Margaret Elzubeir

Identifying characteristics that students, interns and residents look for in their role models.

To identify characteristics which students, interns and residents look for in their role models.

Determinants of women's choice of their obstetrician and gynecologist provider in the UAE

Background.  The objective of this study is to evaluate womens priorities and preferences in selecting their obstetrician and gynecologist in a non‐Western society.

Using DREEM to compare graduating students' perceptions of learning environments at medical schools adopting contrasting educational strategies.

Background: In response to growing concerns about conventional modes of teaching and learning in medicine, some medical schools in Saudi Arabia have converted to hybrid problem-based learning (PBL) curricula while others continue to implement traditional discipline-based curricula. Understanding students’ perceptions of traditional versus PBL learning environments can be helpful for evaluating program strengths and weaknesses and should promote curriculum development. Aim: The purpose of this study was therefore to evaluate the educational environments of two medical schools in Riyadh, Saudi Arabia from perspectives of graduating medical students using the Dundee Ready Education Environment Measure (DREEM) inventory. Results: Compared to medical school implementing a hybrid PBL curriculum, the overall score on the inventory for the conventional school was statistically significantly less (p < 0.001). In addition, students experiencing the hybrid-PBL curriculum held significantly higher perceptions in the learning, academic self-perception and atmosphere sub-domains of the inventory (p < 0.001). Overall, our results align with previous studies pertaining to DREEM scores of other regional conventional and international PBL medical schools. Conclusion: We conclude that applying DREEM as a diagnostic tool provides important insights and understanding of learning environments where different educational strategies are adopted and which may be in need of development and change. Implications for curriculum development and improvement of learning environments in health professions education institutions are discussed.

First Aid and Basic Life Support Skills Training Early in the Medical Curriculum: Curriculum Issues, Outcomes, and Confidence of Students

Background: The importance of training physicians and other health care professionals in first aid and basic life support (BLS) is now widely recognized. The Faculty of Medicine and Health Sciences of the United Arab Emirates University have been offering formal training in these skills to 1st-year medical students since 1989. The aim of this study was to determine the efficacy of the program and the extent to which it provides students with confidence to perform skills on their own after training. Description: 165 of 180 male and female students comprising 3 cohorts (91.7% response rate) completed a self-administered anonymous questionnaire. The questionnaire contained open- ended and Likert-type questions regarding course organization, content, strengths and weaknesses, teaching-learning approaches, and skills development and confidence. The authors analyzed assessment outcomes and associations between self-perceived levels of confidence and ability to practice. Evaluation: Students were uniformly enthusiastic and highly motivated by the program. Self- assessed confidence in ability to perform skills on their own after completing the program was moderately correlated with perceived frequency of opportunity to practice many skills. There was nevertheless a consistent desire for more practice time. Conclusions: The results suggest that the program provides students with sound basic knowledge and adequate practical skills in first aid and BLS and that adequacy of time and physical and human resources are important prerequisites to facilitate practice and engender confidence in skills.

Evaluating the quality of teaching in medical education: are we using the evidence for both formative and summative purposes?

Heightened focus on the quality of teaching in medical schools has led to increased use of student surveys as a means of evaluating teaching. In some institutions, however, the summative purpose is emphasized over the developmental or self-improvement objective. The aim of this study was to examine the utility of a student evaluation of teaching questionnaire for use in administrative decision making (summative purpose) and in identification of faculty whose instruction needs improvement (formative purpose). Results of this analysis are discussed in addition to related issues regarding faculty development and the importance of adopting multiple methods of evaluating and documenting teaching and other educational activity.

Assessing confidence and competence of senior medical students in an obstetrics and gynaecology clerkship using an OSCE.

CONTEXT Assessment of clinical confidence and competence of senior medical students during an obstetrics and gynaecology clerkship using an objective structured clinical examination (OSCE). METHOD A questionnaire was distributed to senior medical students (n=47)to assess pre- and post-OSCE self-perceived confidence and competence in five clinical skills: history taking, performing pelvic examination, interacting and communicating with patients, clinical reasoning and dealing with difficult patient situations. Pre- and post-performance confidence levels were compared and correlated with OSCE scores. RESULTS The five clinical skills were significantly interrelated (p=0.001). There was no significant difference in OSCE performances between male (n=16) and female (n=31) students. Pre- and post-OSCE confidence in performing pelvic examination was significantly higher in female than male students (p=0.01). Post-OSCE confidence in clinical reasoning and dealing with difficult patient situations only were significantly increased in both groups (p=0.01 and p=0.02, respectively). Pre- and post-performance confidence levels were not significantly correlated to OSCE scores. CONCLUSION Of five clinical skills rated, self-confidence in clinical reasoning skills and dealing with challenging or complex patient problems only were significantly increased after an OSCE assessing competence. The content of some of our OSCE stations thus enhance confidence in these skills but psychometric and other characteristics of the OSCE such as duration and performance feedback mechanisms need further investigation.

Diagnostic radiology in an integrated curriculum: Evaluation of student appraisal

RATIONALE AND OBJECTIVES This study determined student perceptions of the effectiveness of an integrated radiology curriculum in a 6-year undergraduate medical school program. MATERIALS AND METHODS Student perceptions of the effectiveness of an integrated radiology curriculum were assessed with a self-administered questionnaire that was developed in house and consisted of Likert-type and open-ended items. The questionnaire was distributed to 1997-1998 and 1998-1999 cohorts of 2nd- to 6th-year medical students. Quantitative data were analyzed by using descriptive statistics. RESULTS Ninety-nine of 173 students (57% response) returned completed questionnaires. Overall, students perceived integrated radiology teaching as satisfactorily achieved and useful in facilitating learning. Compared with students in the 2nd and final years of undergraduate medical education and training, those in years 3-5 considered integrated radiology teaching to be very effective. Results of the survey suggest future modifications to improve the effectiveness of integrated radiology teaching. CONCLUSION Radiology can be successfully integrated into modern medical curricula. Student comments indicate the need to structure and organize the integrated teaching better and to introduce it earlier in the medical school curriculum.

Identifying Core Obstetric and Gynecologic Skills Required of, and Used by, Graduates of the Faculty of Medicine and Health Sciences, United Arab Emirates University

Background: Acquisition of core practical skills by students assures quality and relevance of medical education. Purpose: To determine whether students and interns are acquiring core obstetric and gynecologic skills. Methods: A self-administered questionnaire was sent to obstetric and gynecology clerkship coordinators (n = 3), consultants (n = 14), residents (n = 13); interns (n = 13) and final-year students (n = 29; n = 93, response rate = 77%, N = 72). The questionnaire contained a stimulus list of 21 clinical, 8 communication, and 5 professional skills. Results: Of 34 listed skills, 24 were identified as core skills. At least 50% of consultants, faculty, and residents expected 28 core skills to be covered in the undergraduate program. At least 50% of interns believed that 21 core skills had been acquired at graduation. Conclusion: Our curriculum is facilitating acquisition of core obstetric and gynecologic skills.

Ethics teaching in a medical education environment: preferences for diversity of learning and assessment methods

ABSTRACT Background: Ethics and professionalism are an integral part of medical school curricula; however, medical students’ views on these topics have not been assessed in many countries. Objective: The study aimed to examine medical students’ perceptions toward ethics and professionalism teaching, and its learning and assessment methods. Design: A self-administered questionnaire eliciting views on professionalism and ethics education was distributed to a total of 128 final-year medical students. Results: A total of 108 students completed the survey, with an 84% response rate. Medical students reported frequently encountering ethical conflicts during training but stated only a moderate level of ethics training at medical school (mean = 5.14 ± 1.8). They noted that their education had helped somewhat to deal with ethical conflicts (mean = 5.39 ± 2.0). Students strongly affirmed the importance of ethics education (mean = 7.63 ± 1.03) and endorsed the value of positive role models (mean = 7.45 ± 1.5) as the preferred learning method. The cohort voiced interest in direct faculty supervision as an approach to assessment of knowledge and skills (mean = 7.62 ± 1.26). Female students perceived greater need for more ethics education compared to males (p = < 0.05). Students who claimed that they had experienced some unprofessional treatment had a more limited view of the importance of ethics as a subject (P = 0.001). Conclusion: Medical students viewed ethics education positively and preferred clinically attuned methods for learning.

Reducing the physician workforce crisis: Career choice and graduate medical education reform in an emerging Arab country

Background: In today′s interdependent world, issues of physician shortages, skill imbalances and maldistribution affect all countries. In the United Arab Emirates (UAE), a nation that has historically imported its physician manpower, there is sustained investment in educational infrastructure to meet the population′s healthcare needs. However, policy development and workforce planning are often hampered by limited data regarding the career choice of physicians-in-training. The purpose of this study was to determine the specialty career choice of applicants to postgraduate training programs in the UAE and factors that influence their decisions, in an effort to inform educational and health policy reform. To our knowledge, this is the first study of career preferences for UAE residency applicants. Methods: All applicants to residency programs in the UAE in 2013 were given an electronic questionnaire, which collected demographic data, specialty preference, and factors that affected their choice. Differences were calculated using the t-test statistic. Results: Of 512 applicants, 378 participated (74%). The most preferred residency programs included internal medicine, pediatrics, emergency medicine and family medicine. A variety of clinical experience, academic reputation of the hospital, and international accreditation were leading determinants of career choice. Potential future income was not a significant contributing factor. Discussion: Applicants to UAE residency programs predominantly selected primary care careers, with the exception of obstetrics. The results of this study can serve as a springboard for curricular and policy changes throughout the continuum of medical education, with the ultimate goal of training future generations of primary care clinicians who can meet the country′s healthcare needs. As 65% of respondents trained in medical schools outside of the UAE, our results may be indicative of medical student career choice in countries throughout the Arab world.