Saniya Sabzwari

Experiences, attitudes and barriers towards research amongst junior faculty of Pakistani medical universities.

BackgroundThe developing world has had limited quality research and in Pakistan, research is still in its infancy. We conducted a study to assess the proportion of junior faculty involved in research to highlight their attitude towards research, and identify the factors associated with their research involvement.MethodsA cross-sectional study was conducted in four medical universities/teaching hospitals in Pakistan, representing private and public sectors. A pre-tested, self-administered questionnaire was used to collect information from 176 junior faculty members of studied universities/hospitals. Logistic regression analysis was used to identify factors related to attitudes and barriers in research among those currently involved in research with those who were not.ResultsOverall, 41.5% of study subjects were currently involved in research. A highly significant factor associated with current research involvement was research training during the post-graduate period (p < 0.001). Other factors associated with current involvement in research were male gender, working in the public sector and previous involvement in research. Overall, a large majority (85.2%) of doctors considered research helpful in their profession and had a positive attitude towards research; nevertheless this positive attitude was more frequently reported by doctors who were currently involved in research compared to those who were not (OR = 4.69; 95% CI = 1.54-14.26). Similarly, a large proportion (83.5%) of doctors considered research difficult to conduct; higher by doctors who were not presently involved in research (OR = 2.74; 95% CI = 1.20-6.22)ConclusionLess than half of the study participants were currently involved in research. Research output may improve if identified barriers are rectified. Further studies are recommended in this area.

Mimicking rashes: Use of moulage technique in undergraduate assessment at the aga khan university, Karachi

Background: The use of simulated patients in student assessment is supported by the Best Evidence Medical Education and U.S. Agency for Healthcare Research and Quality, and it provides a safe and effective alternative to real patients in many situations. To assess the validity and feasibility of moulage technique–where a cosmetically constructed rash is used on simulated patients–two dermatologic rashes were developed using moulage simulation on standardized patients at Aga Khan University Hospital for 3rd year medical summative Objective Structured Clinical Examination (OSCE). Methods: Checklists for cases that focused on history taking of a skin rash were developed. These also included a description and identification of lesions, differential diagnosis, and basic management. Cases were first reviewed and approved by the Educational Committee and a dermatologist content expert. Stations were piloted to assess validity and feasibility. Simple nontoxic materials were used to develop the rash by faculty familiar with moulage simulation. Results: Sixty-four students were assessed on a Herpes Zoster case and 32 students on a Herpes Simplex case in morning and afternoon sessions. The total mean score obtained at all OSCE stations was 64.82 ± 10.22. Mean scores on the morning and afternoon dermatology stations were 62.72 ± 9.74 and 69.03 ± 9.98, respectively. Face validity for both stations was established through input of content experts. The internal reliability as measured by Cronbachs alpha between the checklist items on the morning and afternoon stations was acceptable at 0.60 (20 items) and 0.65 (18 items), respectively. Discussion: The use of moulage technique to develop dermatologic lesions on simulated patients may be utilized for student assessment.

11 FACTORS ASSOCIATED WITH MISPERCEPTION OF ABDOMINAL OBESITY AT PRIMARY CARE CLINICS IN KARACHI, PAKISTAN

Objectives: To assess weight perceptions of individuals with abdominal obesity, identify misperceptions and factors associated with these misperceptions to provide appropriate counseling to such individuals. Methods: This was a cross sectional study conducted at primary care clinics from low, middle, and high socioeconomic neighbourhoods. A trained interviewer collected information on a structured questionnaire, after obtaining verbal informed consent, from 493 individuals. Proportion of individuals with misperceived waist circumference was calculated and used as the outcome variable. Univariate and multivariate logistic regression was used to identify factors associated with misperception. SPSS 16 was used for data analysis. Results: Half (n = 251) of the individuals had increased waist circumference. Out of which 77% were obese, 13% were overweight, and 11% were of normal weight. 15% of individuals with normal BMI had increased waist circumference, equally divided between males and females. One third of the individuals with increased waist circumference perceived their weight circumference to be normal. Individuals with increased waist circumference were more likely to misperceive if they were satisfied with their weight (AOR 10.8, 95% CI 6.4-18.2), had a co-morbid (AOR 2.95, 95% CI 1.7-5.0), had not been given weight advice by health professionals (AOR 1.8, 95% CI 1.1-3.0) and were unaware of their weight (AOR 1.9, 95%, CI 1.05-3.3). Conclusions: We found a high proportion of individuals with misperception of their waist circumference. Effective strategies are needed to increase awareness regarding abdominal obesity in this population especially focusing on the identified groups.