scholarly journals Barriers to Women Entering Surgical Careers: A Global Study into Medical Student Perceptions

2019 ◽  
Vol 44 (1) ◽  
pp. 37-44 ◽  
Author(s):  
I. H. Marks ◽  
A. Diaz ◽  
M. Keem ◽  
Seyedeh-Sanam Ladi-Seyedian ◽  
G. S. Philipo ◽  
...  
Keyword(s):  
Medical Students ◽  
Postgraduate Training ◽  
Univariate Analysis ◽  
Middle Income ◽  
Subset Analysis ◽  
Poor Access ◽  
Low Middle Income Countries ◽  
Surgical Career ◽  
Heavy Workload

Abstract Background Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown. Methods A cross-sectional survey was developed by the International Federation of Medical Students’ Associations (IFMSA)’s Global Surgery Working Group assessing medical students’ desire to pursue a surgical career at different stages of their medical degree. The questionnaire also included questions on students’ perceptions of their education, resources and professional life. The survey was distributed via IFMSA mailing lists, conferences and social media. Univariate analysis was performed, and statistically significant exposures were added to a multivariate model. This model was then tested in male and female medical students, before a further subset analysis by country World Bank income strata. Results 639 medical students from 75 countries completed the survey. Mentorship [OR 3.42 (CI 2.29–5.12) p = 0.00], the acute element of the surgical specialties [OR 2.22 (CI 1.49–3.29) p = 0.00], academic competitiveness [OR 1.61 (CI 1.07–2.42) p = 0.02] and being from a high or upper-middle-income country (HIC and UMIC) [OR 1.56 (CI 1.021–2.369) p = 0.04] all increased likelihood to be considering a surgical career, whereas perceived access to postgraduate training [OR 0.63 (CI 0.417–0.943) p = 0.03], increased year of study [OR 0.68 (CI 0.57–0.81) p = 0.00] and perceived heavy workload [OR 0.47 (CI 0.31–0.73) p = 0.00] all decreased likelihood to consider a surgical career. Perceived quality of surgical teaching and quality of surgical services in country overall did not affect students’ decision to pursue surgery. On subset analysis, perceived poor access to postgraduate training made women 60% less likely to consider a surgical career [OR 0.381 (CI 0.217–0.671) p = 0.00], whilst not showing an effect in the men [OR 1.13 (CI 0.61–2.12) p = 0.70. Concerns about high cost of training halve the likelihood of students from low and low-middle-income countries (LICs and LMICs) considering a surgical career [OR 0.45 (CI 0.25–0.82) p = 0.00] whilst not demonstrating a significant relationship in HIC or UMIC countries. Women from LICs and LMICs were 40% less likely to consider surgical careers than men, when controlling for other factors [OR 0.59 CI (0.342–1.01 p = 0.053]. Conclusion Perceived poor access to postgraduate training and heavy workload dissuade students worldwide from considering surgical careers. Postgraduate training in particular appears to be most significant for women and cost of training an additional factor in both women and men from LMICs and LICs. Mentorship remains an important and modifiable factor in influencing student’s decision to pursue surgery. Quality of surgical education showed no effect on student decision-making.

The Identification and Evaluation of Methodologies to Assess the Quality of mHealth apps in High, Low & Middle-Income Countries: a Rapid Review (Preprint)

2021 ◽  
Author(s):  
Fionn Woulfe ◽  
Philip Kayode Fadahunsi ◽  
Simon Smith ◽  
Griphin Baxter Chirambo ◽  
Emma Larsson ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Healthcare Professionals ◽  
Rapid Review ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Mhealth Apps ◽  
Low And Middle Income

BACKGROUND There has been a rapid growth in the availability and use of mobile health (mHealth) apps around the world in recent years. However, consensus regarding an accepted standard to assess the quality of such apps does not exist. Differing interpretations of quality add to this problem. Consequently, it has become increasingly difficult for healthcare professionals to distinguish apps of high quality from those of lower quality. This exposes both patients and healthcare professionals to unnecessary risk. Despite progress, limited understanding of contributions by those in low- and middle- income countries (LMIC) on this topic exists. As such, the applicability of quality assessment methodologies in LMIC settings remains unexplored. OBJECTIVE The objectives of this rapid review are to; 1) Identify current methodologies within the literature to assess the quality of mHealth apps. 2) Understand what aspects of quality these methodologies address. 3) Determine what input has been made by authors from LMICs. 4) Examine the applicability of such methodologies in low- and middle- income settings. METHODS The review is registered with Prospero (CRD42020205149). A search of PubMed, EMBASE, Web of Science and Scopus was performed for papers relating to mHealth app quality assessment methodologies, published in English between 2005 and the 28th of December, 2020. A thematic and descriptive analysis of methodologies and papers was performed. RESULTS Electronic database searches identified 841 papers. After the screening process, 53 papers remained for inclusion; 6 proposed novel methodologies which could be used to evaluate mHealth apps of diverse medical areas of interest; 8 proposed methodologies which could be used to assess apps concerned with a specific medical focus; 39 used methodologies developed by other published authors to evaluate the quality of various groups of mHealth apps. Authors of 3 papers were solely affiliated to institutes in LMICs. A further 8 papers had at least one co-author affiliated to an institute in a LMIC. CONCLUSIONS Quality assessment of mHealth apps is complex in nature and at times, subjective. Despite growing research on this topic, to date an all-encompassing, appropriate means for evaluating the quality of mHealth apps does not exist. There has been engagement with authors affiliated to institutes in LMICs, however limited consideration of current generic methodologies for application in a LMIC settings have been identified.

scholarly journals Bias in patient satisfaction surveys: a threat to measuring healthcare quality

2018 ◽  
Vol 3 (2) ◽  
pp. e000694 ◽  
Author(s):  
Felipe Dunsch ◽  
David K Evans ◽  
Mario Macis ◽  
Qiao Wang
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Healthcare ◽  
Common Element ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Satisfaction Measures ◽  
To Receive ◽  
Satisfaction Surveys

Patient satisfaction surveys are an increasingly common element of efforts to evaluate the quality of healthcare. Many patient satisfaction surveys in low/middle-income countries frame statements positively and invite patients to agree or disagree, so that positive responses may reflect either true satisfaction or bias induced by the positive framing. In an experiment with more than 2200 patients in Nigeria, we distinguish between actual satisfaction and survey biases. Patients randomly assigned to receive negatively framed statements expressed significantly lower levels of satisfaction (87%) than patients receiving the standard positively framed statements (95%—p<0.001). Depending on the question, the effect is as high as a 19 percentage point drop (p<0.001). Thus, high reported patient satisfaction likely overstates the quality of health services. Providers and policymakers wishing to gauge the quality of care will need to avoid framing that induces bias and to complement patient satisfaction measures with more objective measures of quality.

scholarly journals Association of academic stressors with sleep disturbances in medical students: is psychological stress a mediator?

2014 ◽  
Author(s):  
Ahmed Waqas ◽  
Spogmai Khan ◽  
Waqar muhammad Sharif ◽  
Uzma khalid ◽  
Asad Ali
Keyword(s):  
Logistic Regression ◽  
Medical Students ◽  
Psychological Stress ◽  
Sleep Disturbances ◽  
Univariate Analysis ◽  
High Stress ◽  
Poor Sleep ◽  
Quality Of Sleep ◽  
The Mean

Introduction: Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods: This cross-sectional study was undertaken at CMH Lahore Medical College and Institute of Dentistry in Lahore, Pakistan, and was approved by the CMH LMC Research Ethics Committee. Students enrolled in all yearly courses for the MBBS degree were included. The questionnaire consisted of four sections: 1) demographics 2) a table listing 34 potential stressors, 3) the 14-item Perceived Stress Scale (PSS-14), and 4) the Pittsburgh Quality of Sleep Index (PSQI). Data were analyzed in SPSS v. 20. Logistic regression was run to identify associations between group of stressors, gender, year of study, student’s background, stress and quality of sleep. Results: Total response rate was 93.9% (263/280 respondents returned the questionnaire). The mean PSS-14 score was 30.04 (6.97). Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%). The mean PSQI score was 8.09 (3.12). According to PSQI score, 203/263 respondents (77.02%) were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P<0.05). Conclusion: We found a very high prevalence of academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students.

scholarly journals 457 Survey of Perceived Barriers to Medical Students for Progression into Surgery

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Toh ◽  
O Jayawardena ◽  
H Fowler ◽  
M Fok ◽  
R Clifford
Keyword(s):  
Medical Students ◽  
Gender Bias ◽  
Surgical Training ◽  
Postgraduate Training ◽  
Graduate Training ◽  
Career Pathways ◽  
Perceived Barriers ◽  
Male Ratio ◽  
Post Graduate Training ◽  
Surgical Career

Abstract Introduction Applications for surgical training have been decreasing despite higher numbers of medical school graduates. We sought to explore the perceived barriers to medical students for progression into surgery. Method An online anonymised SurveyMonkey® questionnaire aimed at medical students was disseminated in May 2020, with survey invitations advertised through social media. Results A total of 271 responses were obtained, with 95% of respondents being undergraduates and a 7:3 female to male ratio. Approximately one-fifth (19%) were considering pursuing a career in surgery. 82% of students had observed in an operating theatre. 54% of respondents agreed that their surgical rotation was a positive experience, 21% neutral, 8% negative. Most frequent perceived barriers included lack of work-life balance (77%), surgical culture (67%), lengthy post-graduate training pathway (63%), and competitive entry of surgical specialties (63%). Others included a lack of understanding of surgical career pathways (52%), limited exposure to surgery (47%), and lack of interest (37%). Notably, gender bias was a barrier for many (35%). Most wanted more exposure to surgery through surgical skills teaching (85%), theatre experience (67%), surgical placements (59%) and didactic teaching (33%). Conclusions Modifiable barriers need to be addressed in undergraduate and postgraduate training to boost the number of applications into surgical training.

scholarly journals Knowledge of Alzheimer’s Disease Among Medical Students of a Medical College

2018 ◽  
Vol 56 (211) ◽  
pp. 666-669 ◽  
Author(s):  
Rachana Sharma ◽  
Subhash Chandra Sharma ◽  
Sudarshan N Pardhan ◽  
Pratikshya Chalise ◽  
Luna Paudel
Keyword(s):  
Medical Students ◽  
Cross Sectional Study ◽  
Health Concern ◽  
First Year ◽  
Cross Sectional ◽  
Middle Income ◽  
Medical College ◽  
Middle Income Countries ◽  
Medical Study ◽  
Low Middle Income Countries

Introduction:Dementia is a public health concern as the prevalence is increasing worldwide with significant increase being in low-middle income countries. However these countries appear to be less prepared in handling this rise in terms of diagnosis and management. Methods: This cross-sectional study was conducted in Kathmandu medical College, from June 2017 to July 2017. Purposive sampling was done and the medical students who were in their first and final year of study were included in the study after obtaining an informed consent. Results: Total 185 students were included in the study, 80 (43.24%) from first year and 105 (56.75%) from final year of medical study. The mean score of knowledge among the students was 17.44± 2.46; 15.32± 1.22 among first year and 19.06± 1.87 among the final year students. Majority of the students said they have heard about dementia however, only 3 (3.75%) of first year and 43 (41.9%) from final year students have either attended a class or CME on dementia Conclusion:The knowledge about dementia was found to be average among medical students but better among final year medical students in comparison to first year. The knowledge was found to be better statistically among those who had either attended a class or CME on dementia or had exposure through different medias. Keywords:alzheimer`s disease; dementia; knowledge; medical students.

scholarly journals Association of academic stressors with sleep disturbances in medical students: is psychological stress a mediator?

2014 ◽  
Author(s):  
Ahmed Waqas ◽  
Spogmai Khan ◽  
Waqar muhammad Sharif ◽  
Uzma khalid ◽  
Asad Ali
Keyword(s):  
Logistic Regression ◽  
Medical Students ◽  
Psychological Stress ◽  
Sleep Disturbances ◽  
Univariate Analysis ◽  
High Stress ◽  
Poor Sleep ◽  
Quality Of Sleep ◽  
The Mean

Introduction: Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods: This cross-sectional study was undertaken at CMH Lahore Medical College and Institute of Dentistry in Lahore, Pakistan, and was approved by the CMH LMC Research Ethics Committee. Students enrolled in all yearly courses for the MBBS degree were included. The questionnaire consisted of four sections: 1) demographics 2) a table listing 34 potential stressors, 3) the 14-item Perceived Stress Scale (PSS-14), and 4) the Pittsburgh Quality of Sleep Index (PSQI). Data were analyzed in SPSS v. 20. Logistic regression was run to identify associations between group of stressors, gender, year of study, student’s background, stress and quality of sleep. Results: Total response rate was 93.9% (263/280 respondents returned the questionnaire). The mean PSS-14 score was 30.04 (6.97). Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%). The mean PSQI score was 8.09 (3.12). According to PSQI score, 203/263 respondents (77.02%) were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P<0.05). Conclusion: We found a very high prevalence of academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students.

Assessment of the Pharmaceutical Quality of some Brands of Omeprazole Capsules Marketed in Maiduguri Metropolis, Borno, Nigeria.

2021 ◽  
Vol 2 (1) ◽  
pp. 47-57
Author(s):  
F. Yusuf ◽  
◽  
S.J. Madu ◽  
A.O. Abdussalam ◽  
A.S. Ibrahim ◽  
...  
Keyword(s):  
Law Enforcement ◽  
Visual Inspection ◽  
Quality Parameters ◽  
Content Uniformity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Uniformity Test ◽  
Rate Test

BACKGROUND: The proliferation of counterfeit, substandard and inferior quality drugs is a major challenge in low- middle income countries like Nigeria where drug regulation and law enforcement are constrained by limited resources. OBJECTIVES: The aim of the study was to assess the quality parameters of some brands of Omeprazole capsules marketed in Maiduguri Metropolis, Borno State, Nigeria. METHODS: The uniformity of weight, disintegration test, content uniformity and dissolution rate test were the official tests carried out using Pharmacopoeial methods. Organoleptic tests and other non-official tests were carried out. RESULTS: Ten brands of omeprazole capsules were assessed for purity using omeprazole sample as standard for comparison. All the ten brands tested passed the visual inspection, organoleptic tests, weight uniformity and disintegration tests. Three (3) brands (OMC 1, 4 and 6) out of the ten (10) brands passed the content uniformity test, while the other seven (7) brands were either below or above the acceptable Pharmacopoeial limit. For the dissolution test, only three (3) brands (OMC 1, 3 and 8) passed the test. CONCLUSION: The results therefore, indicated that some of the brands of the Omeprazole capsules marketed in Maiduguri Metropolis failed to comply with some Pharmacopoeial standards.

scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2020 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma WOKS ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Post Partum ◽  
Middle Income ◽  
Middle Income Countries ◽  
Perineal Tears ◽  
Safe Childbirth Checklist ◽  
Low Middle Income Countries ◽  
Post Partum Haemorrhage ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low middle income countries, where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 529 per 100,000 live births in 2017 is significantly high. Adherence to essential birth practices by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth Checklist (SCC) was designed as a tool to improve the quality of care provided to women giving birth. It was implemented at the Yaounde Gynaeco-Obsteric and Paediatric Hospital in order to improve quality of care. The purpose of this study was to determine the adoption rate of the SCC and its association with maternal (eclampsia, perineal tears, post-partum haemorrhage) and neonatal (foetal death, neonatal asphyxia and neonatal death) complications, six months after introduction at the maternity. Methods: A retrospective study was conducted from January – June 2018. Six months was chosen because research conducted on the SCC in India showed that adherence to essential birth practices was optimal within this period. Data collection sheets were used to document information from delivery records. The Chi square test was used to compare categorical variables, while the student’s T test was used to compare continuous variables. Results: Out of 1611 deliveries conducted, only 1001 records could be traced, giving 38% of missing data. Twenty-five records were excluded. During the study period, checklists were used in 828 clinical notes, giving an adoption rate of 84.8%. Fewer cases of severe pre-ecclampsia/eclampsia were associated with the use of SCC (2·1% Vs 5·4%, p = 0·017). The difference in the proportion of perineal tears, post-partum haemorrhage, stillbirths, neonatal asphyxia and neonatal deaths observed between the checklist and non-checklist groups was not statistically significant. Conclusion: Our results suggest that the SCC program is a cost effective intervention that could potentially reduce maternal mortality and morbidity, most of reduction coming from prevention of severe pre-eclampsia, eclampsia in low-middle income countries.

scholarly journals Meeting the need for corrective spectacles in visually impaired Chinese school children: the potential of ready-made spectacles

2018 ◽  
Vol 103 (8) ◽  
pp. 1106-1111
Author(s):  
Zhuoting Zhu ◽  
Leon B Ellwein ◽  
Sean K Wang ◽  
Jialiang Zhao ◽  
Mingguang He
Keyword(s):  
Visual Acuity ◽  
Visually Impaired ◽  
Cost Effective ◽  
Middle Income ◽  
Cost Effective Approach ◽  
Poor Access ◽  
Low Middle Income Countries ◽  
Chinese School ◽  
Refractive Correction ◽  
Study Sites

PurposeTo assess the potential of ready-made (spherical) spectacles (RMS) in meeting the need for refractive correction in visually impaired children in China.MethodsEligible children aged 5–17 years were identified from the three study sites in China. Distance visual acuity was measured with a retroilluminated logarithm of the minimum angle of resolution chart with tumbling E optotypes. Cycloplegic autorefraction was performed on all children using a handheld autorefractor. If uncorrected visual acuity (UCVA) was ≤20/40 in either eye, best corrected visual acuity was measured with subjective refractive error.Results A total of 13 702 children were enumerated from the three studies, with 12 334 (90.0%) having both reliable visual acuity measurements and successful cycloplegia. Among the 12 334 study children, the prevalence of UCVA ≤20/40 in the better seeing eye was 16.4% (95% CI 15.0% to 17.8%), with 91.1% (1843) of these improving by ≥3 lines of visual acuity with refractive correction. Prevalence was 12.7% (95% CI 11.5% to 13.9%) for UCVA <20/50 with 97.4% (1521) improving by ≥3 lines, and 9.38% (95% CI 8.39% to 19.4%) for UCVA ≤20/63 with 98.4% (1138) improving by ≥3 lines. Depending on the severity of visual impairment, 62.8%–64.0% of children could be accommodated with RMS if not correcting for astigmatism of ≤0.75 dioptres and anisometropia of ≤0.50 spherical equivalent dioptres. Approximately 87% of children could be accommodated with RMS if astigmatism and anisometropia limits were increased to ≤1.25 and ≤1.50 dioptres, respectively.ConclusionsRMS could substantially alleviate visual morbidity in two-thirds or more of visually impaired schoolchildren in China. This cost-effective approach to refractive correction might also be useful in low/middle-income countries with poor access to optometric services.

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