International Journal of Medical Sciences and Education (IJMSE)
Vol. 5; Issue: 3 (July -September 2018), Date of Publication: 01.10.2018

Table of Contents
     Editorial                                                                                                                                                   292-293
1.   THE TEACHING OF ETHICS TO MEDICAL STUDENTS TO SOLVE THE PROBLEMS OF A REAL-LIFE                    SITUATION
      Dr. Reshu Gupta                                                                                                                            PDF FULL TEXT

1.    NAVIGATING MENTORSHIP OF UNDERGRADUATE STUDENTS IN INDIA:  THE STUDENTS’ PERSPECTIVE                                                                                                                                                  294-296
      Dr. Md Mojahid Anwar, Dr. Mohd Asrarul Haque, Hena Fatma, Dr. Afzal Ahmad,
      Dr. Munawwar Husain                                                                                                                     PDF FULL TEXT

ABSTRACT

Mentoring under graduate medical students is not easy as it appears to be. In India as elsewhere, selection to medical course i.e., MBBS is highly competitive with 1:400 ratio of competing students. Therefore, it can be surmised that entrants are well read, computer savvy and language erudite. If they need mentoring that should be done by qualified mentors possessing inclination and virtue of a mentor. A mentor just cannot fool one and all medical mentees. Therefore, there should be an established process of mentoring in which the students should be free to question and raise doubts. It should a two way channel. With important apex national bodies like Human resource development (HRD), medical Council of India (MCI), University Grants Commission (UGC), Indian Medical Association (IMA) etc., the mentor must take the task seriously and goal oriented.
Keywords: MBBS students mentoring, assessment of mentor, assessment of mentee, mentoring tools

2.    THE ANATOMY TEACHING ADVENTURE OF AN AMERICAN FULBRIGHT SCHOLAR IN THE MIDDLE                   EASTERN STATE OF QATAR: FACILITATING STUDENT SUCCESS WITH TARGETED COMMON ISLAMIC             RELIGIOUS NUANCES, MNEMONICS AND ONLINE RESOURCES                                                     297-299
       Walid M. Al-Ghoul                                                                                                                       PDF FULL TEXT

ABSTRACT

Standard audio-visual tools of teaching require enhancement in topics such as anatomy where the students are required to memorize numerous terms often likened to learning a new language. Such challenge is more paramount when English is not the students’ first language as is the case of Qatar University (Doha, Qatar) where I served as a Fulbright Teaching/Research Scholar. In this work, I share my discovery of a novel connection between the layout of the appendicular skeleton and Islamic practices in the daily lives of my students. Specifically, upper limb bones could be related to the Muslims’ five obligatory daily prayers which are called and practiced almost everywhere in the Middle East including most buildings at Qatar University. Amazingly, this seemingly-simple parallel was a turning point in enhancing student engagement and motivation, which was thence maintained by mnemonic and online resources, with the ultimate outcome of hundred percent student success rate and success along with an overwhelmingly positive student feedback.
Keywords: Skeleton, appendicular, mnemonics, Islamic prayers, Fulbright scholar, Middle East

3.    COMPARATIVE STUDY OF CASE BASED LEARNING WITH TRADITIONAL TEACHING METHOD IN                       PATHOLOGY FOR SECOND YEAR MEDICAL STUDENTS                                                                     300-305
       Dr. M.Janaki, Dr. Payasam Rajeswari, Dr. Hasham Hussain, Dr. Kanaka Sreedhar Babu     PDF FULL TEXT

ABSTRACT

Background :Case based learning (CBL), is a learning method aids learner to reorganize, elaborate their information and provide connection between current and new information. Moreover CBL is student centered, taken in small groups where teacher acts as facilitator or guide. Objective To  perceive the need for initiating CBL , this study  aimed to compare  the  pathology teaching among second year medical students with that of traditional teaching. Methods This is an observational study conducted from September 2016 to April 2017. This research study was conducted on all 98 students of II MBBS students.  Ten ideal case scenarios on the topic of myocardial infraction and diabetes mellitus were prepared, and pre validated by the faculty of pathology  and medical education department.CBL was introduced and total three sessions were conducted and compared with traditional teaching. Results The mean (±SD) value of the score of gain in knowledge was 3.99±1.88 (n=98) for the batch of students who attended case based learningwhile the mean (±SD) gain in knowledge for the batch who underwent TL was 2.63±2.31 (n=98).A paired t-test comparing didactic lectures with self-directed learning showed that the scores following didactic lectures were more compared to SDL and the results were statistically significant. An unpaired t-test comparing case based learningto SDL also showed statistically significant gain in knowledge following didactic lectures. Conclusion This study clearly showed that CBL is more effective over traditional  teaching for our second year MBBS  students and for covering a wider area.
Key words : Case based learning, pathology, traditional learning

4.    LEARNING APPROACHES OF MEDICAL STUDENTS IN A GOVERNMENT MEDICAL COLLEGE, WEST                 BENGAL                                                                                                               ​                                      306-313
       Dr. Subhabrata Kumar                                                                                                                 PDF FULL TEXT

ABSTRACT

Background :Case based learning (CBL), is a learning method aids learner to reorganize, elaborate their information and provide connection between current and new information. Moreover CBL is student centered, taken in small groups where teacher acts as facilitator or guide. Objective To  perceive the need for initiating CBL , this study  aimed to compare  the  pathology teaching among second year medical students with that of traditional teaching. Methods This is an observational study conducted from September 2016 to April 2017. This research study was conducted on all 98 students of II MBBS students.  Ten ideal case scenarios on the topic of myocardial infraction and diabetes mellitus were prepared, and pre validated by the faculty of pathology  and medical education department.CBL was introduced and total three sessions were conducted and compared with traditional teaching. Results The mean (±SD) value of the score of gain in knowledge was 3.99±1.88 (n=98) for the batch of students who attended case based learningwhile the mean (±SD) gain in knowledge for the batch who underwent TL was 2.63±2.31 (n=98).A paired t-test comparing didactic lectures with self-directed learning showed that the scores following didactic lectures were more compared to SDL and the results were statistically significant. An unpaired t-test comparing case based learningto SDL also showed statistically significant gain in knowledge following didactic lectures. Conclusion This study clearly showed that CBL is more effective over traditional  teaching for our second year MBBS  students and for covering a wider area.
Keywords : Case based learning, pathology, traditional learning

5.    DEVELOPMENT AND VALIDATION OF COMPETENCY GAP ASSESSMENT TOOL FOR REPRODUCTIVE             HEALTH CURRICULUM FOR RESOURCE-POOR SETTINGS                                                                314-320
       Dr. Ankur Joshi,  Ajay Halder                                                                                                      PDF FULL TEXT

ABSTRACT

Background:: To construct an integrated tool serving the dual purpose of establishing specific competencies to be attained in reproductive health for Undergraduate students and to measure the extent of exposure pertaining to set competencies. Methods: A listing of potential competencies in reproductive health was done through the Delphi technique in the background of the theoretical framework. The refined competencies list (39 items) was shared with 29 experts for assessing the content validity. Items with Content Validity index [CVI] <0.80 were removed. The structured questionnaire with 34 items was distributed among 140 faculties from 12 medical colleges. Responses were analyzed for normality and suitability for Principle Component Analysis. Reliability of the questionnaire was ascertained by split-half reliability and Chroanback Alfa. Result: Total 34 items finalized through consensus, Suitability for Principle Component Analysis was checked by R-matrix determinate value(R=0.045) and by Kaiser –Meyer-Olkin (KMO) test (0.634).  Five factors emerged namely- exposure to theoretical knowledge for decision making, demonstration of relevant skills, exposure to Health activism, exposure to personal attributes and advocacy to evidence-based practices. Promax rotation methods were used for factor loading (component co-relation matrix value of 0.40 between factor-1 and factor-2). Internal consistency value was determined as 0.907. The correlation between the sums of each item was computed as 0.545. The spearman-brown coefficient value was detected as 0.705. Conclusion: A reliable and valid tool has been developed which can measure the curricular exposure to reproductive health competencies at primary care level.
Keywords: Competency, Principle Component Analysis, competency-based education, validity, reliability

6.    WORK RELATED STRESS AMONG MEDICAL TEACHERS: A QUESTIONNAIRE BASED OBSERVATIONAL           STUDY                                                                                                                                                        321-327
       Dr.Swapnali.S.Kadam, Dr.Surekha.S.Khedkar, Dr.Tushar.R.Bagle                                         PDF FULL TEXT

ABSTRACT

Background: Medical profession has witnessed a tremendous change in the last four decades, this has caused an increase in work stress in the Medical teachers. Material & Methods: A questionnaire-based study was done in medical teachers from government, semi-government and private medical college and teaching hospitals that was cross sectional observational. Institutional Ethics Committee permission was taken before starting the study. Test–retest reliability was estimated with a subsample of 10 medical teachers by taking two interviews seven days apart. The stress questionnaire was prepared from occupational stress the Bristol and Stress and Health at Work Study. Stress questionnaire had components that included Autonomy (5), Work condition (3), Communication & Relationships (5), Stress / Work out (8), Attitude (3), Support (5), Self Confidence (3), Social life (6), Performing meaningful work (3). Results: The average age in our study was 42.05 ± 9.22years. There were 45 females and 55 males. The total stress score in medical teachers was 119.45 ± 11.46, in clinical teachers was 117.15 ± 10.86 and in preclinical and paraclinical teachers was 121.8 ± 12.07 (p=0.045). The teachers had problems of insufficient space, sitting arrangement that was seen more in preclinical and paraclinical teachers while exposure to infectious diseases was seen more in clinical teachers.  Teaching was done more by preclinical and paraclinical teachers and research more by clinical teachers. Conclusion: Stress is highly neglected by medical professionals. It is important to take steps to relieve the medical teachers of various stressors in the medical profession.   
Keywords: Fatigue, Clinical, Teaching, Research,

7.    A STUDY OF FACTORS INFLUENCING LEARNING IN MEDICAL STUDENTS                                   328-334
       Dr. Udaragudi Prasada Rao,Dr. Samson Sanjeeva Rao Nallapu                                            PDF FULL TEXT

ABSTRACT

Background: Adaptation of teaching methods according to students’ learning manners is likely to improve their motivation and performance. Teachers are accountable to present educational content and skills in diverse ways in tune with the varying learning modes of their students.Objective: To identify factors influencing medical students’ study routines and behaviors in a medical college from South India and to identify their learning style preferences.Methods: This cross-sectional study done at NRIMC, Guntur from July to September 2015, involved 282 medical students from the 5th and 7th semesters. A Likert type questionnaire enquired into factors like gender and semester differences and learning habits. Fleming’s questionnaire on VARK (Visual, Aural, Read & Write and Kinesthetic) was used to identify learning styles. The findings were subjected to Chi square test at 5% level of significance. Result: Female students prefer to understand subject matter, (p 0.02) and desire academic achievement (p 0.014). Statistically significant factors affecting the 5th semester students (compared to 7th) include, teacher related factors (favoritism, personality, ability to inspire) and a gap between self appraisal and academic achievement, (p 0.0000003). Attitudes, peer pressure, assessment and feedback were seen to be important. As in other studies, almost half (49.3%) prefer a single style (unimodal).  Learning style inclined significantly towards Kinesthetic. Conclusion: In addition to gender, many other factors play a significant role in learning. Learning experiences also differ between batches with the teacher playing an important role. As kinesthetic style is the preferred one in a majority of students, there is a need for less lecturing and more hands on experiences.
Keywords: medical student, study habits, VARK, learning styles, performance, attitudes.

  8.    LEARNING STYLE PREFERENCES OF MEDICAL AND DENTAL STUDENTS: AN OPEN LABEL, VARK              QUESTIONNAIRE BASED STUDY                                                                                                          335-342
          Dr. Kranti Tekulapally, Dr.Vibha Rani, Dr.Padmavathi                                                         PDF FULL TEXT

ABSTRACT

Background: Learning style preferences vary among individual students.Knowing the learning styles of students will guide the faculty in tailoring their teaching methodologies to their learning styles so that they can acquire maximum knowledge and their performance can be improved.Materials and Methods: An open label cross sectional study was conducted among 231 medical students and 168 dental students belonging to Malla Reddy Group of Institutions, Suraram, Hyderabad. Paper copies of validated Visual-Aural-Reading/Writing-Kinesthetic (VARK) questionnaire consisting of 16 questions were administered to the students after taking informed consent. The responses were scored according to VARK scoring chart and were sent to the copyright holder of VARK questionnaire to convert them into VARK categories. Out of two algorithms assigned to each student, scores obtained from research algorithm were used to analyze by using descriptive statistics.Results: Majority of the students had unimodal (60.1%) learning styles while multimodal learning styles were only 39.8%. Among the unimodal learning styles, Visual mode of learning style was most preferred (58.27%).Conclusion: Since majority of the students are unimodal visual learners who learn best by visualizing the information, faculty should try to incorporate many charts, pictures, and illustrations in their teaching methodologies. Students should also be taught some strategies to learn better which includes concept maps, color coding and flash cards.
Keywords: Learning styles, Medical students, Dental students, Teaching – learning methodologies

  9.    ATTITUDE AND COMMUNICATION IMPLEMENTATION – 6 MONTHS EXPERIENCE WITH MBBS                            STUDENTS                                                                                                                                              343-352              Dr. Balaji Arumugam, Sneha Moan, Dr.Sowmya KR, Dr.Sree T Sucharita                           PDF FULL TEXT

ABSTRACT

“A good physician treats the disease;a great physician treats the patient who has the disease.”  To become a successful practitioner the most important skill is the ability to connect and communicate with patients. The paternalistic model of health care which focussed more on physician’s opinion has now been widely replaced by the new model which engages the patient in active decision making. An effective communication benefits both the patient and the doctor. Communication skills’ training in medical curriculum is still in the nascent period in our country. Priming medical students in effective doctor patient communication is important to establish good doctor patient relationship and to be a successful physician. Knowing its importance, in this article, a detailed review will be presented on the communication skill training given to students on the importance of effective doctor-patient communication in health care set-up. We implemented seven modules specified in the ATCOM (Attitude and Communication) as per the MCI guidelines and Sri Ramachandra Medical College and Research Institute FDP training to second year medical students. This training proved to be successful in fostering the importance of doctor patient relationship and has also helped to mould the students towards patient centered approach.
​Keywords: Communication skills, medical curriculum, medical students, ATCOM (Attitude and Communication).

  10.    EFFECTIVENESS OF PRE AND POST EVALUATION METHOD OF TEACHING
           IN MEDICAL PROFESSION                                                                                                                 353-357     
        Neetha Kundoor, Radhakishan Narsini                                                                                   PDF FULL TEXT

ABSTRACT

Medical education is emerging with new compelling instructional tools and methods of teaching medical concepts, providing new learning possibilities for the faculty and student. Assessments could be invaluable; this helps teachers to identify the strengths and weaknesses of each student and it also helps to guide the next steps in instruction. Pre-evaluation in one of the techniques to improvise students attention and cognitive skills to get the concepts more clearly when taught by the faculty. Objective: The present study is taken up to learn the effect of pre and post-evaluation in understanding medical biochemistry by the students. Methods: A total of 100 first year MBBS students were involved in the study. MCQ questions were given to the students as prior to the class as pre-evaluation. Same MCQs was given to them after the class as post evaluation. After completion of the chapter students, perceptions were collected using a standard questionnaire. Results: The scores were high in post-assessment when compared to the pre-evaluation and were statistically significant p < 0.0001. Majority of the students strongly agreed that the use of the evaluation method was useful in medical education. Conclusion: Pre and Post- evaluation is one of the useful tools to improve the concentration and understanding of the concepts by the medical students, it is a different approach to make the didactic lectures more interesting. It improves the attention of students to learn the concepts with great ease.
Keywords: Evaluation, Biochemistry, Medical education.​​

  11.    A STUDY TO FIND OUT ASSOCIATION BETWEEN MORPHOMETRY OF PLACENTA AND NEONATES                   PROFILE AT TERTIARY CARE TEACHING HOSPITAL, BIKANER                                                    358-363    
           Shabnam Qureshi, Dr. Jaskaran Singh, Dr. Mukesh Fulwaria, Dr. Om Prakash Yadav    PDF FULL TEXT

ABSTRACT

Morphometry of placenta reflects the development of fetus and disease pattern in later in life. Therefore a study was conducted to find out the association between morphometry of placenta and neonates profile at the tertiary care teaching hospital, Bikaner. Materials and Method: One hundred routine delivery cases in the Department of Gynecology & Obstetrics were interviewed, and the placentas required for measurements were collected from respective mothers. Results: Out of the 100 pregnant women 74 were uniparous, 21 were biparous, and five were multiparous. Out of hundred cases recorded the maximum pregnant women weight groups were 56 to 60 kilograms found. The mean value for the neonate weight was calculated as 2832.94 grams. Seventy-seven and twenty-three subjects had the round and oval shape of placenta respectively. No other shape was found in the present study. Conclusion: Placental morphology like weight, surface area, gender, and volume reflects the birth weight effectively for the planning of better maternal care.
Keywords: Placental Morphometry, Newborn, Pregnant Women

  12.    CLINICAL PROFILE OF ACUTE ALCOHOLIC LIVER DISEASE                                                       364-368    
           Dr. Ravindra K Hadakshi, Dr Gaurav Modi                                                                           PDF FULL TEXT

ABSTRACT

The Alcoholic liver disease has a varied spectrum of complications ranging from liver steatosis to severe liver cirrhosis. Liver disorders from alcoholism were reported since ancient times. Chronic and excessive alcohol abuse is the most common known causes of chronic liver disease worldwide. In India also alcoholism is the most common cause of the eclectic range of liver diseases. Material & Methods: A total of 100 patients were enrolled for study, who were attending the OPD of general medicine department of Zydus medical college and hospital, Dahod Gujarat. The patients who were diagnosed clinically and also biochemically as acute onset alcoholic liver disease enrolled for study by simple random sampling. Results: The most common clinical feature reported among patients of alcoholic liver disease was nausea and vomiting seen in 84% of patients, which was followed by jaundice, which was reported among 83% of cases. The third most common feature was hepatomegaly which was present in 68% of patients, accompanied by signs of liver failure present in 60% of patients which was followed by anorexia present in 56% of patients. Splenomegaly was present in 35% of patients, fever was present in 31% of patients, abdominal pain was present in 26% of cases, and ascites was reported among 17% on patients. Conclusion: Alcohol consumption in larger quantities over a longer duration of time leads to high morbidity and even mortalities. Alcoholic liver disease is a social burden which required frequent hospitalization and results to be unwanted out of pocket expenditure, economic loss along hindrance for the health care system.
Keywords: alcoholic liver disease, hepatomegaly, liver cirrhosis.

  13.    CORRELATION BETWEEN DIABETIC RETINOPATHY AND LIPOPROTEIN(A)IN PATIENTS WITH TYPE                2 DIABETES MELLITUS                                                                                                                       369-373    
           Dr.Kavita bansal, Dr. Nikhil Agrawal, Dr.Mahendra K. Jharwal                                          PDF FULL TEXT

ABSTRACT

Background: Retinopathy is a significant complication among patients of diabetes mellitus. Raised serum Lipoprotein(a) [Lp(a)] levels have found to be an independent risk factor for thromboembolic events and atherogenesis. Also, the capillary occlusion is a frequent observation in diabetic retinopathy, Lp(a) is postulated to play a critical role in the initiation and progression of diabetic retinopathy. Material & Methods:200 patients with type 2 diabetes mellitus of five years or more duration were enrolled for study by simple random sampling. Patients enrolled in this study have been diagnosed to have type 2 diabetes mellitus as per the American Diabetes Association criteria. Among these 200 patients, 100 patients who had no retinopathy served as the control group, and 100 who had retinopathy enrolled in the study group. Results: The average Lp(a) levels in patients who had retinopathy were 69.38 mg/dl and in the control group 28.11 mg/dl. This difference was obtained to be statistically significant.TheLp(a) levels in patients who had NPDR were 66.49 mg / dl and in patients with PDR Lp(a) levels were 105.10 mg/dl. This difference was also reported to be statistically significant. On applying logistic regression analysis, diabetic retinopathy was reported to be statistically related to serum Lp(a) levels (P<0.001, odds ratio 1.068).Conclusion: Lipoprotein (a) levels were found significantly greater in patients with diabetic retinopathy in comparison to patients who had no retinopathy. Hence Lipoprotein (a) may act as an independent risk factor for developing diabetic retinopathy.
Keywords: Diabetic retinopathy, lipoprotein(a), diabetes mellitus.​