14 Evidence based medicine in low-middle income countries; online or face-to-face teaching method?

2018 ◽  
Author(s):  
Iman El Sayed ◽  
Sherif Abdelmonem
Keyword(s):  
Evidence Based Medicine ◽  
Teaching Method ◽  
Evidence Based ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Based Medicine

scholarly journals Building capacity in evidence-based medicine in low-income and middle-income countries: problems and potential solutions

2019 ◽  
pp. bmjebm-2019-111272
Author(s):  
Peter J Gill ◽  
Shabana M Ali ◽  
Yasmin Elsobky ◽  
Raymond C Okechukwu ◽  
Tatiane B Ribeiro ◽  
...  
Keyword(s):  
Low Income ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Middle Income ◽  
Building Capacity ◽  
Middle Income Countries ◽  
Based Medicine

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

Smartphone-based DIY home microsurgical training with 3D printed microvascular clamps and Japanese noodles

2021 ◽  
Author(s):  
Zhi Yang Ng ◽  
Calum Honeyman ◽  
Alexandre G Lellouch ◽  
Ankur Pandya ◽  
Theodora Papavasiliou
Keyword(s):  
Back Wall ◽  
Internal Validation ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Video Recordings ◽  
Low Middle Income Countries ◽  
Konjac Flour ◽  
3D Printed ◽  
Set Up

We have recently incorporated simple modifications of the konjac flour noodle model to enable DIY home microsurgical training by (i) placing a smartphone on a mug to act as a microscope with at least 3.5-5x magnification, and (ii) rather than cannulating with a 22G needle as described by others, we have found that cannulation with a 23G needle followed by a second pass with an 18G needle will create a lumen (approx. 0.83 mm) without an overly thick and unrealistic “vessel” wall. The current set-up however, did not allow realistic evaluation of anastomotic patency as the noodles became macerated after application of standard microvascular clamps, which also did not facilitate practice of back-wall anastomoses. In order to simulate the actual operative environment as much as possible, we introduced the use of 3D printed microvascular clamps. These were modified from its previous iteration (suitable for use in silastic and chicken thigh vessels) and video recordings were submitted for internal validation by senior surgeons. A “wet” operative field where the knojac noodle lumen can be distended or collapsed, unlike other non-living models, was noted by senior surgeons. With the 3D clamps, the noodle could now be flipped over for back-wall anastomosis and allowed patency testing upon completion as it did not become macerated, unlike that from clinical microvascular clamps. The perceived advantages of this model are numerous. Not only does it comply with the 3Rs of simulation-based training, it can also reduce the associated costs of training by up to a hundred-fold or more when compared to a traditional rat course, and potentially, be extended to low-middle income countries (LMICs) without routine access to microsurgical training for capacity development. That it can be utilised remotely also bodes well with the current limitations on face to-face training due to COVID restrictions and lockdowns.

scholarly journals COVID-19: An opportunity to strengthen Public Health Policy and Advocacy Efforts in LMIC (Low- Middle-Income Countries)

2021 ◽  
Author(s):  
Ponn P Mahayosnand ◽  
Saman Essa ◽  
ZM Sabra
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
World Health ◽  
Evidence Based ◽  
Middle Income ◽  
Policy Problem ◽  
Middle Income Countries ◽  
Successful Case ◽  
Low Middle Income Countries ◽  
Public Health Practitioners

Similar to how physicians practice evidence-based medicine to treat individual patients, policymakers should govern the public's health according to evidence-based data. Initiated by the World Health Organization's directive to make COVID-19 research open and freely accessible, (1,2) multidisciplinary studies are still published daily. Collectively, policymakers worldwide have not used available data effectively to make noteworthy reductions in the pandemic that is now over a year old. This brief commentary introduces a policy problem, then shares 3 categories of successful case studies as possible solutions: [1] Low- and Middle-Income Countries (LMIC): Vietnam and Iran, (3,4) [2] public health practitioners: social workers in Africa and pharmacists in Zambia, (5,6) and [3] public health programs: a smoking cessation program and inmate health program. (7,8) Examples from LMIC were selected to demonstrate practical, cost-effective and duplicable methods. A collaborative multidisciplinary approach with community health partners is also proposed. (2,9)

scholarly journals A Study on How Using an Interactive Multimedia E-Book Improves Teachers’ Ability to Teach Evidence-Based Medicine, Depending on Their Seniority

2021 ◽  
Author(s):  
Yu-Hsuan Liao ◽  
Kuo-Shu Tang ◽  
Chih-Jen Chen ◽  
Ying-Hsien Huang ◽  
Mao-Meng Tiao
Keyword(s):  
Evidence Based Medicine ◽  
Clinical Teaching ◽  
Teaching Method ◽  
Control Group ◽  
Study Group ◽  
Evidence Based ◽  
Fresno Test ◽  
Before And After ◽  
Study Type ◽  
Based Medicine

Abstract Background Teaching evidence-based medicine (EBM) is not an easy task. The role of the electronic book (e-book) is a useful supplement to traditional methods for improving skills. Our aim is to use an e-book or PowerPoint to evaluate instructors’ teaching effects. Methods Our study group was introduced to learning evidence-based medicine (EBM) using an interactive e-book available on the Internet, while the control group used a PowerPoint presentation. We adopted the Modified Fresno test to assess EBM skills before and after their learning. EBM teaching sessions via e-book or PowerPoint were 20–30 minutes long, followed by students’ feedback. We adopted the Mann-Whitney U tests to compare teachers’ evaluation of their EBM skills and the students’ assessment of the teachers’ instruction. Results We found no difference of EBM skills between the two groups prior to their experimental learning. Physicians in the study group ranked higher in “Choose a case to explain which kind of research design is used for the study type of the question and explain your choice” (P = 0.011) and “How are the important results expressed in the articles found” (P = 0.023), which was assessed by the Modified Fresno test. Teaching effect was better in the e-book group than in the control group for the items, “I am satisfied with this lesson,” “The teaching was of high quality,” “This was a good teaching method,” and “It aroused my interest in EBM.” No difference was observed between the two groups in the physicians with more than 10 years’ experience. Conclusions The use of interactive e-books in clinical teaching can enhance teachers’ EBM skills and teaching and is thus clinically useful.

scholarly journals Just-in-time postnatal education programees to improve newborn care practices: needs and opportunities in low-resource settings

2020 ◽  
Vol 5 (7) ◽  
pp. e002660
Author(s):  
Laura Subramanian ◽  
Seema Murthy ◽  
Prasad Bogam ◽  
Shirley D Yan ◽  
Megan Marx Delaney ◽  
...  
Keyword(s):  
Survey Data ◽  
Newborn Care ◽  
Just In Time ◽  
Evidence Based ◽  
Care Seeking ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Education Model ◽  
Care Practices

Worldwide, many newborns die in the first month of life, with most deaths happening in low/middle-income countries (LMICs). Families’ use of evidence-based newborn care practices in the home and timely care-seeking for illness can save newborn lives. Postnatal education is an important investment to improve families’ use of evidence-based newborn care practices, yet there are gaps in the literature on postnatal education programees that have been evaluated to date. Recent findings from a 13 000+ person survey in 3 states in India show opportunities for improvement in postnatal education for mothers and families and their use of newborn care practices in the home. Our survey data and the literature suggest the need to incorporate the following strategies into future postnatal education programming: implement structured predischarge education with postdischarge reinforcement, using a multipronged teaching approach to reach whole families with education on multiple newborn care practices. Researchers need to conduct robust evaluation on postnatal education models incorporating these programee elements in the LMIC context, as well as explore whether this type of education model can work for other health areas that are critical for families to survive and thrive.

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