Simerjit Singh

Qualities of an effective teacher: what do medical teachers think?

BackgroundEffective teaching in medicine is essential to produce good quality doctors. A number of studies have attempted to identify the characteristics of an effective teacher. However, most of literature regarding an effective medical teacher includes student ratings or expert opinions. Furthermore, interdisciplinary studies for the same are even fewer. We did a cross-sectional study of the characteristics of effective teachers from their own perspective across medicine and dentistry disciplines.MethodsA questionnaire comprising of 24 statements relating to perceived qualities of effective teachers was prepared and used. The study population included the faculty of medicine and dentistry at the institution. Respondents were asked to mark their response to each statement based on a 5-point Likert scale ranging from strongly disagree to strongly agree. These statements were grouped these into four main subgroups, viz. Class room behaviour/instructional delivery, interaction with students, personal qualities and professional development, and analysed with respect to discipline, cultural background, gender and teaching experience using SPSS v 13.0. For bivariate analysis, t-test and one way ANOVA were used. Multiple linear regression for multivariate analysis was used to control confounding variables.ResultsThe top three desirable qualities of an effective teacher in our study were knowledge of subject, enthusiasm and communication skills. Faculty with longer teaching experienced ranked classroom behaviour/instructional delivery higher than their less experienced counterparts. There was no difference of perspectives based on cultural background, gender or discipline (medicine and dentistry).ConclusionThis study found that the faculty perspectives were similar, regardless of the discipline, gender and cultural background. Furthermore, on review of literature similar findings are seen in studies done in allied medical and non-medical fields. These findings support common teacher training programs for the teachers of all disciplines, rather than having separate training programs exclusively for medical teachers. Logistically, this would make it much easier to arrange such programs in universities or colleges with different faculties or disciplines.

Diabetic Foot Ulcer-Diagnosis and Management

Diabetes Mellitus is known to have many complications and one of the most distressing is diabetic foot ulcer which affects 15% of people with diabetes. It puts enormous financial burden on the patient and the health care services, even though it is preventable. Diabetic foot ulcer is characterized by a classical triad of neuropathy, ischemia, and infection. Each of these has a multifactorial aetiopathogenesis. These factors are compounded by mechanical stress created by foot deformities. The most commonly used classification systems are the Wagner-Ulcer Classification system and the University of Texas Wound Classification. These classifications help to predict the outcome of this condition. Prevention of this condition is paramount to prevent long term morbidity and sometimes mortality. This can be achieved by patient self-awareness and emphasis on regular foot examinations during follow-up. Care of the diabetic foot should be multidisciplinary. Debridement, dressings and offloading are the pillars of local management. Simultaneous glycemic and infection control is also essential. Amputations are usually the treatment of last resort but occasionally can be considered early to allow for faster mobilization and rehabilitation. Causative factors like peripheral vasculopathy and neuropathy must also be appropriately treated.

Learning Preferences of Clinical Students: A Study in a Malaysian Medical College

Introduction: Awareness of learning preferences can have useful learning and teaching implications. However, there is paucity of literature on the learning preferences of clinical students in a medical school. This study uses the VARK questionnaire to explore the learning preferences of the clinical students of Melaka-Manipal Medical College, Malaysia. VARK is an acronym that stands for visual [V], aural [A], reading [R] and kinesthetic [K] sensory modality of learning. Materials and Methods: The study was approved by the College ethical committee. After taking an informed consent, the clinical students participated in the study in April/May 2012 [ n = 176]. Instrument: VARK questionnaire Version 7.1 was used and it consisted of 16 multiple choice questions. It was distributed among students in the form of hard copy and they submitted their responses to the VARK questionnaire in a classroom setting. Statistical Analysis: Strong preference was calculated on Microsoft Excel using the VARK guidelines. Likert scale [1 to 5] was used to know their perceptions of their VARK score. Feedback written legibly by the participating students was included in the study [ n = 127]. Results: The majority of students [ n = 99] were multimodal. Kinesthetic modality was the strongest single preference [ n = 35]. Out of 127 feedbacks included in the study, the majority of students [82.7%] agreed with the validity of their VARK score. Conclusion: The majority of clinical students is multimodal in their learning preference and kinesthetic modality is their strongest single preference. Educational Implications: Students can develop learning strategies based on their preferences of learning. Teaching should involve all sensory modality so that all types of students can actively participate in learning session. Students pursuing clinical science can benefit more with the kinesthetic modality of learning.

Diabetic Foot Ulcer â Diagnosis and Management

Diabetes Mellitus is known to have many complications and one of the most distressing is diabetic foot ulcer which affects 15% of people with diabetes. It puts enormous financial burden on the patient and the health care services, even though it is preventable. Diabetic foot ulcer is characterized by a classical triad of neuropathy, ischemia, and infection. Each of these has a multifactorial aetiopathogenesis. These factors are compounded by mechanical stress created by foot deformities. The most commonly used classification systems are the Wagner-Ulcer Classification system and the University of Texas Wound Classification. These classifications help to predict the outcome of this condition. Prevention of this condition is paramount to prevent long term morbidity and sometimes mortality. This can be achieved by patient self-awareness and emphasis on regular foot examinations during follow-up. Care of the diabetic foot should be multidisciplinary. Debridement, dressings and offloading are the pillars of local management. Simultaneous glycemic and infection control is also essential. Amputations are usually the treatment of last resort but occasionally can be considered early to allow for faster mobilization and rehabilitation. Causative factors like peripheral vasculopathy and neuropathy must also be appropriately treated.

Medical simulation: Overview, and application to wound modelling and management

Simulation in medical education is progressing in leaps and bounds. The need for simulation in medical education and training is increasing because of a) overall increase in the number of medical students vis-à-vis the availability of patients; b) increasing awareness among patients of their rights and consequent increase in litigations and c) tremendous improvement in simulation technology which makes simulation more and more realistic. Simulation in wound care can be divided into use of simulation in wound modelling (to test the effect of projectiles on the body) and simulation for training in wound management. Though this science is still in its infancy, more and more researchers are now devising both low-technology and high-technology (virtual reality) simulators in this field. It is believed that simulator training will eventually translate into better wound care in real patients, though this will be the subject of further research.

Offloading techniques for diabetic foot

The sole of the foot does not have equal distribution of pressure while in stance or gait. The brunt of the weight falls over metatarsal heads and the heel. In patients with DM the biomechanical changes in the soft tissues of the foot lead to deformities and consequently high pressure points.7 Abnormally high foot pressures leads to development of foot ulcers.8,9 Furthermore as a result of the deformities, the gait is altered. Both the forefoot and hind-foot pressures has been found be increased in diabetic patients with peripheral neuropathy.10 In patients at risk of foot ulceration, screening for loss of protective sensation and evaluation of foot pressure is recommended.

Objective Assessment of Orthopaedic Skills

Medical education is moving away from facilitator driven to learner-centered, patient focused education.1 This has changed the emphasis to gaining practical skills as opposed to theoretical knowledge. Surgical disciplines call for psycho motor skills that are traditionally learned by practice on live patients. Simulation provides a good alternative without inherent risk to the patients.2 For example, task trainers have been used to teach/learn basic skills such as cannulation and venipuncture.3 Orthopedic office procedures are commonly used by many general practitioners and internists as part of their daily practice4,5 and are useful for medical students to learn. However it has been noted that these are not adequately taught during medical training,6 and that there is no organized training of such skills in most medical curricula. Realizing the need to teach these skills in an organized manner Vogelgesang et al. developed an instructional program to teach aspiration and injection techniques of the knee and shoulder to medical students and residents. They used didactic lecture and hands-on workshop using anatomical models made of synthetic materials. They found that didactic and workshop trained students outperformed the traditional group and were more confident in doing procedures.7 We have been using task trainers for teaching various techniques such as injections for carpal tunnel, trigger finger with tenosynovitis and knee joint lavage. At present these skills are being taught in a nonsystematic manner and we do not have an objective method of evaluating them. We decided to systematize the delivery and evaluation of these skills using our existing task trainers in order to deliver standardized, uniform and comprehensive training in these skills for students posted in orthopaedics.

Diabetic Foot Ulcer â Diagnosis and Management

Diabetes Mellitus is known to have many complications and one of the most distressing is diabetic foot ulcer which affects 15% of people with diabetes. It puts enormous financial burden on the patient and the health care services, even though it is preventable. Diabetic foot ulcer is characterized by a classical triad of neuropathy, ischemia, and infection. Each of these has a multifactorial aetiopathogenesis. These factors are compounded by mechanical stress created by foot deformities. The most commonly used classification systems are the Wagner-Ulcer Classification system and the University of Texas Wound Classification. These classifications help to predict the outcome of this condition. Prevention of this condition is paramount to prevent long term morbidity and sometimes mortality. This can be achieved by patient self-awareness and emphasis on regular foot examinations during follow-up. Care of the diabetic foot should be multidisciplinary. Debridement, dressings and offloading are the pillars of local management. Simultaneous glycemic and infection control is also essential. Amputations are usually the treatment of last resort but occasionally can be considered early to allow for faster mobilization and rehabilitation. Causative factors like peripheral vasculopathy and neuropathy must also be appropriately treated.

Formative Assessment of Ophthalmology Problem-Based Learning Tutorials During Undergraduate Medical Training.

PurposeOne of the major challenges lies in the use of strategies to assess students working in small groups. The assessment by tutors and peers, and self-assessment by students appear to be integral parts of problem-based-learning (PBL) tutorials. Our study aimed to analyze the formative assessment scores by students themselves, their tutor and peers during undergraduate ophthalmology tutorials. DesignA cross sectional study. MethodsOne hundred undergraduate students’ self-assessment made during ophthalmology PBL tutorials were compared with that made by their tutor and student peers. At the end of every session, each student and student peers were given an assessment form dealing with criteria like responsibility, information processing, communication, critical analysis and self-awareness. The questionnaires were filled using the 5-point Likert scale. The tutor’s assessment was made using the same criteria. ResultsThere were significant positive correlations between self-assessment and tutor assessment in regard to participation in PBL session (P = 0.01), punctuality for each session (P ⩽ 0.001) and bring new information (P = 0.001). There was a positive correlation between self-assessment and peer assessment regarding active participation (P = 0.02) and bringing new information (P = 0.003). However, there was no significant correlation between the overall scores given by selves and those by peers and the tutor. ConclusionsStudents tended to overrate themselves. The self-assessment scores were generally higher than those given by their tutor and peers. To foster evidence-based practice of ophthalmology, the information acquisition skills need to be improved.