Mohammad Irshad

Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals

Background Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies, internship, and residency training, which affects their cognitive function, practical life, and patient care. In the present study, an assessment of the prevalence of self-perceived stress among new medical graduates during their internship training has been performed, and correlations of self-perceived stress with sex, marital status, and clinical rotations have been evaluated. Patients and methods Interns of the King Khalid, King Abdulaziz, and King Fahd University hospitals in Saudi Arabia were invited to complete a stress inventory known as the Kessler 10, which is used for stress measurement. Apart from stress evaluation, the questionnaire collected personal data, such as age, sex, and marital status, in addition to information relevant to hospital training, assigned duties, and clinical training rotations. Results Our results showed that nearly 73.0% of interns were under stressed conditions. Most of the interns were affected by a severe level of stress (34.9%), followed by mild (19.3%) and moderate (18.8%) levels of stress. The stress level was significantly higher (84.0%) among female interns in comparison with male interns (66.5%) (odds ratio =2.64; confidence interval =1.59–4.39; P<0.0002). There were statistically significant differences between the percentages of male and female interns (P≤0.047) at mild, moderate, and severe stress levels. Marital status had no role in causing stress. The highest stress level was reported by interns during the clinical rotations of medicine (78.8%), followed by surgery (74.7%), pediatrics (72.4%), obstetrics and gynecology (70.1%), and emergency (58.3%). The prevalence of stress among the interns and their corresponding clinical rotations in all three hospitals had significant linear correlations (r≥0.829, P≤0.041). Conclusion We found a significantly high level of stress among the medical interns. High stress may have negative effects on cognitive functioning, learning, and patient care. Hence, medical interns need support and subsequent interventions to cope with stress.

Students’ perception towards the problem based learning tutorial session in a system-based hybrid curriculum

Objectives: To evaluate students’ perception towards the problem based learning (PBL) session in a system-based hybrid curriculum. Methods: We conducted a cross-sectional study in the College of Medicine, King Saud University, Saudi Arabia at the end of the 2012-2013 academic year. The survey questionnaire was self-administered, and examined perceptions of PBL session benefits, appropriate running of sessions, and tutor’s roles. Results: Out of 510 students, 275 (53.9%) completed the questionnaire. Most of the students reported that PBL sessions were helpful in understanding basic sciences concepts (p=0.04). In addition, they agreed that PBL sessions increased their knowledge of basic sciences (p=0.01). Most students reported that PBL sessions encouraged self-directed learning, collaborative learning, and improved decision making skills. However, 54.5% of students reported lack of proper training before starting the PBL sessions, and only 25.1% of students agreed that the teaching staff are well prepared to run the sessions. Most students used the internet (93.1%), lecture notes (76.7%), and books (64.4%) as learning resources. Most students reported repetition of topics between PBL sessions and lectures (p=0.07). Conclusion: The study highlighted the significant role of PBL in a system-based hybrid curriculum and helped students improve their knowledge and different learning skills. Students and staff training is required before the utilizing the PBL as an instructional method.

Physical activity and academic achievement among the medical students: A cross-sectional study.

Abstract Aims: To explore physical activity (PA) habits among the medical students and examine the correlation with their grade point average (GPA) achievement at College of Medicine, King Saud University, Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted among the medical students (n = 409), during the academic year 2012–2013. Students’ physical activity habits were self-reported. GPA, body mass index (BMI) and body fat percent (BF%) were collected and analyzed with SPSS software. Results: Out of 409 students, 193 (47.2%) students reported being physically active. Our result showed a significant positive association between students’ PA habits and high-GPA achievement (χ2 = 10.65, p = 0.001). The greatest odds ratio of high GPA was found among the fourth year students (OR = 3.08, CI: 1.15–8.28, p = 0.025) and fifth year students (OR = 5.07, CI: 1.48–17.31, p = 0.010). In addition, significant association was found between the normal BMI and high-GPA achievers (χ2 = 8.30; p = 0.016). However, no statistically, significant association was found between BF% and GPA. Conclusions: The present study showed a positive associations was found between PA habits and high academic achievement. In addition, positive association was found between PA, obese students and GPA achievement. Therefore, there is a need for the establishment of physical activity education and public health programs to promote importance of PA in Saudi population.

Stress and its association with working efficiency of junior doctors during three postgraduate residency training programs.

Background The residency training period in the medical profession is well known for physical and mental stress, which may affect cognitive function and practical life. The aims of this study were to assess prevalence of stress among the resident trainees of the three medical specialties of Saudi Commission for Health Specialties (SCHS) training programs, namely, Internal Medicine, Emergency Medicine, Family Medicine, and their association with training years, sex, and marital status. This study also aimed to correlate the stress levels with the working efficiency and self-perceived general health problems. Participants and methods Resident trainee physicians of SCHS were invited to complete a stress inventory Kessler 10, which is used for stress measurement. Pearson’s chi-square test (χ2) and odds ratios (ORs) were used to quantify the associations between categorical variables. A P-value of <0.05 was considered statistically significant. Results A total of 318 (out of 389, with the response rate of 82%) resident trainees participated in this study. The mean (± standard deviation) age of the study population was 27.9 (±1.6) years. The results showed 70.4% of resident trainees had stressful conditions, which consisted of severe stress: 22.6%, moderate stress: 20.4%, and mild stress: 27.4%. During the 1st year (R-1), moderate stress (OR =5.87; 95% confidence interval =2.93–17.79; P=0.001) and severe stress (OR =11.15; 95% confidence interval =4.35–28.51; P=0.0001) levels were quite high. The highest stress level was found in Emergency Medicine (80.5%), followed by Internal Medicine (73.6%), and Family Medicine (63.2%) (χ2=6.42; P=0.04). The stress level decreased with the increase of years of training in Emergency Medicine (χ2=23.76; P<0.0001) and Internal Medicine (χ2=60.12; P<0.0001), whereas increased in Family Medicine (χ2=11.80; P=0.008). High stress level was significantly associated with absence from duty days (χ2=28.48, P<0.0001), inefficient day activities (χ2=39.15; P<0.0001), and general health problems (χ2=45.27; P<0.0001) of resident trainees. Conclusion We found significantly high levels of stress among the resident trainees of SCHS. High levels of stress may have an effect on their working efficiency and general physical health. The high stress level decreased efficient day activity and made the trainees absent from the workplace.

Self-reported cheating among medical students: An alarming finding in a cross-sectional study from Saudi Arabia

Academic misconduct/dishonesty has become widespread behavior among many university students across the globe, and medical education is not an exception. Until recently, few efforts have been made to study the dishonest behavior in Middle-Eastern universities. This study examined the prevalence and predisposing factors of cheating among medical students in Saudi Arabia and suggests suitable preventive measures. A cross-sectional survey-based study was conducted at a government medical college during the 2014–2015 academic year. The response rate was 58.5% (421/720). The overall cheating behavior practiced by the participants was 29%, predominantly by male students. High GPA scoring students were the least likely to cheat. The participants living with their families were more likely to cheat compared to those who were living apart from their families. The reasons participants gave to justify their cheating behavior included getting better grades, passing the course, and lacking preparation while still recognizing that cheating is a ‘mistake.’ Overall, significant academic misconduct concerning cheating was found among the Saudi medical students; this misconduct is alarming in a reputable government institution. The implementation of strict punishments, requiring ethical courses and creating ethical awareness by exploiting the potential of Islamic religious belief might help to control this problem.

Students' perception and experience of intimate area examination and sexual history taking during undergraduate clinical skills training: A study from two Saudi medical colleges.

AbstractThis study explores the experiences of Saudi undergraduate medical students about intimate-area examination (IAE) and sexual history taking (SHT) skills and assesses the barriers and their impacts on students’ learning. This survey-based study was performed at 2 Saudi university medical colleges and revealed that most of the students never performed IAE, that is, female breast, male genital, female genital, female pelvic, male rectal, and female rectal. We found that 42.3% students had never taken any sexual history during their course. Both, male and female students reported barriers of patient refusal, mismatched sex, cultural background, ethical factors, lack of supervision, lack of training, and lack of skills. Among the currently used pedagogical techniques, majority of the students were satisfied with real patient-based learning, followed by video and manikin-based learning. The study indicates that Saudi students do not have sufficient experience of IAE and SHT because of above-mentioned barriers along with religious issues. This study suggests that teachers provide positive support to students and that they develop novel, competent teaching-and-learning techniques to meet the skills training of students without compromising on religious, sociocultural, and ethical values of the kingdom.

Association of the PTEN IVS4 (rs3830675) Gene Polymorphism with Reduced Risk of Cancer: Evidence from a Meta-analysis

PTEN (phosphatase and tensin homologue), as a tumor suppressor gene, plays a significant role in regulating cell growth, proliferation, and apoptosis. Results from published studies for association between the PTEN IVS4 I/D (rs3830675) polymorphism and cancer risk are inconsistent and inconclusive. We therefore conducted a meta-analysis to evaluate the potential association between PTEN IVS4 I/D polymorphism and risk of cancer in detail. We searched PubMed (Medline) and EMBASE web databases to cover all relevant studies published until December 2013. The meta-analysis was carried out and pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were used to appraise the strength of association. A total of 1,993 confirmed cancer cases and 3,200 controls were included from six eligible case-control studies. Results from overall pooled analysis suggested a significant effect of the PTEN IVS4 I/D polymorphism and cancer risk in all genetic models, i.e., allele (I vs D: OR=0.743, 95%CI=0.648 to 0.852, p=0.001), homozygous (II vs DD: OR=0.673, 95%CI=0.555 to 0.816, p=0.001), heterozygous (ID vs DD: OR=0.641, 95%CI=0.489 to 0.840, p=0.001), dominant (II+ID vs DD: OR=0.626, 95%CI=0.489 to 0.802, p=0.001) and recessive (II vs DD+ID: OR=0.749, 95%CI=0.631 to 0.889, p=0.001). Significant publication bias was detected during the analysis. The present meta-analysis suggests that the PTEN IVS4 I/D polymorphism is significantly associated with reduced risk of cancer. However, future larger studies with other groups of populations are warranted to clarify this association.

No Evidence of Association of the Arg72Pro p53 Gene Polymorphism with Cancer Risk in the Saudi Population: a Meta-Analysis.

BACKGROUND Earlier studies on the association between p53 codon 72 Arg>Pro polymorphism and cancer risk were inconclusive and conflicting for the Saudi population. Therefore, we performed a meta-analysis to investigate the relationship between the codon 72 Arg>Pro polymorphism and overall cancer risk in Saudi Arabia. MATERIALS AND METHODS We searched all eligible published studies and data were pooled together to perform the meta-analysis. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for homozygous, heterozygous, dominant and recessive genetic models. RESULTS A total of five eligible published studies covering 502 cancer cases and 784 healthy controls were included in the meta-analysis. No publication bias was detected in this study. The results suggested that the variant (Pro vs Arg: p=0.960; OR=1.004, 95% CI=0.852-1.183), homozygous (Pro.Pro vs Arg.Arg: p=0.970; OR=1.006, 95% CI=0.729-1.390), heterozygous (Arg.Pro vs Arg.Arg: p=0.473; OR=0.783, 95% CI=0.402-1.527) carriers were not associated with overall cancer risk. Similarly, dominant (Pro.Pro+Pro.Arg vs Arg.Arg: p=0.632; OR=0.886, 95% CI=0.540-1.454) and recessive (Pro.Pro vs Pro.Arg+Arg.Arg: p=0.269; OR=1.163, 95%CI=0.890-1.521) models also did not indicate increased risk of cancer. CONCLUSIONS The current meta-analysis suggests that the codon 72 Arg>Pro polymorphism of the p53 gene might not contribute to cancer susceptibility in Saudi population. Future well designed large case control studies are needed to validate our findings.