used qualitative in-depth interviews with 17 graduates from the previous 13 batches of the Master of Medical Education program, Saudi Arabia. In-depth interviews were conducted with participants by face to face and Zoom, using a semi-structured interview guide. The interviews were conducted in English, and the recordings were transcribed verbatim. Next, the interview text was read multiple times to familiarize with the data for thematic analysis, where the text was coded inductively. Themes were generated by identifying patterns in the data and merging similar codes. The data were interpreted within the themes and supported with the most relevant quotations.

RESULTS

We identified four distinct but interrelated themes and the first theme, the importance and advantages of conducting research and its publication, explains the participants need to conduct research and publish it to survive and progress in the academic environment. In the second theme, positive experiences of conducting research and its publication, we identify what participants' positive experiences of the research process entail. In the third theme, challenges to conducting research and its publication, we explore the participants' opinions on the barriers to their efforts to undertake and publish their research. In the last theme, facilitators for conducting research and its publication, we summarize various facilitating factors that participants described as necessary to complete the research process successfully to peer-reviewed publication.

CONCLUSION

Masters' student researchers, especially those with demanding projects, need to be supported by providing them with critical supervision, an enabling environment, technical support, and guidance at each step of the research process.

Factors and Determinants of Choosing Pathology as a Future Career: Results From a Multi-Institution Study

Background Globally, less than 10% of graduating medical students select pathology as a future career. Many factors were reported from different settings to influence the choice of pathology. The aim of this study was to investigate the factors that determine medical students' preferences in choosing pathology as a future career. Methods This cross-sectional study surveyed students from three governmental medical schools in Riyadh, Saudi Arabia. A self-administered questionnaire that contained demographic questions and items that addressed perceived factors that affect the choice of pathology was distributed to medical students. Collected data were analyzed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). A chi-square test was used to determine the association between independent variables and interest in pathology. Results Out of the 400 questionnaires distributed, 338 students completed the survey with a response rate of 84.5%. Overall, surgery (24%) and internal medicine (20%) were the most favored, specialties with only 5% of the students selecting pathology as their first choice. Patient-doctor interaction (72.2%) was perceived as the most important factor in not choosing pathology as a future career. Taking an elective course, younger age groups, and year in medical school were all significantly associated (p<0.001) with an interest in pathology. Conclusion In this study, most of the students indicated surgery and internal medicine as their first specialty choices. Only 5% of the students chose pathology as their first choice. Two-thirds of medical students perceived pathologists do not interact with patients. A significant association was found between younger age groups, enrolling for a pathology course, and having an interest in pathology.

Quality Improvement and Patient Safety Education in Internal Medicine Residency Training Program: An Exploratory Qualitative Study

BACKGROUND

Quality improvement and patient safety (QIPS) are a global health priority. Accordingly, QIPS education in medical education became mandatory. Despite that, information about QIPS education in postgraduate training in Saudi Arabia is limited. This study aimed to explore the educational aspects of QIPS in the internal medicine residency training program at King Abdulaziz Hospital in Al Ahsa, Saudi Arabia.

METHODS

This was a qualitative study employing the constructivist grounded theory approach. The sample size was determined using the theoretical saturation point, and we utilized a purposeful sampling technique. A semi-structured interview was used for data collection and was conducted between September 6 and October 20, 2020.

RESULTS

Twenty-two internal medicine trainee residents were required to serve the study purpose. The emerged themes were organized under awareness, education, barriers and opportunities and improvement priorities. Awareness of participants about the QIPS concept, importance, and value of education was found. The participants did not recognize specific dedicated QIPS education components under the structured training program. However, they recognized participation in patient safety-oriented activities but not in quality improvement activities. Consultants' observations and written exams were perceived as the assessment tools. Barriers including time limitation and opportunities including participation in quality improvement projects were identified. Participants suggested making QIPS education mandatory under the training program as an improvement priority.

CONCLUSION

This study highlighted the awareness of internal medicine residents of the QIPS concept, importance, and value of QIPS education. However, we found crucial gaps related to education including lack of a dedicated QIPS component under the training program. There is a need for multicenter studies to measure the magnitude of our findings for improvement of QIPS education in residency training in Saudi Arabia. This is the first study about QIPS education in residency training in Saudi Arabia up to our best knowledge.

Level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services

Background

Many studies are available in the literature about e-health in Saudi Arabia, however, data is limited to a few organizations and does not necessarily reflect the current and potential use of e-health for health care organizations in the country. This study aimed to determine the level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services and significant predictors of their practice.

Methods

A cross-sectional survey of 440 medical students in Riyadh, Saudi Arabia, was conducted, during October/November 2019, using a previously validated questionnaire, to assess: (1) knowledge in three domains; e-health definition (13 statements), fields of application of e-health (8 statements), methods of using e-health (7 statements), (2) attitude toward using e-health (8 statements) and (3) reported practice of e-health in medical training (5 statements). A scoring system was used to calculate the total and percentage score of knowledge, attitude, and practice for each student. Multiple regression analysis was applied to identify predictors of e-health practice. Significance was considered at p < 0.05.

Results

Of 440 medical students, the majority were females (55.7%) and from families whose monthly income was more than 10,000SR (82.8%). Overall knowledge about e-health was unsatisfactory (percentage mean score, PMS = 71.6%), with only 43.6% of students reporting a satisfactory level. However, this level was satisfactory for fields of application (Percentage mean score-PMS = 76.6%) and unsatisfactory for the definition of e-health (PMS = 70.7%) and methods of its use (PMS = 65.7%) domains. The overall attitude towards e-health use was positive (PMS = 82.3%), with nearly three-quarters of students (73.4%) reporting a positive attitude. Generally, a good level of practice of e-health was reported by students (PMS = 84.3%), with more than three-quarters of students (78.4%) reporting good practice. Adjusting for age, gender, stream, educational grade, and family monthly income, good practice was significantly predicted with higher knowledge (t = 2.22, p = 0.03) and attitude (t = 2.11, p = 0.04) scores.

Conclusion

This study provides basic information regarding medical students’ level of awareness of internet-based health-related information seeking and developing to support health services. More resources should be directed to elevate medical students’ knowledge and to motivate them to practice e-health using the available tools.

Factors associated with length of stay following trans-catheter aortic valve replacement - a multicenter study

Background

Most patients undergoing Transcatheter aortic valve implantation (TAVR) are elderly with significant co-morbidities and there is limited information available regarding factors that influence length of stay (LOS) post-procedure. The aim of this study was to identify the patient, and procedural factors that affect post-TAVR LOS using a contemporary multinational registry.

Methods

We conducted a retrospective cohort study, with patients recruited from three high volume tertiary institutions. The primary outcome was the LOS post-TAVR procedure. We examined patient and procedural factors in a cause-specific Cox multivariable regression model to elucidate their effect on LOS, accounting for the competing risk of post-procedural death. Hazard ratios (HR) greater than 1 indicate a shorter LOS, while HRs less than 1 indicate a longer LOS.

Results

The cohort consisted of 809 patients. Patient factors associated with longer LOS were older age, prior atrial fibrillation, and greater patient urgency. Patient factors associated with shorter LOS were lower NYHA class, higher ejection fraction and higher mean aortic valve gradients.

Procedural characteristics associated with shorter LOS were conscious sedation (HR = 1.19, 95% CI 1.06–1.35, p = 0.004). Transapical access was associated with prolonged LOS (HR = 0.49, 95% CI 0.41–0.58, p < 0.001).

Conclusion

This multicenter study identified potentially modifiable patient and procedural factors associated with a prolonged LOS. Future research is needed to determine if interventions focused on these factors will translate to a shorter LOS.

Electronic supplementary material

The online version of this article (doi:10.1186/s12872-017-0573-7) contains supplementary material, which is available to authorized users.