scholarly journals An OxPLORE Initiative Evaluating Children’s Surgery Resources Worldwide: A Cross-sectional Implementation of the OReCS Document

Author(s):  
Krupa Ravi ◽  
Annabel Killen ◽  
Angus Alexander ◽  
Frances Bell-Davies ◽  
James Biganiro Sebintu ◽  
...  

Abstract Background The Global Initiative for Children's Surgery (GICS) group produced the Optimal Resources for Children’s Surgery (OReCS) document in 2019, listing standards of children’s surgical care by level of healthcare facilities within low resource settings. We have previously created and piloted an audit tool based on the OReCS criteria in a high-income setting. In this study, we aimed to validate its use in identifying gaps in children’s surgery provision worldwide. Methods Our OReCS audit tool was implemented in 10 hospitals providing children’s surgery across eight countries. Collaborators were recruited via the Oxford Paediatrics Linking Our Research with Electives (OxPLORE) international network of medical students and trainees. The audit tool measured a hospital’s current capacity for children’s surgery. Data were analysed firstly to express the percentage of ‘essential’ criteria met for each specialty. Secondly, the ‘OxPLORE method’ was used to allocate each hospital specialty a level based on procedures performed and resources available. A User Evaluation Tool (UET) was developed to obtain feedback on the ease of use of the tool. Results The percentage of essential criteria met within each category varied widely between hospitals. The level given to hospitals for subspecialties based on OReCS criteria often did not reflect their self-defined level. The UET indicated the audit tool was practicable across multiple settings. Conclusions We recommend the use of the OReCS criteria to identify areas for local hospital improvement and inform national children’s surgical plans. We have made informed suggestions to increase usability of the OReCS audit tool.

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241553
Author(s):  
Paul Truche ◽  
Rachel E. NeMoyer ◽  
Sara Patiño-Franco ◽  
Juan P. Herrera-Escobar ◽  
Myerlandi Torres ◽  
...  

Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.


2020 ◽  
Vol 9 (1) ◽  
pp. 4-4
Author(s):  
Maryam Baradaran Binazir ◽  
Mohammad Barzegar ◽  
Fariba Heidari

Background: Evaluating the state of clinical teaching is a very essential aspect of useful teaching.It helps in determining areas of strength and areas for improvement. Accordingly, the aim of this study was to evaluate clinical teaching activities in a pediatric hospital at the Tabriz University of Medical Sciences, based on standards provided by the Ministry of Health in Iran. Methods: A cross-sectional study was conducted from October to December 2018 in the setting of a pediatric hospital of the Tabriz University of medical sciences. Participants were selected from this hospital: academic members and medical students who were present in the pediatric hospital during this investigation. The evaluation tool was a checklist of standards relating to clinical teaching settings. The outcome measures included four domains, assessed using mean standard scores: teaching round, morning report, journal club, and outpatient clinic. Analysis of variance (ANOVA) was used to compare scores on the checklist among academic members and medical students. Results: A total of 126 participants completed the checklist. Among the participants, 50 (39.6%) were 5th-year medical students, 51 (40.4%) were final-year medical students and 25(19.8%)were academic members. The highest and lowest mean standard scores were 85.3 and 34.5,the morning report and the teaching round by final-year medical students, respectively. No statistically significant differences were found among academic members and medical students’mean standard scores for teaching round (P = 0.983), morning report (P = 0.696), journal club (P= 0.952), and outpatient clinic (P = 0.060). Conclusion: Considering both academic members and medical students, clinical teaching standards were not widely regarded as important in the pediatric wards of the Tabriz University of Medical Sciences. Some interventions are indicated to improve adherence to the Ministry of Health standards.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
H. P. Dunn ◽  
C. J. Kang ◽  
S. Marks ◽  
J. L. Witherow ◽  
S. M. Dunn ◽  
...  

Abstract Background Fundoscopy outside ophthalmology is in decline, and the technical demands of the traditional direct ophthalmoscope examination are likely contributing. Alternative fundoscopy technologies are increasingly available, yet valid comparisons between fundoscopy technologies are lacking. We aimed to assess medical students’ perceptions of usefulness and ease of use of traditional and contemporary fundus-viewing technologies including smartphone fundoscopy. Methods One hundred forty-six second-year medical students participated in a cross-sectional, randomised, cross-over study of fundoscopy methods. Medical students completed small group training sessions using six current fundoscopy technologies including: a non-mydriatic fundus camera; two types of direct fundoscopy; and three types of smartphone fundoscopy. A novel survey of perceived usefulness and ease of use was then completed by students. Results Repeated-measures ANOVA found students rated both the perceived usefulness (p< 0.001) and ease of use (p< 0.001) of smartphone fundoscopy significantly higher than both the non-mydriatic camera and direct fundoscopy. Conclusions Smartphone fundoscopy was found to be significantly more useful and easier to use than other modalities. Educators should optimise student access to novel fundoscopy technologies such as smartphone fundoscopy which may mitigate the technical challenges of fundoscopy and reinvigorate use of this valuable clinical examination.


2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Talal Al-Khatib ◽  
Sanaa Bin Othman ◽  
Basem El-Deek

Objectives. To investigate patients’ perception regarding medical students’ role in the operating theatre.Methods. A cross-sectional study was conducted on a randomly selected sample at King Abdulaziz University Hospital.Results. 131 participated in this study. 77 of the participants were females and 50 participants were males. 46.4% think that it was important for the future doctors to be in theater during surgery. 60.2% thought that medical students only observed surgeons in the theatre and 39% thought that medical students performed minor procedures in the theatre.Conclusion. Patients underestimated the importance of medical students’ attendance and involvement in theatre compared to bedside teaching and outpatient clinics. Patients believed that medical students should obtain their consent prior to observing them in the theatre.


Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Mohammed Madadin ◽  
Ritesh G. Menezes ◽  
Maha A. Alassaf ◽  
Abdulaziz M. Almulhim ◽  
Mahdi S. Abumadini ◽  
...  

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.


2019 ◽  
Vol 2 (2) ◽  
pp. 211-220
Author(s):  
Ahmed Waqas ◽  
Aqsa Iftikhar ◽  
Zahra Malik ◽  
Kapil Kiran Aedma ◽  
Hafsa Meraj ◽  
...  

AbstractObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.


2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711293
Author(s):  
Sarah Garnett ◽  
Hajira Dambha-Miller ◽  
Beth Stuart

BackgroundEmpathy is a key health care concept and refers to care that incorporates understanding of patient perspective’s, shared decision making, and consideration of the broader context in which illness is experience. Evidence suggests experiences of doctor empathy correlate with improved health outcomes and patient satisfaction. It has also been linked to job satisfaction, and mental wellbeing for doctors. To date, there is a paucity of evidence on empathy levels among medical students. This is critical to understand given that it is a key point at which perceptions and practices of empathy in the longer term might be formed.AimTo quantify the level of empathy among UK undergraduate medical studentsMethodAn anonymised cross-sectional online survey was distributed to medical students across three universities. The previously validated Davis’s Interpersonal Reactivity Index was used to quantify empathy. The survey also collected information on age, sex, ethnicity, year of medical school training and included a free-text box for ‘any other comments’.ResultsData analysis is currently underway with high response rates. Mean empathy scores by age, sex, year of study and ethnic group are presented. A correlation analysis will examine associations between age and year of study, and mean empathy sores.ConclusionThese data will help to provide a better understanding of empathy levels to inform the provision of future empathy training and medical school curriculum design. Given previous evidence linking experiences of empathy to better health outcomes, the findings may also be significant to future patient care


Background: Information technology (IT) is a new way of teaching and learning. One of the promising media of information technology is e-Learning, which is used to enhance knowledge and skills among users. A student gains better and deep knowledge through a useful tool. This survey aimed to determine practices among medical students for e-Learning. Methods: This cross-sectional survey was conducted on 184 students amongst the 500 students currently enrolled in medical college. Data was collected using questionnaires and were analyzed through SPSS version 22. Chi-square was used for qualitative values. Results: Majority 90.80% (n=167) students were aware of e-Learning and were statistically high in first year students (p-value: 0.018). The student did not show statistically significant results for content learned through e-Learning with a p-value of 0.063. Different resources were used for e-Learning in which videos had the highest percentage (87.60%) and audios were used as the least resource for e-Learning (29.20%). Daily, 56% of the students use e-Learning for 1 hour or less and only 3% of the students used it for more than 4 hours. Conclusion: Majority of undergraduate medical students were aware of the use of e-Learning and most of them preferred e-Learning for their course work and studies showing a significant increase in understanding and use, compared to studies conducted earlier. Participants found e-Learning useful and effective tool in increasing knowledge and understanding of their subject. Keywords: e-Learning; Practices; Students.


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