Ali Ibrahim Alhaqwi

Sleep disorder among medical students: Relationship to their academic performance

Background: Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. Objective: To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. Methods: This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. Results: There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6–10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). Conclusion: A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

What determines the selection of undergraduate medical students to the specialty of their future careers

Background: It is important to understand the factors that influence the undergraduate medical students’ specialties choice for the post-graduation. Objectives: To identify the number of undergraduate medical students who decided their post-graduate specialty career, factors that may influence their decision to select a particular specialty, and their career specialties preference. Methods: A self-administered questionnaire was used to achieve the objectives. Results: Less than half of the students (40.2%) showed a future specialty preference. Senior students and having background about specialties were the significant factors for career choices. General Surgery (27.4%), ENT-Ophthalmology (24.6%) and Internal Medicine (22%) were preferred specialties. Male students preferred General Surgery (15.7%), Internal Medicine (15%), ENT-Ophthalmology (12%) and Orthopedics (9.1%). Female students showed interest in ENT-Ophthalmology (12.1%), Surgery (11.7%), Pediatrics (10.8%) and Dermatology (8.2%). The least popular specialties were Community Medicine, (6.6%), Anesthesia, (6%) and Forensic Medicine (4.6%). Obstetrics and Gynecology (Ob/Gyne) was a less popular branch even in female students. Conclusions: General Surgery, ENT-Ophthalmology and Internal Medicine were the most preferred specialties, while Community Medicine, Forensic and Ob/Gyne, even for female students were least selected specialties. Proper information and counseling should be offered to students about the challenges and opportunities to select their future careers.

Cigarette smoking among female students in five medical and nonmedical colleges

Objectives This study was conducted to determine the prevalence of smoking, knowledge about the ill effects of smoking on health, and the influence of family members’ smoking habits among Saudi female students. Methods This is a type of cross-sectional study. A sample of 1,070 female students was selected by a nonrandom and convenient sampling method from five colleges (Medicine, Business and Administration, Computer Sciences, Education, and Languages and Translation) of King Saud University, Riyadh, Saudi Arabia. A self-administrated questionnaire was used to determine the personal, social, and educational characteristics of the respondents. In addition, questions about their smoking types, status, duration of smoking, knowledge about the ill effects of smoking, daily cigarette consumption, and reasons for quitting smoking were included. Results The students’ response rate was 85%. The prevalence of current smoking was 4.3% and 5.6% for cigarettes and water-pipes, respectively, whereas 3.9% of the participants were ex-smokers. The prevalence of current smoking was highest in the College of Business and Administration (10.81%) and lowest in the College of Medicine (0.86%). The majority (77%) of the smokers’ parents (current and ex-smokers) were also smokers. More than half (54%) of the smokers started their smoking habit for entertainment, and 44.4% of the participants did not know that smoking causes serious health problems. The most common factors for quitting smoking were health concerns (54%), religious beliefs (29%), and parent’s advice (17%). Conclusion The study concludes that the prevalence of smoking varies in different subject streams and that family and friends have a great influence on individuals starting or stopping smoking. Extensive health education programs are needed to educate young women on the health hazards of smoking and help stop them from smoking.

Medical students' evaluation of their exposure to the teaching of ethics

Background: The subject of Biomedical Ethics has become recognized as an essential integral component in the undergraduate curriculum of medical students. Objectives: (1) To review the current Biomedical Ethics Course offered at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS). (2) To explore the perception of medical students on the different components of the course. Materials and Methods: The medical students were requested to participate in the study at the end of the course by filling in a pre-designed questionnaire. A qualitative approach was used also to examine their perceptions about certain components of the course. Results: Forty-one medical students participated in this study. All students expressed their strong agreement on the importance of their learning biomedical ethics. Their views about the role of Biomedical Ethics were also considered. These include professional development, assessment of ethical competencies, and the timing of the teaching of ethics. Conclusion: The students provided valuable comments that were supported by the literature reviews. Medical Students’ views of the teaching of the various components of biomedical ethics are important and should be sought in the planning of a curriculum.

Development of the clinical learning evaluation questionnaire for undergraduate clinical education: factor structure, validity, and reliability study

BackgroundTeaching and learning of clinical skills for undergraduate medical students usually takes place during the clinical clerkship. Therefore, it is of vital importance to ensure the effectiveness of the rotations within this clerkship. The aims of this study were to develop an instrument that measures the effectiveness of the clinical learning environment, to determine its factor structure, and to find first evidence for the reliability and validity of the total scale and the different factors.MethodsThe Clinical Learning Evaluation Questionnaire (CLEQ) is an instrument, consisting of 40 items, which have been developed after consideration of the results of a qualitative study that investigated the important factors influencing clinical learning, both from the perspective of students, as well as teachers. Results of relevant literature that investigated this issue were also incorporated in the CLEQ. This instrument was administered to a sample of students (N = 182) from three medical colleges in Riyadh city, the capital of Saudi Arabia. The factor structure of the CLEQ (Principal component analysis, Oblimin rotation) and reliability of the factor scales (Cronbach’s α) were determined. Hypotheses concerning the correlations between the different factors were tested to investigate their convergent and divergent validity.ResultsOne hundred and nine questionnaires were returned. The factor analysis yielded six factors: F1 Cases (8 items), F2 Authenticity of clinical experience (8 items), F3 Supervision (8 items), F4 Organization of the doctor-patient encounter (4 items), F5 Motivation to learn (5 items), and F6 Self awareness (4 items). The overall internal consistency (α) of the CLEQ was 0.88, and the reliabilities (Cronbach’s α) of the six factors varied from .60 to .86. Hypotheses concerning the correlations between the different factors were partly confirmed, which supported the convergent validity of the factors, but not their divergent validity. Significant differences were found between the scores of the students of the three different schools on the factors Supervision and Organization of patient-doctor encounter.ConclusionsThe results of this study demonstrated that CLEQ is a multidimensional and reliable instrument. It can be utilized as an evaluation tool for clinical teaching activities, both by educators as well as students. Further research is needed into the validity of the CLEQ.

Quality issues in continuing medical education in Saudi Arabia.

The issue of continuing medical education (CME) in Saudi Arabia is no longer quantity but rather quality. Quality Management (QM) of the current huge number of CME activities is essential to ensure its merits and outcomes. Sound evaluation is the cornerstone of any QM process to CME. However, issues related to models of evaluation, CME stakeholders, principles of adult learning and assessment should be considered before deciding on the type of evaluation appropriate for QM of CME. Our aim is to draw attention to the importance of developing a QM process for CME that is valid, reliable, feasible and acceptable to different CME stakeholders. The huge volume of CME programs needs QM to ensure its utility for healthcare providers and consumers. Understanding relevant evaluation models and the complexity of evaluating CME is a necessary step towards appropriate action.

Reprioritizing current research trends in medical education: A reflection on research activities in Saudi Arabia

Abstract Background: There are numerous national efforts to determine and develop research priorities of medical education in Saudi Arabia. These priorities were first proposed in 2010 by “Dr Al-Khuli’s Chair for Developing Medical Education in Saudi Arabia”. The proposed priority domains were: curriculum, students, faculty, and quality assurance and accreditation. Aim: To investigate publications in medical education at the national and international levels in areas relating to these proposed priorities. Methods: Electronic search within PubMed database for papers relating to each domain of priority was conducted at national and international levels in the last three years, using the same keywords as the priority domains, but only confined to undergraduate medical education. Results: Out of 3145 articles retrieved when searching with keyword as broad as “undergraduate medical curriculum” only 81 articles worldwide and 3 articles from Saudi Arabia were dealing with curriculum related issues as a whole. Further search on the sub-domains “effective strategies to manage undergraduate curriculum” and “undergraduate medical education models”, resulted in the retrieval of few articles worldwide and none from Saudi Arabia. At the national level, there were 63 publications from Saudi Arabia that were either course (topic)-specific or could not be classified under the four domains specified by Dr Al-Khuli’s Chair. Conclusion: Research activities in medical education in Saudi Arabia in the last 3 years showed diversity and lack of focus in the research priorities. Efforts of academic and research centers should continue to monitor and encourage these activities toward achieving the recommended priorities.

Problem-based learning in undergraduate medical education in Saudi Arabia: Time has come to reflect on the experience

Abstract Background: Problem-based learning (PBL) is being increasingly used in many undergraduate medical schools worldwide due to its recognized advantages. Objectives: To explore views of medical students in the Kingdom of Saudi Arabia (KSA) about the appropriateness of the PBL concepts and process. Differences in students’ views were examined as well. Methods: This is a cross-sectional, questionnaire-based study conducted in two medical colleges in Riyadh, Saudi Arabia, during the period from April to June 2012. Results: One hundred seventy four undergraduate medical students participated in the study. Majority of the participants supported the concept of PBL and thought it is a beneficial learning strategy. However, only about half of them consider the problems used in tutorials are relevant for the local setting. Significant differences have been identified between the gender, schools, and study level of participants and their views on the process of PBL tutorials. About 35% of participants either undecided or will not recommend medical schools that adopt PBL curriculums for their friends. Conclusions: The majority of participants were satisfied with PBL approach and valued its importance in their learning process. Specific concerns have been expressed about relevance of some aspects of PBL. Underlying factors should be further explored in order to improve the outcomes of PBL curriculum in the local Saudi setting.

Shared clinical decision making. A Saudi Arabian perspective

Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes.

Obesity and overweight in a major family practice center, central region, Saudi Arabia

Background: Obesity and overweight are associated with significant health and health-related conditions, which have a negative impact on the quality of life. Objectives: To determine the proportion and characteristics of obesity among adults visiting a major family practice center in central Saudi Arabia and to compare the demographic and health-related conditions among obese and nonobese adults. Materials and Methods: A cross-sectional study conducted in a major family practice center in Riyadh, Saudi Arabia. Patients attending the center between 1 st September and 30 th November 30, 2013 were interviewed using a data collection form developed to meet the objectives of the study. Logistic regression was used to generate the odds ratios and their 95% confidence intervals for the association of body mass index and risks factors. Results : A total number of 300 adult participants were included in this study. The mean age and standard deviation were 46 years (±17 years). The proportion of overweight and obesity in the total sample was 32% and 50% respectively. Frequency of obesity was found to increase with age till the age of 50 where it drops afterward. Obesity significantly affects the participants within the age group from 40 to 60 more than other age groups (P < 0.001). Obesity was significantly associated with female gender and marital status (P < 0.018 and 0.006, respectively). The presence of obesity was found to decline significantly with increasing level of education. The presence of obesity was more in patients who have other chronic medical problems and those who reported less exercise. In addition to nonsmoking status, stepwise multiple logistic regressions showed that low level of education and having chronic medical diseases especially hypertension could be considered as predictors of developing obesity. Conclusion: This study confirmed previously published data about the seriousness of overweight and obesity among adults in Saudi Arabia. Certain patient categories are at a higher risk as women, married, and less educated patients. The positive role of education was clearly demonstrated and highlights the important role in effective health education strategies to minimize the negative public impact of obesity and overweight.