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   Table of Contents - Current issue
January-April 2022
Volume 35 | Issue 1
Page Nos. 1-38

Online since Thursday, September 29, 2022

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EDITORIAL  

Co-Editors' notes p. 1
Michael Glasser, Danette McKinley, Payal Bansal
DOI:10.4103/efh.efh_272_22  
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ORIGINAL RESEARCH ARTICLES Top

Social accountability in undergraduate medical education: A narrative review Highly accessed article p. 3
Ariana Mihan, Laura Muldoon, Haley Leider, Hadi Tehfe, Michael Fitzgerald, Karine Fournier, Claire E Kendall
DOI:10.4103/efh.efh_305_21  
Background: Medical schools have been increasingly called upon to augment and prioritize their social accountability (SA). Approaches to increasing SA may include reorienting and focusing curricular activities on the priority health needs of the region that they serve. To inform the undergraduate medical education (UGME) curriculum renewal at our school, we examined how SA has been expressed in medical education across several countries and the impacts of SA activities on medical student experience and community-level outcomes. Methods: We conducted a narrative literature review using two electronic databases and searched for studies that reported on SA UGME activities implemented in Canada, Australia, New Zealand, the United States, and the United Kingdom. Studies were screened for inclusion based on predetermined eligibility criteria. Results: We included 40 studies for descriptive analysis and categorized UGME activities into five categories: (1) distributed medical education and community-specific placements/services (32; 80%), (2) community engagement and advocacy activities (23; 58%), (3) international elective preparation and experiences (8; 20%), (4) classroom-based learning of SA-related concepts (17; 43%), and (5) student engagement in SA UGME activities (6; 15%). We categorized impact into four main outcomes: student experience (21; 53%), student competencies (11; 28%), future career choice/practice setting (15; 38%), and community feedback (7; 18%). Student experience was most frequently examined, followed by future career choice/practice setting. Discussion: SA was primarily expressed in UGME activities through placement/service activities and most frequently assessed through student experiences. Student experiences of SA UGME activities have been reported to be largely positive, with benefits also reported for student competencies and influences on future career choice/practice setting. The expression of SA through community engagement in the development of curricular activities indicates a positive shift from social responsibility to SA, but a highly socially accountable curriculum would increasingly consider measures of community impact.
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Determinants of social accountability for medical schools in Iraq: A qualitative case study Highly accessed article p. 9
Mohamed Elhassan Abdalla, Thamer Al HilFi, Mohammed Al Kurtas, Taghreed Alhaidari
DOI:10.4103/efh.EfH_186_19  
Background: The mandate of medical schools is to enrich the health system through education, research, and service to satisfy the health needs of the societies they serve. The social accountability (SA) movement aims to intensify the medical school's mission. Although the context of every school is unique, one of the increasingly significant roles of medical education is to develop the indicators that promote SA. The aim of this study is to define the determinants of SA in Iraq using AlKindy College of Medicine/University of Baghdad, Baghdad, Iraq as a case study. Methods: This is a qualitative research using open-ended questions through an online mode; data were analyzed using the content analysis technique. Results: Different themes related to the roles of medical schools, stakeholders, medical schools' mission, curriculum content, research characteristics, service characteristics, enhancers of SA, and accreditation role were identified. The themes are meant to characterize a socially accountable medical school within the context of Iraq. Discussion: The study needs to be replicated in different medical schools to successfully build the national determinants of SA.
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BRIEF COMMUNICATION Top

Clinicians' perceptions of medical student teaching in a tertiary hospital p. 16
Nick S R Lan, Sana Nasim, Seng Khee Gan, Gerard T Chew
DOI:10.4103/efh.efh_312_21  
Background: Medical student placements in teaching hospitals are a cornerstone for gaining clinical experience. However, the ever-evolving nature of health care has also changed the delivery of student education. Few studies have examined clinicians' perspectives toward teaching students in this setting. We sought to explore the attitudes of clinicians involved in teaching medical students at an Australian tertiary hospital. Methods: Clinicians were invited by email to complete an anonymous online survey developed using a combination of questions from previously validated surveys. The questions utilized 5-point Likert scale statements and were based around the themes of “personal purpose and enjoyment of teaching” and “barriers and challenges to teaching.” Results for each question are presented as frequency and percentage. Results: Of 490 invited, 67 (13.7%) consultant clinicians from various specialties responded. The majority (>92%) enjoy teaching and see it as part of their work. However, approximately half thought that medical student teaching was under-recognized and half did not have adequate time to teach due to workload. Approximately 60% responded that there was insufficient time to get to know students to provide feedback and approximately 40% indicated that the scope of student knowledge and desired outcomes are not clearly defined by medical schools. Discussion: Our contemporary survey identifies modifiable factors which should be targeted. If these factors are addressed successfully, it may allow the hospital and university medical school to harness the valuable resource of clinical teachers. This could enhance the medical student experience and promote a culture of teaching and learning in hospitals.
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STUDENT CONTRIBUTIONS Top

Psychological distress among first-year medical students amidst COVID-19-related uncertainty at a medical college in Western India: A cross-sectional study p. 20
Anish Ashok Shyadligeri, Frederick S Vaz, Sudeep Ramdas Lokapure
DOI:10.4103/efh.efh_612_20  
Background: The sudden and rapid spread of the COVID-19 pandemic has created fear, worry and uncertainty in the student community. First-year medical students are likely to be doubly affected, for in addition to the stress of adapting to new learning processes, they are also now faced with uncertainties due to the COVID-19 pandemic. It was therefore decided to estimate psychological distress among the 1st-year medical students among the COVID-19 pandemic-related uncertainty. Methods: A cross-sectional study was conducted on 1st-year medical students studying at a Medical College in western India. Demographic and COVID-19 related data was collected from the students through Google Forms and psychological distress was measured by using the 20 point World Health Organization-Self Reporting Questionnaire (WHO-SRQ 20). The study was approved by the Institutional ethics committee. Informed consent was taken before administering the questionnaire to the study participants. Statistical analysis was conducted using the SPSS statistical software. Results: Prevalence of Psychological distress among the study participants by WHO-SRQ 20 Scale with cut off 7/8 as found to be 25.5%. Worried about themselves contracting COVID-19 Infection (odds ratio [OR]: 3.44; 95% confidence interval [CI]: 1.25–9.42), worried of the adverse financial effect on self and family due to COVID-19 pandemic (OR: 3.01; 95% CI: 1.29–7.04), worried that online mode of learning was putting them at disadvantage compared to traditional Teaching-Learning method (OR: 3.44; 95% CI: 1.25–9.42), and worried about adverse effects on social support due to COVID-19 pandemic (OR: 2.63; 95% CI: 1.27–5.43), were the factors significantly associated with psychological distress among the medical students. Discussion: There is an urgent need to develop a system to render counseling/professional help to all the students in need. This would ensure better mental health and would minimize any adverse academic outcomes among the students due to the COVID-19 Pandemic.
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The application of the constructivism learning theory to physician assistant students in primary care p. 26
Sanjeef Thampinathan
DOI:10.4103/efh.EfH_333_20  
When examining different clinical programs, educators must incorporate the most appropriate educational theory to the learners, especially in a clinical setting. The implementation of constructivism learning theory will help preceptors and learners understand and assess educational content appropriately. This literature review covers the key components on the application of constructivism learning theory to physician assistant students in primary care. The history, fundamental principles, and the clinician/educator role in constructivism learning theory are discussed.
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Educating for Quality Transgender Health Care: A Survey Study of Medical Students p. 31
Virginia H Dale, Ranmini Philomin
DOI:10.4103/efh.efh_508_20  
Background: The worse health outcomes suffered by transgender patients is compounded by the lack of training that students receive on addressing the needs of this population. Medical students are future doctors, and in this role, they should be learning to provide care to all of their potential patients. Methods: This study uses pretest–posttest design to assess the impact of a teaching session on students' responses across three themes: understanding, education, and profession. Students and members of the public (n = 25) attended a 2-h teaching session covering important topics in relation to transgender health. Assessment was carried out using a six-question survey that gathered responses on a Likert scale. Results: Level of understanding showed a significant increase (P < 0.05), as did one of the questions associated with profession (comfort seeing a transgender patient for a gender issue). The questions on education showed no significant change with the majority of students believing in the importance of learning about transgender health care. Despite the teaching session, there was no increase in the comfort level of medical students' with seeing a transgender patient for a nongender issue. Discussion: Medical students are ready to be part of reducing the barriers to quality health care for transgender people. Education delivered with the help of the transgender community and specialist doctors can equip medical students with the understanding and level of education required to provide care to all of their patients.
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LETTERS TO THE EDITOR Top

Experiencing blended learning during COVID-19 p. 35
Paiwei Qin, Jianhui Wei, Shengjun Lin, Shaoming Huang, Qiongying Deng, Li Wei
DOI:10.4103/efh.efh_319_21  
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Language barriers related to non-english-speaking patients and effects on nurses and quality of nursing care p. 37
Asokan Govindaraj Vaithinathan, Sayed Ali Hussain, Mariam Fareed Jawad, Fatima Ali, Sara Abdulla, Muyssar Sabri Awadhalla
DOI:10.4103/efh.EfH_101_17  
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