Conference 2012

March 03 - 05, 2012

Islamabad - Pakistan

ABSTRACT
In the name of Allah the most Beneficial & Merciful
PLENARY
PRESENTATIONS
Can we improve learning and assessment in the workplace?"

John Norcini, Ph.D.

President and CEO, Foundation for Advancement in Medical Education and Research (FAIMER), USA

Over the past decade there has been growing interest in the use of performance in the workplace as a means of
teaching and assessing doctors and other professionals. This talk will address the issue of why workplace-based
assessment, with a focus on providing formative feedback, is central to both learning and improvement during
training and later in practice. It will present the UK's Foundation Programme as one model of formative assessment
during training. For practicing doctors, it will present a model, based on the use of patient outcomes and process of
care measures, which supports ongoing quality improvement.

Program evaluation, global standards and accreditation

Ara Tekian, PhD, MHPE

Associate Dean, Medical Education Department University of Illinois at Chicago, USA

Globalization is one of the trends in medical education, and as a result with increased migration and variation in
standards of educational and training programs, the need for standardization and quality assurance has become a
necessity and high priority for many countries, institutions, and organizations. Over the past two decades program
evaluation, global standards and minimum requirements for accreditation have been extensively discussed,
debated, and their appropriate application reexamined. This presentation will explore the true purpose of
undertaking such initiatives, examine the political and social environments, and reflect on the effectiveness and
usefulness of preparing such reports that meet a set a criteria, standards and requirements, and discuss how each of
these three components intersect.

Medical education and the healthcare service: a dependency

too little considered.

Janet Grant, PhD

Professor Open University Senior Advisor WFME, UK

Although medical education is dependent on the health care service, and has, as its first purpose, to develop the
physicians and surgeons of the future who will staff that service, there has rarely been a concerted analysis of the
complex relationship between medical education and the health care service. This presentation will tease out some
of the many facets of this complex relationship. These include:
?Situated learning: medical education as professional induction
?Situated learning and communities of practice
Plenary Presentations

?Professionalism and role models

?The need to move beyond competency: Practice makes perfect
?The health service and continuing professional development
?Medical migration
?Social accountability, medical education and the health care service.
In all of this, interdependency and mutual responsibility will be considered.

03
 The Social Responsibilities of Medical Schools /Colleges

Professor John SG Biggs MA, MD, FRCOG, FRANZCOG DHMSA.

Visiting Fellow chair of the Australian Capital Territory Human Research Ethics Committee Australian National
University in Canberra. Australia.

Introduction
The social responsibilities of medical schools /colleges (medical schools) have aroused new interest in the last 4
years as unmet health needs and discrimination have been raised in public media and by governments. This lecture
looks at ties of medical schools and growth of their social awareness. Specific fields – recruitment of minority
students; gender balance; meeting needs for more family doctors; and encouraging graduates into practice in
underserved areas –are addressed, and accountability of schools for achievement in such matters examined.
Methods:
The social mission of medical schools in Australia was studied by interviews of deans; identified priorities led to
searches of national and international literature. Information on the outcome of students' plans and careers came
from work with the NHS Medical Workforce Research Unit in Oxford and the NHS Specialist Workforce Advisory
Group, and experience as Dean of Postgraduate Medicine in Cambridge. Particular note was made of the work of
Fitzhugh Mullan et al. on social scoring of medical schools in the USA. Information was gained from the author's
work on medical education in Pakistan.

Results:
Australian schools responded to public and government pressures and were active in recruitment of indigenous
students and encouragement of careers in general practice and underserved areas. Other priorities were evident, as
in other countries. The role of school experience in career development was seen and its role in workforce planning
evident. Deficiency in maintained information on graduate careers is a block to effective workforce planning.

Discussion and Conclusions:

While social changes are accepted by schools there are other priorities like research and clinical excellence that
must be retained. Encouragement of minority students in Australia has been evidently effective. Possibilities are
inherent in the principle of accountability of schools for graduate careers.

Commitment to quality improvement of medical education

through accreditation

Umar Ali Khan

Pro Vice Chancellor (Health Sciences)
Isra University Islamabad Campus. Islamabad. Pakistan

As the world divided by boundaries and independent nations started taking their stock, the problem of health, health
professionals and health resources came in the forefront. With diverse geographical conditions, population,
resources and different disease challenges nations setup their own institutions and established their own guidelines
for medical education and health services. The matter did not stop here for some nations as war and huge quantum's
of natural disasters force these nations to compromise on the economic share of these institutions. Pakistan is one of
Plenary Presentations

these nations yet it has kept up its honors of quality medical education and its graduates are providing excellent
medical care the world over. Pakistan Medical & Dental Council and Higher Education commission of Pakistan takes
the flag.

04
Developing Departments of Medical Education

Syed Moyn Aly.

Chairperson, Department of Medical Education College of Medicine,
Taif. University Saudi Arabia.

The paper attempts to explicate the importance of Departments of Medical Education (DME) in the modern
educational world. It goes on to explain the importance of strategic planning, developing vision and mission
statements in line with the institutional vision and mission statements, write clear values and goals and then translate
them into action plans. The functions and scope of the department need to be spelled out. A department of medical
education should be working towards providing academic services to the institution. This would include supporting
the curricular activities, improving the quality of assessment, maintenance of the entire process of learning, inclusion
of modern computer-based technologies and faculty and student development. Other functions of Departments of
Medical Education should be promotion of educational research, collaboration with national and international
departments of medical education and promotion of the profession of health professions education. Where possible,
the department must look after the professional welfare and promotion of faculty members especially those
belonging to the medical education profession itself. The presentation will go on to give examples of the
organizational structure of departments of medical education from various national and international institutions.
This would highlight how various organizations have structured themselves; what the relation of the Director of the
department of medical education is with the authorities in the medical and/or dental college is. Towards the end, the
author will deliberate upon how most departments of medical education are functioning in Pakistan, what their
strengths and opportunities are and how they may overcome their challenges.

Ensuring Patient Safety through Standardized Patient and

Mannequin-Based Simulations

Anthony Errichetti, Ph.D.

Chief of Virtual Medicine and Professor in the Department of Psychiatry and Behavioral Medicine at New York
College of Osteopathic Medicine (NYCOM), USA.

This presentation will discuss the new discipline “patient safety,” a movement emphasizes the reporting, analysis,
and prevention of medical errors. It will review the most common types of procedural and communication errors that
lead to adverse healthcare events. It will also review strategies for using Standardized Patient and mannequin-
based patient simulations with health care teams to reduce or eliminate medical errors and as a method of selecting,
prior to employment, competent medical residents.

Application of Simulation for Assessment in Medicine

John (Jack) R. Boulet, PhD.

Vice President of ECFMG, USA.

Foundation for Advancement of International Medical Education and Research (FAIMER)

The use of simulation-based assessments in medicine is expanding at a rapid pace. This growth has involved
numerous modalities, including computer-based case simulations, standardized patients, part-task trainers, and
electromechanical mannequins. While the development of new educational programs and related assessment
activities can lead to better trained practitioners, there numerous challenges, including those associated with
Plenary Presentations

finances, assessment administration logistics, scenario development, scoring, standard setting, and the provision of
meaningful feedback. This presentation will provide an overview simulation-based assessment, concentrating on
methods currently employed in high-stakes certification and licensure examinations. The review of the application
of simulation techniques is this arena provides guidance on how to deal with many of the challenges, most important,
those associated with the provision of valid and reliable scores. Knowing more about these psychometric
challenges, and how to address them, will allow assessors, especially those involved in certification activities, to
develop and administer more defensible tests.

05
ORAL
PRESENTATIONS
Assessing clinical competence at an early stage of a PBL curriculum.
At the college of Medicine KSAU-HS Riyadh. Saudi Arabia.

Tarig Awad Mohamed, Lecturer in Medical Education.

Prof. Mohi Magzoub, Chairman Medical Education Department

Introduction:
The college of Medicine KSAU-HS adopted a 4 year graduate problem based & community oriented curriculum. In
our curriculum clinical skills are integrated and introduced at an early stage of the curriculum starting from the 1st
block.
Assessing clinical skills at an early stage of the curriculum is a big challenge to medical educators; in our curriculum
clinical skills are assessed using an instrument known as OSCE. It is a performance-based exam in which students
are observed demonstrating various clinical skills as they rotate through a series of stations. Each station usually
tests a different component of clinical competence such as taking a history, conducting a physical examination,
ordering diagnostic tests, making a diagnosis, planning treatment, or communicating with real or simulated patients.
Faculties are requested to write OSCE items according to four forms. The first form describes the type of station and
what adjectives are tested, the task, time required, and the materials needed. The second form includes the
checklist for examiner, the third form describes the instructions for students, and the last form describes the
instructions for the simulated patient or regular patient. Each year the COM develops between 20 and 30 OSCE
items.At COM KSAU-HS , an OSCE's time is 7 minutes for the preclinical students in phase two, and 9 minutes for
the clinical phase exams.

Methods:
We measure the reliability & content validity, in addition to the satisfaction of the examiners, students as well as the
simulated patients utilized.

Results:
Reliability was found to be 0.5 and content validity was shown that all objectives were well covered by the exam.
Stations were carefully reviewed by the assessment unit OSCE committee; both students &examiners in addition to
the SPs are highly satisfied with the exam.

Conclusion:
Introducing and assessing clinical competence early in the curriculum increase relevance and authenticity, OSCE
was found to be valid, reliable & acceptable. However it requires a lot of logistics & preparations. The process is
laborious and challenging, but critical to good assessment of student performance.
Feedbacks from different stakeholders were found to be helpful to improve the exam.

CorTTex and centricity

Tunio MA
Assistant Professor
King Fahad Medical City Riyadh, Radiation Oncology Department, Comprehensive Cancer Center, King Fahd
Medical City, Saudi Arabia.

Outcomes of CorTTex and Centricity (electronic health record system) after implementation in Our Radiation
Oncology Department

Background:
Computerized physician order entry (CPOE) in electronic health records has now been recognized as an important
tool for optimal health care provision, which can reduce errors and improve safety. We conducted this study to
describe documentation completeness and user satisfaction of electronic medical charts before and after
implementation of CorTTex, centricity in our radiation oncology department and to provide guidelines for other
hospitals which are shifting from old paper chart system to electronic records.

Materials and Methods:

Retrospective chart review of 30 patients was carried out for patients who received radical radiotherapy for prostate,
cervix and thyroid between 2007 and 2011. Documentation completeness scores were assigned to each chart
Oral Presentations

based on the number of documented data points found out of the total data points assessed. CorTTex
documentation completeness was compared with completeness of paper charts orders of the same regimens. A
user satisfaction survey of the paper chart and CorTTex/ center city was conducted among the physicians, nurses,
and pharmacists who worked with both systems.

Results:
The mean percentage of identified data points successfully found in the CorTTex charts was 93% versus 67% in the
paper charts. 07
 Evaluation of Centralized Accreditation Process: Experience of
a Medical College in Saudi Arabia

Abdul Rahman Al Mohaimeed , Farid Midhet, Issam Barimah

College of Medicine, Department of Family and Community Medicine, Qassim University, Saudi Arabia

Introduction:
Rapid growth in the number of post-secondary institutions necessitated the creation of a government agency for
quality assurance of higher education. In 2004, the Council of Higher Education approved the founding of National
Commission for Academic Assessment and Accreditation (NCAAA). This study aims to examine the accreditation
process of NCAAA in Saudi Arabia

Methodology:
We conducted a semi-qualitative study at the Qassim University College of Medicine, where an accreditation
exercise led by NCAAA was recently completed. Data about applicability and impact of the accreditation process
were collected through semi-structured interviews, focus-group discussions and structured questionnaires. Some
data were compared with information available from two years prior to accreditation. We collected and analyzed the
data using the appropriate tools.

Results:
The accreditation process lasted about two years, culminating in the preparation of a self-evaluation report and a
visit of four external reviewers. The process itself brought significant changes in the educational processes and
administration and implementation of the curriculum. Our analysis also indicated significant improvements in the
quality of medical education in the College. However, there were questions about the applicability of the NCAAA
accreditation process on medical education.

Discussion:
The awareness increased the critical judgment regarding the education processes in the college. It is difficult to
provide information on all areas of impacts of NCAAA accreditation. However, we have presented an account of
some of the initial impacts of the first accreditation exercise in the College. Our study suggests that, while
applicability of each of the NCAAA standards to medical education is debatable, the impact of the accreditation
processes (including intense data collection and analysis, documentation, and participation of and feedback to
faculty members and students) was clearly felt at all levels.

Conclusions: NCAAA accreditation process was successful in improving the quality of medical education.

A task-based learning approach to specialty induction for medical students.

Burch DJ

Lancaster University has a small medical school delivering the Liverpool University syllabus. This follows modern
educational theories, including early clinical contact, problem based learning, and student selected components.
The obstetrics and gynaecology course consists of 7 weeks in the third and four in the fourth year of the course. This
year it was decided to start third year with a series of introductory half-day sessions. I did not think that a set of
conventional lectures would be an adequate introduction, and in any case it would be hard to know what to pick out of
the whole course. On the other hand, a group of 50 students is too large to allow bedside or small group teaching.
I devised a novel approach using role play and task-based learning. A junior doctor played the doctor and a senior
medical student the patient. They role played an initial history which was followed by group discussion. Then initial
results were shown and the trainee counselled the patient, which was again followed by using a task-based learning
approach to structure the students' understanding of what was going on. Finally they were shown the operative
results and the post-operative explanation and plan were role-played. The students were divided into small groups
to focus on one of Harden's (1999) three-circle learning outcomes.
A task based approach is motivating for the students by focussing on the skills they will require after qualification. It is
also a systematic way of structuring learning and making sure no area of the curriculum is forgotten. Mapping
learning outcomes to the curriculum in this way contributes to quality control and is stimulating for the students.
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08
The Virtual Master class: collaborative online training
for young medical specialists”

Janet Strivens*
Director of Postgraduate Diploma/ Master Program
University of Liverpool. United Kingdom

The European-funded project “The Harmonisation of Haematology Training across Europe” (H-Net) included the
piloting of a haematology master class for young haematologists towards the end of their training. We report here on
the design, implementation and evaluation of what we believe is a sustainable model of online, collaborative
learning which fulfils the requirements of a 'Master class' for young medical professionals.

The Master class consisted of twenty-five haematology trainees, in five groups together with a 'mentor' ( five
experienced haematologists chosen without regard to their particular sub-specialisms). No two group members
shared the same nationality. All discussions and materials were through the medium of English. Study materials
based on real, complex cases were prepared by relevant experts in the different sub-areas of haematology –
Haemostasis and Thrombosis, Clinical Haematology, Diagnosis and Transfusion Medicine. In all, six cases were
studied over a six-month period. Groups were required to produce reports on their discussion at fortnightly intervals.
Following each case, case authors received the groups' reports and at a set time made an online presentation
discussing the case and giving feedback to the groups. This presentation was recorded and made available for
further viewing.
Three tools were used in an integrated way; a social networking site (NING) for the main learning and discussion; a
conferencing tool (Elluminate) used for feedback on the trainees' reports from the 'experts' who designed the study
material ; and a portfolio/content management tool (Confolio) to store study materials, background literature and
group reports on their deliberations.
The evaluation of the Master class is based on data gathered on three key aspects: the quality of learning; the
experience of the learners; and the cost of supporting the Master class in terms of time spent by case authors and
mentors.

Ensuring quality through International collaboration?

developing a conceptual and practical model

Ian Willisisan *
Academic Developer and the Director of Studies, University of Liverpool, United Kingdom.

The University of Liverpool and the University of Health Sciences in Lahore are developing an international
collaboration, with the aim of improving learning and teaching in medical education in the Punjab. The strength
of the collaboration is founded on a model of multi-level connections between the universities. We are now
making real progress; including initiatives in teaching programmes, accredited and non-accredited. This
presentation looks behind the progress so far to pick out the practical lessons being learnt and to propose a
theoretical underpinning. We believe that the model and the lessons learnt will have application to other
international collaborations in medical education.
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09
 The place of anatomy education in everyday clinics

Tabinda Hasan*
Dept of anatomy, Faculty of medicine, Jazan University, Jazan, Saudi Arabia

Introduction:
Anatomy as a subject has always been considered overtly dogmatic, superfluous and archaic. The knowledge of
anatomy is usually painstakingly acquired and cheerfully let go, as soon as the undergraduate years pass away.
However, anatomy's role in forming the basic concepts of human body is pivotal to the optimal treatment of patients
in real life.
This paper evaluates the relevance of anatomy education in daily-clinics by observing trends among practicing
physicians/surgeons.

Methods :
A semi structured questionnaire analyzed perceptions and practice of 41 doctors (28 males, 13 females; age26-
55years) in Para-clinical/Clinical departments of a ministry-of -health-hospital-KSA. Basic descriptive statistics was
used to evaluate data.

Results:
Majority of the respondents admitted to anatomy being important in clinical settings. (Extremely important n=25 /
60%; Some-what important n=11 / 27 %; Not important n=5 /13 %). The frequency of referring to Regional/Clinical
anatomy books during routine practice varied (In-three-months n= 13/ 32 % ; In-six-months n=19/ 46 %; Never n=
9 / 22 %). Interestingly, a majority of favorable responses regarding the importance of anatomy concepts and the
need to consult books came from surgical based branches. (p<.05; significant) Professional status,experience and
gender did not influence the practice of consulting books, but age did seem to be an influencing factor. It was more
popular among young-junior doctors as compared to old-senior doctors. (p<.05; significant)

Discussion and Conclusion:

Our study provides objective evidence on the importance of gross human anatomy far beyond a mere assessment
criterion of the undergraduate curriculum. This study gives greater credibility to the role of anatomy knowledge in
daily professional practice for physical examinations, symptom interpretation, inference of radiological images,
effective clinical-communication and avoidance of medical errors. It also underlines a deeper need for rigorous
reforms in attitudes of the stakeholders of medical-education community towards anatomy education and its vertical
integration in later clinical years.

Acquiring procedural skills competency in internal medicine:

what do residents expect?

Muhammad Tariq * Nizar Bhulani, Asif Jafferani, Afaq Motiwala, Saeed Hamid
Associate Professor, Department of Medicine
The Aga Khan University., Karachi, Pakistan.

Introduction:
Procedural skills training forms an essential yet difficult to assess component of an Internal Medicine Residency
Program. We report the development of our own process of documentation and assessment of procedural skills
training.

Method:
A survey was conducted within the Department of Internal Medicine, The Aga Khan University Hospital, Karachi in
order to determine the optimal number of procedures needed to be performed by residents at each year of residency.
Respondents included both faculty and residents in the Department. Thereafter the responses were analyzed with
the expert opinion of a focus group in cases of discordant responses.

Results:
A total of 64 responses were obtained of which about 70% consisted of resident responses. Focus group's
assistance was taken on a total of 8 procedures due to difference in responses of faculty and residents.
Oral Presentations

Conclusion:
Program guidelines were formulated and a logbook has been designed which will facilitate the assessment of the
procedures performed at the facility by the residents. Since this is a novel step in our region of the world, these
guidelines can serve as a tool for other programs in the country and region for the evaluation and assessment of
procedural skills in Internal Medicine residency programs.

10
Innovations in anatomy education: The promise of computer graphics

Tabinda Hasan*
Dept of anatomy, Faculty of medicine, Jazan University, Jazan, Saudi Arabia

Introduction:
Virtual reality (VR) and augmented reality (AR) are emerging technologies in computer graphics being used to
create novel applications in human anatomy teaching. They are immersive, intuitive, interactive and promise 'state-
of-the-art' progress in 21st century medical education. A paradigm achievement was the creation of "Visible Human
project" conducted by National Library of Medicine in 1993. This paper addresses the scope of VR and AR as tools
for teaching anatomy.

Methods:
An extensive review of published literature with strict inclusion / exclusion criteria was done to extract relevant
information from 120 representative articles (2000- 2011) in context of the pedagogical implications of VR and AR in
anatomy education.

Results:
Available evidence suggests that VR and AR have great potential in providing 3-D visualization for medical students
to understand anatomy in a less complex way as compared to cadaveric dissections by producing interactive
multidimensional simulations.

Discussion and Conclusion:

Teaching anatomy is mainly an illustrative process involving pictures, diagrams, models for easier understanding.
Changing trends and limited logistics of 21st century-medical-education have abridged cadaveric dissection and
promoted "time-cost-effective-user friendly" teaching alternatives. Biomedical and computer engineering have
merged with traditional systems to produce innovative instructional aids like VR and AR which allow students to
"peer-under-the-skin" and reveal the "inner-workings" of human body in a "state-of-action". It enables interactive
curricula designs that incorporate scientific / cultural components to anatomy classes. Students acquire integrated
spatial concepts through virtual "drag-and-drop" technique and construct visual images of complex structural inter-
relationships through applying "layering-and-de-layering" features to biological systems. It facilitates
comprehensive visualization of hard to access areas like nerve/arterial plexus. Virtual procedures can be infinitely
repeated; materials can be conveniently stored / transported to multiple locations.
Such novel applications can effectively replace old school descriptive teaching to re-invent a revolutionized anatomy
that will be easier for 'tomorrow's doctors' to acquire and to retain.

The Experience of Objectively structured clinical examination

in Prosthodontics at BDS Level

Fazal Ghani
Professor & Head of Department
Khyber College of Dentistry, College of Dentistry, University Campus, Peshawar. Pakistan.

The objective of this investigation was to assess the effectiveness of Osce as a method of assessing the clinical,
practical and communication skills of BDS students after completion of their exposure to training and teaching in the
specialty of prosthodontics at Khyber College of dentistry. For this purpose, multiple OSCE stations including static,
observed and interactive stations were constructed. Multiple faculty members were involved in conducting the
examination. Apart from the wider coverage of the syllabus in the specialty, both the students and examiners
appreciated this new method of examination. Especially the students and teachers found the method more
organized and the students feeling happier with the equal time and same examination material presented to each of
them. The results and experience of these new examinations and the ways to improve further method shall be
presented.
Oral Presentations

11
 Professionalism in physical therapy, growth, development &
perception of Pakistani physical therapists.

Naveed Babur
Isra School of Rehabilitation sciences, Isra University Islamabad Campus.

Objective:
The objective of this cross sectional survey was to know the difficulties physical therapists are facing in their
professional practice. To find out where the physical therapists of Pakistan dream their profession in future. To figure
it out what professional developments are currently going on and what kind of necessary efforts are required for
professional growth in Pakistan in future?
Design: Cross sectional survey

Method:
This cross sectional study was completed in three months. One hundred Physiotherapists participated in the study.
Purposive sampling was used and Structured Questionnaire (close ended) was selected as a data collection tool.
The data were entered and analyzed using SPSS 11.5. The quantitative data was presented in the form of Mean +/-
S.D along its range. The categorical data was presented in the form of frequency tables, percentages and pie charts.
Multiple bar charts were used to present two or more categorical variables. Chi-square test for significance was used
to see the association between categorical variables. A p-value less than 0.05 were considered significant.

Results:
In this study, a total of 100 professional Physiotherapist (PT) were interviewed about their opinion regarding their
future and satisfaction about physiotherapy profession. There were only 43 PTs (35 males and 8 females) who were
satisfied with their earnings and 57 PTs (34 males and 23 females) were not satisfied with their earnings. There were
only 35 PTs (28 males and 7 females) who were happy with the efforts done so far, for professional growth in
Pakistan and 65 PTs (41 males and 24 females) were not happy about the efforts done so far. There were only 37 PTs
(28 males and 9 females) who wanted to be physiotherapists by their own choice, 61 (39 males and 22 females)
were in this profession because they did not qualify for other professions and there were only two male
physiotherapists who did not intend to practice after graduation that's why they were in this profession.

Conclusions:
Participants reported that they were not satisfied with their earnings and quality of education. Participants stated that
the struggle for the regulatory body is the best advancement in the development of profession. Mostly the
participants were hopeful in future to see their profession developed and standardized system of education.

Key words:
Professionalism in Physical therapy (PPT), Professional growth (PG), Professional Development (PD), Physical
Therapists or Physiotherapists (PTs).

Gaps between the documentation and implementation

of health policies in Pakistan

Adeela Rehman*, Dr Saif Abbassi

International Islamic University Islamabad
Department of Gender Studies, Fatima Jinnah Women University Rawalpindi, Pakistan

Health policy is the basic millstone to build up the health services for both men and women and its implementation
reflect the gender based differentials in accessing and utilizing health services. The efficient utilization of health
services is the reflection of competence of health policies and its successful implementation. The study was design
to find out the gaps between the documentation of health policy and its implementation to target the women's health
status. Both quantitative and qualitative research design was used to conduct the study. Firstly, the health policy of
2001 and 2009 was analyzed to explore the focus issues of health regarding the gender needs and the aspects
which were priority for women's health. Secondly the implementation of these policies was measured by conducted
survey in hospital to find out the implementation of targets highlighted in the policy document regarding women's
health. The findings of the study indicated that although the policies focuses the women's health needs in its top
priorities areas, but not detail guidelines has been illustrate to achieve these goals and targets. There is gap between
Oral Presentations

the formulation and implantation of health policies with respect to women's health. The monitoring and evaluation of
utilization of resources and the performance of staff has not using effectively. Programs exist but are underfunded for
most priorities identified in national health policy due to lack of health system reform programs to address workforce,
management and financing issues. It is indicated that issues related to women's health were not only addressed but
also develop some strategies for its functions, but has not been implemented in a proper way, therefore the gap
existed between the policy documents and the actual practice of these strategies that represents the failure of
governance.
12
An evaluation of students perceptions about educational environment on
Dundee Ready Education Environment Measure DREEM A single centre study

Mohammed Shahzad Anwer* mohammed idrees Anwer, tariq ghafoor

Assistant professor
Sheikh Zayed medical college hospital Rahim Yar Khan, Pakistan

Introduction:
Education environment makes an important contribution to student learning and determines the success of
undergraduate medical student. The DREEM (Dundee Ready Educational Environment Measure) questionnaire is
a validated instrument for assessing educational environment, by identifying means of remediation of poor aspects
of environment.

Aims:
This study used qualitative analysis, in association with the DREEM questionnaire, to evaluate the educational
environment of fourth year and final year undergraduate medical students, and identify areas for change to enhance
student experience.

Methods:
The DREEM questionnaire was administered to 160 undergraduate students of 4th year & final year MBBS
maintaining anonymity. The results were analyzed using SPSS 16 & relevant statistical tests. Results were
compared with similar study.

Results:
The sample size was 160 and the mean sample score of all items were 92.04. It was 22.03 in students perception of
learning, 21.03 in students perception of teachers, 13.39 in students academic self perceptions, 22.21 in students
perceptions atmosphere and 13.11 in students social self perception. Through responses on the DREEM
questionnaire weak areas were identified as requiring remediation.

Conclusion:
The qualitative data have substationally enhance questionnaire interpretation and allowed actions to address the
common causes of student dissatisfaction. This methodology is recommended for medical institution to assess the
overall educational environment.

Statistical methodological and logical errors in

biomedical journals of Pakistan revised version

Asif Hanif*
Assistant professor and Head of Department
Gulab devi PGMI, Lahore Pakistan

Background:
Statistical methods are very important attributes of biomedical research or biostatistics. All investigations and
scientific process are lacking or incompetent without its numerical presentation. In Pakistan, we do not involve the
professionals like the people of applied Statistics or biostatisticians in designing and completing any research.
Almost all surveys/ researches are accomplished without the professional's assistance, which directs to statistical,
technical and logical errors like, inappropriate sampling methodology, study design, inappropriate data collection
and analysis including wrong or incomplete interpretation.

Objective:
The objective of this study is to present a mountain of errors and their consequences on wrong interpretation.
Results:
The proportion of errors regarding study designs, sampling techniques and selection of statistical test was
prominent in all the reviewed articles. The use of appropriate analysis especially non-parametric statistics was not
up to the required level.
Oral Presentations

Conclusion:
The authorities of medical journals should assure the involvement of professionals to avoid the errors such as
selection of statistical procedures and interpretations.

Keywords:
Biomedical research, statistical errors, Statistical interpretations.
13
 Why Should Training In communication skills be mandatory
at all levels of medical education
Abid Jameel*
Associate Professor and Director Medical Education
Postgraduate Medical Institute Hayatabad Medical Complex Peshawar. Pakistan.

Objectives:
(1) To assess the perception, skills and comfort level of postgraduate residents regarding breaking bad news (BBN).
(2) To study the perceptions of cancer patients regarding disclosure of cancer related information.

Methods:
(1) To assess the perceptions of residents, pre- and post-workshop questionnaires were distributed among 97
residents during workshops on communication skills. (2) To assess the perceptions of cancer patients regarding
BBN, a cross sectional survey was conducted on a total of 60 cancer patients using a pre-designed questionnaire.

Results:
Ninety two (95%) residents had not received any training in communication skills at undergraduate level. Only 64
(66%) residents had witnessed bad news being broken by a consultant. Before the workshop, 83 (85%) residents felt
either not comfortable or somewhat comfortable while BBN compared to 36% post workshop (p < 0.0000). Sixty four
(66%) residents reported BBN to be extremely stressful or very stressful before the workshop versus 25% post
workshop (p < 0.0000). Before the workshop, 18 (19%) residents said they will withhold the information from the
patient on family's insistence, despite patient's wish to be informed, compared to 6% post workshop (p < 0.007).
Ninety one (94%) residents said that this workshop had changed their perceptions regarding BBN to a major extent.
Ninety two (95%) residents rated the workshop as extremely useful or very useful.

Survey of cancer patients showed that 48% (29/60) cancer patients wished for full disclosure of cancer diagnosis.
Ninety three percent (56/60) of cancer patients wanted full information about all side-effects of treatment. Fifty eight
percent (35/60) cancer patients wanted their close relatives to be present while bad news was being broken.

Conclusion:
Almost half of patients in our study wished for full disclosure of information regarding cancer diagnosis. Over 90%
patients wanted full information regarding all side-effects of chemotherapy. A vast majority of our residents (85%) felt
uncomfortable with BBN and had not received any formal training in this area. It is recommended that training
regarding how to break bad news be made mandatory part of our medical training both at undergraduate and
postgraduate levels.

Teaching and Assessment of “Patient Centered Professionalism”

for Residents at Khyber Pukhtunkhwa
Abid Jameel,
MBBS; PhD; FRCP; DHPE, Director Medical Education, Postgraduate Medical Institute (PGMI),
Peshawar and FAIMER Fellow.

Introduction:
Although most of the accrediting and professional bodies throughout the world have included professionalism as a
core competency yet this is not the case in Pakistan. PGMI Peshawar, in collaboration with FAIMER Institute,
Philadelphia, has initiated to formally introduce teaching of “patient-centered professionalism” to all 1st and 2nd year
residents.

Objective:
To introduce teaching and assessment of patient-centered professionalism to residents.

Methodology:
A three-day comprehensive workshop on professionalism is being conducted for residents of PGMI since January
2012. Each workshop enrolls 20 trainees. Teaching strategies include OSCE followed by introductory interactive
lecture, case based discussion and reflective exercises. Assessment is initially focusing on the cognitive component
of professionalism, and therefore, we are assessing the understanding of our residents by using a pre-test and post-
test in the form of OSCE and SAQ on case-based scenarios. Difference in pre- and post-test scores will give some
indication regarding improvement in residents' knowledge of core principles of professionalism and the application
of these principles. Use of Multi-Source Feedback (MSF) will be encouraged on voluntary basis initially. Residents
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are encouraged to write reflective diaries regarding issues related to professionalism faced by them and how these
were handled by applying the principles of ethics/professionalism learnt.

Results:
collected from workshops held so far shall be analyzed and will be discussed in the presentation.

Conclusions:
14 Initial results are very supportive of this training. It is recommended that structured training and assessment of
professionalism be provided to all residents in Pakistan.
Quality assurance in the delivery of vertically integrated curriculum

Nazish Rafique * Basil Alsheikh

Chairman Physiology Department & Vice president Academic affairs
College of Medicine University of Dammam. Saudi Arabia.

Background
Integrated learning is slowly gaining grounds in developing world. We, in the physiology department implemented
the vertically integrated teaching methodology in the year 2010. Across this implementation, one of the most
challenging features was to assure and improve quality. We introduced various quality assurance methods for
effective implementation of this vertically integrated curriculum. We would like to share the model utilized for this
purpose in this article.

Materials and Methods:

For effective planning, delivery and assessment departmental meetings were held on regular basis. Faculty
members were given agenda for each meeting. Meetings covered learning objectives, determining learning
strategies, developing integrated assessments (formative/summative), peer review, post-hoc analysis of results,
review of feedback and future strategies to improve. Each faculty member presented their output in faculty forum
for broader input and refinement. At the end of the year, feedback of the students was taken in the form of a
questionnaire.

Results:
Above mentioned processes helped in better integrated curricular delivery and at the same time contributed towards
faculty development in medical education. Hands on training to faculty were provided through various workshops
regarding lecturing skills, microteaching, principles of adult learning, Integrated Course Design, facilitating small
group sessions, creating integrated MCQs, analyzing MCQ responses. All these activities resulted in adjustments in
subsequent delivery of the curriculum, better curriculum planning and management.

Conclusions.
The above mentioned tools helped to identify the deficiencies in the modular delivery and assessment.
Recommendations of the team helped in overcoming these shortcomings and better future planning to overcome
these problems. Our “hands on” model also educated most of the faculty members and motivated them to improve
quality and produce competent graduates who are capable of meeting the challenges of the medical profession.

Implementation of vertically integrated methodology for teaching

and assessment of physiological concepts

Nazish Rafique *Basil Alsheikh

Chairman Physiology Department & Vice president Academic affairs
College of Medicine University of Dammam. Saudi Arabia.

Background
Under the existing system of undergraduate curriculum, teaching was done in a non integrated manner. Our
objective was to develop and implement a vertically integrated curriculum for teaching physiology to 2nd year
Medical students, which would focus on teaching and assessment of physiological concepts via integrated learning
using multiple teaching methodologies. It also aimed to assess the feasibility for the continuation of this vertically
integrated curriculum for the students of University of Dammam in the coming years.

Materials and Methods

Regular departmental meetings were held for discussion and refinement of the case scenarios used for vertical
integration, developing integrated assessments (formative/summative), analysis of the vertically integrated MCQs,
post-hoc analysis of results, review of feedback, future strategies to improve. Learning strategies used were large
group interactive sessions (LGIS), problem based learning (PBL), small group discussions (SGDs), and practical
sessions. Student feedback questionnaire was administered at the end of module.

Results
85% of the students agreed that teaching physiological concepts in integration with clinical scenarios is a better
approach than traditional teaching. 99% of the students responded that integrated approach makes learning and
understanding easy. 80% of the students think that assessment of the physiological knowledge via clinical scenario
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based MCQs is a better way of judging the knowledge of the students. 76% of the students agreed that this mode of
teaching and assessment motivated their critical thinking. 90 % of the students indicated that this model of teaching
would be helpful to them in future for better understanding of clinical concepts and 92% of the students favored the
continuation of this integrated approach in future.

Conclusion
In conclusion students well received the idea of delivering physiology curriculum via the integrated means and
favored its continuation in the future. So integrated curricular delivery can be implemented successfully in 15
undergraduate medical education.
 The quality of student feedback: Motivating students
to give high quality feedback

Mark Norrish
Oman Medical College. OMAN.

Introduction
The course experience questionnaire has long been established as one of the strongest performance indicators of
teaching quality in medical education. However it is clear that the mere collection of such questionnaires does not
automatically lead to improvements in the quality of the educational provision. Several hindrances to quality
enhancement from the course experience questionnaire have been identified. These include; their use as an audit or
appraisal tool rather than as a developmental tool, rigid standardization and limited scope for evaluating innovation
in teaching, and sometimes the lack of truly voluntary participation by students.

Methods:
This study therefore looked at the role of providing feedback to students on the changes that have resulted from the
evaluations by previous cohorts as a motivator for students to participate more actively in providing quality feedback.
This was done with three cohorts of students (n=284) on two courses in preclinical medicine. All courses have a
course evaluation questionnaire, some courses also provide specific feedback to students on the changes arising
from previous evaluations. Within-group comparisons of the nature and quality of student responses were made
between these courses.

Results:
When faculty provided this kind of feedback to students, students were more likely to provide higher quality
feedback. This was demonstrated in two ways; (i) an increase in the number of voluntary prose evaluations, an
increase in word count, and more responses that involved 'considered' evaluation, (ii) a reduction in the number of
evaluations determined to have been spoiled by responder bias or fatigue.

Conclusions:
As suggested by theories of behavioral modification and motivation, this study shows that students need to believe
that their behavior is likely to effect change, in order for them to become actively involved in the evaluation process.
If this is done, students do provide high quality feedback. With this in mind, we as faculty need to value students as
stakeholders in the delivery of quality medical education.

“Oh! I have to give a Feedback: That is difficult. Overcoming the challenges

of giving feedback in postgraduate medical education.”
Tabassum Zehra* Muhammed Tariq Syeda Kauser Ali
Senior instructor
Aga Khan University Karachi Department of Medicine. Karachi. Pakistan.

Introduction:
There is a general agreement in literature that giving feedback can be difficult and challenging. Clinicians are worried
by time constraints and load of patient care responsibilities that decreases interaction with the residents. Limited
interaction of the faculty with the students and residents restricts firsthand information about their performances. A
baseline survey conducted with the residents at Department of Medicine, Aga Khan University Hospital Karachi
informed that although informal feedback was often provided to the residents, regular and structured feedback was
lacking. This paper reports faculty perspectives on challenges in providing feedback.

Objective:
To explore faculty's perceptions of challenges in providing verbal feedback to the residents and ways to overcome
the challenges

Methodology:
After taking informed consent five focus group discussions were conducted with the faculty as part of faculty
development workshops by qualified medical educationists. The faculty comments were noted verbatim which were
categorized and then themes were identified. Results Of 54 faculty members 49 participated in the FGDs. The
challenges identified were grouped under: 1. Time constraint a. high patient load in clinics b. limited interaction with
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resident 2. Faculty related issues a. apprehension of effect on their own evaluation by residents b. no incentive for
faculty c. feedback technique not known 3. Educational issues a. feedback not emphasized b. unclear expectations
from residents 4. System and Logistic issues a. ambiguous evaluation form b. No support system

Conclusion:
Faculty was concerned about quantity and quality of observations made and the legitimacy of utilizing subjective
opinions to assess and provide feedback. Faculty felt that learner-centered approaches and faculty development
16
workshops in improving feedback skills will be a major source of overcoming the challenges.
STRENGTH of chain is determined by the weakest link: The missing link development of
structured “self” study plan for postgraduate trainees: model suggested for a unified national
synchronization of training

Abbasi AN,*
Director Residency Program & Head of Dept. of Radiation Oncology, Aga Khan University Hospital, Stadium Road
Karachi.

OBJECTIVE
Primary:
? To enhance academic standard of postgraduate training in Pakistan.
Secondary:
? To establish a learning objective (LO) based training program.
? To develop skills among the training according to the specified proficiency levels.

MATERIAL AND METHOD

An oncology skill development pyramid was constructed and discussed in the department of Radiation Oncology,
Aga Khan University Hospital (AKU), Karachi.
Residency program director and coordinator made multiple deliberations with six CPSP registered post graduate
trainee residents working at this tertiary referral centre.
Briefing sessions were conducted with postgraduate trainees form AKUH, KIRAN, JPMC, NIMRA and other national
cancer hospitals. Valuable input has been incorporated to develop the basic plan for studying oncology and other
relevant subjects.
Weekly ATLC (Any Topic of Learner's Choice) session were started to cover the queries brought up by the residents,
developing from the sectioning of topics. The basis & strength of gaining knowledge lie in the short group
discussions (SGD), from which each trainee develop his/ her own LO to be covered in LO. Tutorials carried out by the
consultants after mutual discussion about the topic.
All the trainees went through quarterly end of term assessment (EOTA) which was followed by EOTB (end of term
briefing) with trainer for the feedback of trainees to identify areas requiring improvement. End of year exam
evaluated residents' academic grip over the subject according to the predefined training proficiency level.

RESULTS
The results of EOTA , end of year exam & feedback by trainees in EOTB help specify the areas of improvement in this
study plan. Each section of the study plan needs special attention following the structure triangle. Monthly refreshers
provided a chance to share learning experience among the trainer and learner of different clinical oncology
institutes.

CONCLUSION
The suggested structured self study plan is appreciable although it has to go through a learning curve to rectify the
problems. This would help establish country wide oncology training programs for post graduate students.

Experience of E-learning and paperless environment in a

medical education program in Pakistan.

Prof Mohammad Idrees Anwar

FRCS(Glasgow),DCPS,HPE.
Head of Surgery Sheikh Zayed Medical College, Rahim Yar Khan. Pakistan

Higher educational institutions are increasingly moving toward the use of the Internet for delivery of their courses,
both on campus and at a distance. The Internet provides significantly different and interesting possibilities for
computer-meditated communication and learning from other forms of educational technologies. In some cases,
courses are delivered exclusively online to students in remote locations and supplementary materials may also be
mailed out. The entire class website can be duplicated onto a CD-ROM for the students with slow and unreliable
Internet access. In other cases, the lecturer may use a class website as a supplement to their face-to-face delivered
classes. Some lecturers utilize the class website for the teaching of specific skills and knowledge through automated
pre-programmed online activities that can provide specific feedback to students' answers. There are, therefore,
ways in which e-learning environments may be utilised based upon pedagogical needs.
With the ever-increasing integration of online learning (or e-learning) into university courses, there is strong need for
sharing experience of creating pedagogically effective e-learning environments. This study is our experience of
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creating such an environment in masters program in Health professions Education. The students who had previous
no experience in e learning were introduced to such an environment and their satisfaction and perception recorded.

17
 Professional Competencies Percieved By Dental Graduates In Pakistan

Ambrina Qureshi*

Objectives:
This study was conducted with intentions to assess students' perceived level of competencies for all domains of
dental practices; and to develop a consistent and reliable tool for self-assessment measure that may be used to
identify graduate competencies that can be applied or translated to different environments.

Material and Methods:

A thirty-seven items questionnaire related to dental competencies was administered amongst first batch of final year
dental students of a local public sector university in Pakistan. Responses were recorded on a 3- score likert scale (0-
2). Mean scores and percentages for each item were calculated. Cronbach's alpha was computed for reliability and
internal consistency of the questionnaire.

Results:
Highest competency level was reported for “oral health assessment” (38.2%) with mean score 1.27 (SD= 0.65).
Lowest level reported was for “oral health research” (31.5%) with a mean score 0.86 (SD= 0.68). Cronbach's
coefficient alpha obtained for 5 (out of total 6) domains was 0.70 or higher.

Conclusion:
Students perceived that they have obtained most of the required dental competencies. However, concrete courses
on oral health research along with more attention towards 'practice management related items' is required. This will
help the dental practitioners independently and collaboratively practice evidence-based comprehensive dentistry
with an eventual goal at improving public health.

Keywords: Education,
Dental practice,
Professional competence,
Clinical competence,
Research

Internet based examination delivery system

Najam Siddiqi* Mark Norrish Tom Heming

Associate Professor
Oman Medical College. Oman.

Introduction:
Examinations are a critical component of medical education. Not only is the content important but the process needs
to be error-free and user-friendly. It is essential that examination assessments are valid and reliable. Ideally
questions would be statistically pre-tested before their use in an examination. Multiple-choice questions (MCQs)
have become the assessment method of choice in international medical education. This is in part due to their
standardization, but also in their applicability across a student population with varying standards of English
language.

Methods:
In this paper we describe the web-based examination delivery system that is in use at Oman Medical College: the
Secure Online Learning Environment (SOLE). Examinations are conducted in PC-equipped hall. These MCQ
examinations have many advantages over the equivalent paper-based system; (i) Practical advantages – Grading is
done automatically, paper is saved, examination preparation time is reduced, and grades can be securely released
to students electronically at the faculty's discretion. (ii) Security advantages – The exam is secure, password-
protected, only available during the allocated time. Both the questions and answers are presented in a random order
to minimize potential for student–student cheating (iii) Pedagogic advantages – SOLE provides quantitative item
analysis which can be used to determine the quality of items in the examination and it allows for the inclusion of more
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graphical and interactive media into the examination.

Conclusion:
The practical and security advantages are significant. Item analysis can be used to generate a statistically pre-tested
question bank of high quality questions. One further pedagogic benefit is that high quality colour pictures,
radiographs and animations can be used. Thus, we conclude that this type of web-based examination delivery tool is
helping to enhance the quality of medical education.
18
Self-evaluation of anterior crown preparations
by second year pre-clinical students

Alia Ahmed*,
Associate Professor,
Islamic International Dental College, Islamabad Pakistan

Introduction:
Acquisition of accurate tooth preparation skills is one of the basic learning outcomes in the Operative Dentistry
Curriculum. Ability to evaluate oneself accurately is also one of the learning objectives of a competency based
education.

Aim:
The aim of this study was to determine the accuracy of self evaluation of students of second year BDS compared to
their instructor when asked to assess their crown preparations for the first time

Methodology:
Fifty students of second year BDS of the Islamic International Dental College were asked to evaluate their anterior
porcelain crown preparations according to a ten-point checklist. Each point was measured out of ten.

Results:
On average the students overrated themselves compared to their senior teacher by 2.7 marks.. There was a positive
correlation between self and instructor scores for items 1 and 9. For all other items (2-8 and 10), no statistically
significant positive or negative correlation was found between self and instructor scores.

Conclusion:
All steps were overevaluated by students. Steps most easily showed received less student- instructor rating
differences and vice versa.
Keywords:
Self-evaluation, porcelain crown,

Comparing the Teaching Tools: Power Point, Black Board and

Over Head Projector for Undergraduate Medical Teaching

Dr. Rukhsana Rubeen*

Associate Professor of Biochemistry, Coordinator for Medical Education Cell,
Dow Medical College, Dow University of Health Sciences. Karachi. Pakistan.

Introduction
MBBS students receive lectures using either blackboard (BB), transparency over head projector (TOHP) or
PowerPoint (PPT) presentations as teaching tools.

Objective:
This study was done to assess student's perception regarding different teaching methods for undergraduate
medical teaching.

Design:
A cross sectional, questionnaire based, descriptive study on the comparison of different teaching tools for
undergraduate medical students was conducted at Dow Medical College from April to September 2010.

Subject: A total of 314 students of all batches of Dow Medical College, DUHS were included. Main Outcome
Measures were comparison of 8 different features between PPT, TOHP and BB.

Result:
Our study depicted that student overall preferred the use of PowerPoint presentation in lectures (53%) than
blackboard and overhead projector. The students have a more favorable response towards PowerPoint
presentation than Blackboard and Transparency for: better inclusion of content1, understanding of text2 and figures3,
use of examples and illustrations4 and for summarizing the lecture5. (p=<0.001)
On the other hand, they preferred blackboard over PowerPoint presentations and transparency for facilitation of
interaction between teacher and students6, coping with teaching speed7 and stressing on important and relevant
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points8. (p=<0.001)
The result also indicated that the students considered blackboard and PowerPoint presentation equally effective
than transparency for generation of interest in learning and help to grasp the content. (p=<0.001)

Conclusion:
Our study concluded that PowerPoint presentation should be used as an instruction tool essentially for certain
aspects of learning. One teaching modality is not enough to cope up with student's level of understanding and thus a
combination of modern and traditional style of teaching should be incorporated. 19
 Evaluating the role of mini-cex in learning and assessment of clinical skills

Nadia Saeed*, Nabia Tariq, Tara Jaffery.

Senior Registrar
Medicine, Shifa College of Medicine, Islamabad. Pakistan.

Introduction
Mini-CEX (Mini- Clinical Evaluation Exercise) is an important tool for formative assessment of clinical skills. We
evaluated mini-CEX as a learning and assessment tool for clinical competencies and assessed the acceptability of
mini-CEX to assessors and students in junior clerkship.
Methods
We analyzed the results of the mini-CEX of 96 fourth year students of Shifa College of Medicine during the academic
year of 2011. The students underwent five clinical rotations over one year in their junior clerkship. They had two mini-
CEX encounters in each rotation (10 mini-CEX for each student). A validated form (adapted from Royal College of
Physician) was used to assess clinical competencies and overall rating, document feedback and suggest action
plan for improvement. Satisfaction with mini-CEX was noted on a scale of 10. Paired sample T test was used to
compare the mean scores of various competencies between rotations. We intend to apply Generalizability
coefficient to determine reliability of our assumptions regarding students' scores.

Results:
Analysis of 938 available mini- CEX forms demonstrated a progressive increase in mean scores from first rotation to
fourth rotation in most competencies (p<0.05). Average feedback time was 9.8±5.8 minutes and related mainly to
emphasis on improvement in interviewing and examination skills (58%). Students' and assessors' satisfaction with
mini-CEX were 8±1.4 and 7.8±1.2 respectively.

Conclusion and discussion:

Mini-CEX demonstrated the progression of students' clinical performance skills over the year.
Mini- CEX is a valuable assessment tool for performance skills and provides useful opportunity for feedback on
students' performance.

Faculty perception regarding single, best response multiple choice questions

(mcqs) in undergraduate medical education

Shahid Shamim*
Associate Professor Surgery MHPE-DUHS student
Memon Medical Institute Hospital, Sindh Pakistan

Background
Medical Colleges in Karachi have moved on to the MCQs for assessment. Since the move began, faculty training
programs were also implemented in the Institutes. However, how the faculty perceives this change has not been
reported.

Objective
The objective of the study is to asses faculty perception regarding MCQs.

Method
Six point questionnaires with closed and open ended questions was circulated among faculty of three University
Medical Colleges of Karachi. Convenience sampling technique was used to select participants. Variables included
respondents' bio data including experience in developing MCQs. Closed ended questions looked into the
respondents' perception on single-best MCQ as the preferred method of assessment, ease in developing and
solving them, and discriminating power Data from closed ended questions were transferred on SPSS worksheet and
analyzed. Content of the responses from open ended questions were analyzed identifying common themes and
categorizing them into groups before interpreting results.

Result
Forty faculty members (private/public sectors) belonging to different specialties completed the questionnaire from 4
different medical colleges. There years of experience as medical educators ranged from 1 to 25 (median 3.5), and
developed an average of 55 Single-best MCQs per year (range 20-100).
2/3rd of the respondents believed that Single-best MCQs are the best method for written examinations, 50%
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considered MCQs not good discriminators and majority stated they are easy for faculty to develop and students to
solve.
Majority of the respondents' opinions were similar regarding: favoring MCQs, need for faculty development and
adding other tools (EMQs and SEQs) with MCQs for improving assessment.

Conclusion
Faculty members of medical colleges of Karachi are consciously aware of the benefits and pitfalls of using Single-
20 best MCQs as assessment tool. Faculty input in curriculum management can play an important role in improving
assessment in local scenario.
Views and attitudes of medical students dental and pharmaceutical to implement
a virtual medical education expertise at the Shiraz University of Medical Sciences

Pouya Rahemi*
Education Development center of Shiraz University of Medical Sciences, Shiraz. Iran.

Introduction:
In recent years, using the online technologies in education is provided many opportunities for learning new
techniques and effective training methods. This new teaching method which is referred to the virtual e-learning, is as
the most advanced educational methods in the today world and uses advanced technologies such as networking,
databases, knowledge management and other using. Given the emerging nature of this method at the University of
Medical Sciences and also the dynamics of medical knowledge on learning skills and other related information on
medical education in medical students, we designed the above to perspective of the students in this study.

Methods:
This study is a cross-sectional. In this study were used a random sample of 150 students at SUMS, and data
collection tools (questionnaires, including 26 cases). Check its validity by experts and scholars of the Center of
Medical Education and its reliability has been measured by using the alpha Kvrnbakh method. Results: Significant
percentages of the students agree to teach a virtual method (75%) and also had emphasized that virtual teaching
method is flexibility in the way of education (64%). The student's attitudes are that training is more effective than
virtual method in changing the attitudes (58%) Some medical students believe that medical education needs to
teach virtual methods in the medical university were sensed (63.6%) and 19% of students were opposed. Another is
the students' familiarity with medical education to change their attitude towards learning other courses of Medical
Sciences (58.6%).

Conclusion:
Receptive to the views of students and their positive attitude towards to implement a virtual medical training Shows
that the realization of e-learning university should be take steps on cooperation and interest of students. Preparing
facilities, justify and training professors are the other factors that are required to follow up and pay attention.

The utilization of methods emphasizing on the contemporary style of

teaching among medical students of Pakistan

Atif Mahmood, Fahmida Khatoon*, Mukarram Ali, Saima Ejaz, Kamran Afzal, Masood Anwar Qureshi.
Department of Physiology, Dow University of Health Sciences. Karachi. Pakistan.

Objective:
To determine the perception and preferences of medical students' about the use of different teaching methods
including lectures, role playing, case studies, videotapes and problem based learning in order to recommend ways
for their optimal utilization.

Methods:
Cross sectional survey was conducted on a convenient sample of 1200 undergraduate medical students during the
month of May 2011 to September 2011 at three medical colleges affiliated with Dow University of Health Sciences;
Dow Medical College, Sindh Medical College, Dow International Medical College, Karachi, Pakistan.

Results:
Seventy nine percent of the students responded to the questions asked. Over all 43.5% of the undergraduate
medical students chose Problem based learning to be a reliable method of teaching and favored it as interesting and
interactive teaching method over case studies (19.2%), videotapes (15.0%), lectures (11.6%) and role playing
(10.6%). They believe that PBL provides a better learning experience as compared to other teaching tools.

Conclusion:
Students have chosen PBL as the best teaching method and have preferred the integration of different teaching
methods for better understanding.

Keywords:
Teaching methods, Lectures, role playing, videotapes, problem based learning, case studies.
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21
 Overseas Pakistanis seeking medical education in Pakistan

Fahmida Khatoon* Atif Mahmood, Saima Ejaz, Mukarram Ali

Lecturer/Research Associate
Biochemistry, Dow University of Health Sciences. Karachi Pakistan

Background:
Pakistanis migrated to western countries face difficulty in letting their children get higher education from abroad. It
has been observed that many overseas Pakistanis feel secured to send their children to Pakistan to acquire higher
education. The purpose of this study was to evaluate the reasons for overseas Pakistani students seeking medical
education in Pakistan.

Methods:
A cross-sectional survey was conducted from October 2010 to May 2011 recruiting overseas Pakistani students
studying in different medical colleges of Sindh, Pakistan. Cluster of 8 medical colleges were selected and a
convenient sample (n=700) was recruited. Of the 700 administered questionnaires, 530 (76%) were returned and 25
were incomplete and therefore, rejected. A total of 505 (72%) were included in the analysis.

Results:
A statistical significance was found when origin of students was compared with the economic aspect of medical
education in Pakistan (p=0.01). Overall 71% students agreed that the cost of medical education in Pakistan is much
less then their respective countries of origin. Another highly significant difference was observed (p<0.001) between
student's origin and their reasons behind taking medicine as a career.

Conclusion:
The study establishes that Pakistan as a country offers quality medical education in minimum possible costs and
more foreign students can pursue medical education in Pakistan.

Keywords:
Overseas Pakistanis, Medical Education

The quality of student feedback motivating students to

give high quality feedback

Mark Norrish*
Oman Medical College
Head of Department Of Social and Behavioral Science
Oman Medical College. Oman.

Introduction:
The course experience questionnaire has long been established as one of the strongest performance indicators of
teaching quality in medical education. However it is clear that the mere collection of such questionnaires does not
automatically lead to improvements in the quality of the educational provision. Several hindrances to quality
enhancement from the course experience questionnaire have been identified. These include; their use as an audit or
appraisal tool rather than as a developmental tool, rigid standardization and limited scope for evaluating innovation
in teaching, and sometimes the lack of truly voluntary participation by students.

Methods:
This study therefore looked at the role of providing feedback to students on the changes that have resulted from the
evaluations by previous cohorts as a motivator for students to participate more actively in providing quality feedback.
This was done with three cohorts of students (n=284) on two courses in preclinical medicine. All courses have a
course evaluation questionnaire, some courses also provide specific feedback to students on the changes arising
from previous evaluations. Within-group comparisons of the nature and quality of student responses were made
between these courses. Results: When faculty provided this kind of feedback to students, students were more likely
to provide higher quality feedback. This was demonstrated in two ways; (i) an increase in the number of voluntary
prose evaluations, an increase in word count, and more responses that involved 'considered' evaluation, (ii) a
reduction in the number of evaluations determined to have been spoiled by responder bias or fatigue.
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Conclusions:
As suggested by theories of behavioral modification and motivation, this study shows that students need to believe
that their behavior is likely to effect change, in order for them become actively involved in the evaluation process. If
this is done, students do provide high quality feedback. With this in mind, we as faculty need to value students as
stakeholders in the delivery of quality medical education.

22
Comparison of students self assessment to examiners assessment in a formative OSCE and
correlation between cumulative score and global rating scale for students and faculty evaluation.

Firdous Jahan,* Naeem Shaikh, Rizwan Qasim, Najam Siddqi

Oman Medical College Sohar. Sultatanate Oman.

Objective:
Comparison of students self assessment to examiners assessment in a Formative OSCE and correlation between
cumulative score and global rating scale for students and faculty evaluation.

Background:
Clinical teaching targets acquiring competence in patient interviewing, communication skills, history taking, and
characteristics of physical examination skills of each system. Self-assessment of knowledge and accuracy of skill
performance is essential to the practice of medicine and self-directed life-long learning.
Method:
Cross sectional study done on 6th year medical students of Oman Medical College, Family Medicine rotation in a
formative OSCE. A self-assessment questionnaire was completed by all the Year 6 students immediately after the
OSCE. Statistical analysis of the Likert items was conducted by calculating frequencies, means and standard
deviations. Regression analysis was used to correlate self reported rating and actual performance in each station. A
p value of < 0.05 was considered significant. Correlation between cumulative score and global rating scale for
students and faculty evaluation was calculated by Spearman correlation.

Result:
Students overestimated their performance in the approach and differential diagnosis of abdominal pain and they
have underestimated their performance in knee joint examination. There was statistically significant, strong
correlation between students assessment 5 point rating scale with the global rating scale for the history station and
moderate correlation for the (66%, p=< 0.001) examination ( 62%, p=< 0.001). The correlation between faculty's
assessment on the standardized and global scale was statistically significant and very strong for all three study
stations .

Conclusion: Most of the border line students over estimated their performances. To strengthen the clinical
teaching, emphasis should be given on areas identified in this study.

Computer based evaluation software

Rukhshanda Zaman*
Shifa college of Medicine
Shifa College of Medicine, Islamabad. Pakistan.

at every institution there is a feedback system both for faculty and students to evaluate both sides for improvement of
education system. Manually it takes time , effort and paper of course to make this system work. CBES is a php /
mysql based intranet software which is being used for evaluation of students as well as faculty members in Shifa
College of medicine. The software is currently working on intranet bases which is planned to be on internet making it
available on-line for students and faculty for evaluation purpose. basic forms which are added in this software are as
follows. 1) Clerkship evaluation by students. 2) Faculty evaluation by students. 3) Clerkship/course director
evaluation by team members. 4) Team members evaluation by clerkship/course directors. 5) MiniCEX. After data
being put into the computer by members , reports are generated along with graphical presentation of each report to
individuals by email.
Oral Presentations

23
 Evaluation of University of Shiraz Medical Students satisfaction with facilities
of the Internet and Computer Center of Shiraz Medical School

Alireza Alborzi*, Arash Hosseini Moghadam, Parastoo Neamatollahi

Medical Student
Education Development center of Shiraz university of Medical Sciences
Shiraz university of Medical Science. Shiraz. Iran.

Introduction:
World Wide Web, today as one of the main channels of information is using by about millions of users especially
students. The interest of this media in the students is through a variety of resources both in terms of availability of
huge amount of information and communication infrastructure and information-sharing, provided. The effect of this
network in research and education is very important, so that today it is unavoidably in universities and a significant
portion of the budget, spent on infrastructure and access to Internet information resources, including hardware and
software requirements and human resources. Evaluation of student satisfaction with the facilities of the Medical
Internet center can assist authorities in order to achieve their goals.

Methods:
This study was conducted cross sectional-descriptive with simple sampling of 80 students from Shiraz University of
Medical Sciences. Data collected by a questionnaire containing 16 questions, depending on the Likert scale with a
reliability coefficient of á = 87%. Students were given questionnaires in good condition, and data were analyzed
using SPSS 15 software.

Results:
The 30.8% proportion of students satisfied with the softwares in the computer center and their needs. 50% of
students expressed that the Internet speed is low. Physical space of the computer center for students to meet their
needs is good in terms of 37% and 63% had no opinion. But how far the computers are ,is good in this center (44.4%).
84% of students said that giving account and password to each student will increase the security of using Internet.
The students believed that the limit load specified to each student per month (3 GB) is not enough (40.7%).

Conclusion:
Increasing volume and possibility of reaching to wireless Internet in university, reduces the load of referrals to the
Internet Center. Also promoting the culture of optimal using of center's facilities, can also reduce unnecessary
referrals.

New trend in manipulating of seminar in the PBL

Mahmoud Salah* Mahmoud Ahmed

Associate professor
Faculty of Medicine, King fahad Medical City, Riyadh. Saudi Arabia.

Introduction:
Seminar is one of the most important activities in the PBL. It helps to fill in the gap of students' knowledge in the PBL
system. It was found that the students loss their interest regarding the attendance and interaction in seminars.

Material and Methods:

We looked at the attendance sheets in through 5 sessions and it was noted that more than 30% of students were
absent. Also among the attendees it was noted that 50% did not show any interest. The batch included 45 students
were allocated into 5 groups in the seminar sessions. Each group was asked the questions which they wanted. Then
the groups were invited to answer the questions and the difficult one was answered by the staff, the subject matter
experts who was represent each basic science' subject. The staffs decided the marks for each group and supply the
members of winner group with gifts.

Results:
All students were eager toward interaction during the seminar sessions and the attendance of the students was jump
to 98%.
Oral Presentations

Conclusion and take-home messages:

The old fashion in manipulation of the seminars needed to be reviewed

24
Evaluation the use and introduction of students in Basic Sciences Shiraz Faculty of Medicine
considering the National Digital Library Medicine of Iran and widely used Internet software

Arashhoseini Moghadam*, Alireza Alborzi , Parastoo Nematollahi

Education Development Center of Shiraz University of Medical Sciences
Medical Student
Shiraz University of Medical Science. Shiraz. Iran.

Introduction:
Progress and the increasing volume of medical knowledge in this field have led to dependence and need of this
knowledge to the Internet and cyberspace will increase dramatically. Notably, all of the world's leading scientific and
research journals are available online. students' access to databases banks is necessary for better communication.
The National Digital Library Medicine of Iran provides access to the latest medical information resources available in
the world in any place and at any time for masters, researchers and medical students to all universities and research
centers in the country. In this study the students' familiarity with the site and introduction of necessary software and
training need will be discussed.

Methods:
This descriptive study with a sample size of 75 students from Shiraz University of Medical Sciences was conducted
by the questionnaire includes 14 questions on the Likert scale. Reliability and validity have been confirmed by
experts and has been calculated. Data were analyzed with SPSS 15 software.

Results:
Students' routine referring to data bases in priority are: ISI web of Knowledge 27% ,JAMA 6%, MD CONSULT 6%
and PROQUEST 4%. Most students use simple search (47%) and search by keyword (78%) were used. 56% of
students using internet, daily and in a large amount. Among the applications that have been questioned "WORD"
was most used (84%) and "POWER POINT" with (36%) was in the second rank, as well as SPSS data analysis
software with the lowest ration (16%) were used. The number of students admitted to the databases on the contrary,
is very low (84% never and less).

Conclusion:
Promoting students' skills in using information resources that is placed in INLM.ORG by the Ministry of Health and
Medical Education should be on the top priority of educational and research programs. Also holding workshops in
the field of using useful softwares can be helpful.

The need to train the trainers.

Nosheen Sheikh*,
Consultant Psychiatrist
Ex-consultant South Africa and New Zealand,
Assistant Professor and Head of Department of Behavioural Sciences and Psychiatry, Independent University
Hospital/ Independent Medical College, Faisalabad.

Background:
The aim of presentation is to look at the role of the socio-behavioural sciences in medicine and healthcare, to
prepare the professionals adequately to practice the science of medicine and the art of the profession in varying
socio-cultural contexts of diverse health care systems, to look at a need for closer integration of teaching, research
and health policy in both general medicine and dentistry, and to explore barriers to teaching behavioural and social
sciences in medical education.

Discussion:
The need for including BSS in medical education was recognized more than 30 years ago, but little progress has
been made in improving the quality and quantity of behavioural sciences' teaching in medical schools, even in
developed countries. Numerous barriers that impede better integration have been identified such as there are no
uniform guidelines, well established curricula, training modules or materials. Much variation exists in the delivery of
behavioural sciences teaching. Little of the teaching is skills-based but is focused on theoretical perspectives with
little clinical application. Students require a behavioural sciences course that addresses patient management issues
Oral Presentations

and is clinically relevant and the teachers need an ability to engage students in dialogue and create a safe and
respectful clinical oriented context for sharing ideas, views, and experiences.

25
 The use of Narrative story Simulation as a Tool for Teaching Anatomy

Huma Musarrat Khan *

Professor of Anatomy
Islamabad Medical and Dental College Islamabad. Pakistan.

Objective:
To assess the effectiveness of narrative-story simulation as a tool for teaching anatomy and to determine whether
this method enhances student satisfaction.

Methods:
The study was carried out in a private sector medical college on first year MBBS students (n=92). The students were
given a narrative story, adapted from: “The case of the dividing cell: mitosis and meiosis in the cellular court”
(http://www.sciencecases.org/mitosis_meiosis/mitosis_meiosis.asp) by Clyde Freeman Herreid. Copyright held by
National Center for Case Study Teaching in Science, University at Buffalo, State University of New York (used with
permission). The story was a simulation, set in an imaginary court room in which the jury was made of eukaryotic
cells and the defendant was an oocyte charged of mutation. The prosecution and the defense called witnesses
which included Mr. Spermatocyte and Mr. Nuclear Membrane. The witnesses argued, and so the testimony
continued unfolding the miracles of cell division, gametogenesis and mutations. The students were divided into
small groups who discussed the learning issues in three interactive sessions, after which, they were given a test and
an anonymous questionnaire which was answered on an open scale of 1-10 (1 being the minimum score and 10
maximum) regarding the effectiveness of this methodology.

Findings:
Majority of the students enjoyed the sessions and would like similar sessions in future (mean evaluation score:
6.12/10±3.15). An overall satisfaction score of 6.62/10±1.75 was obtained. Mean of assessment results was
93.7%±10.4. 48.6% of the students felt that it was more time consuming as compared to conventional lectures.

Conclusion :
The use of narrative-story simulations as a tool for teaching anatomy captured the interest of majority of the students
who found it an effective teaching methodology. However, the need for other conventional tools of teaching as an
integral part of anatomy curriculum was suggested.

How frequently are the learning outcomes for professionalism used in years one and two
MBChB Vocational Studies course End how they are matched with Tomorrows Doctors

Usman Mahboob* Phillip evans

Medical Education Scholar, Director of HPE
Khyber medical university University of Glasgow

Introduction:
The study has been done to map the learning outcomes for professionalism in undergraduate Years 1 & 2 MBChB
vocational studies (VS) course.

Aim:
The aim was to see how these learning outcomes will match the learning outcomes laid by the General Medical
Council (GMC).

Objective:
The objectives were to recognize and compare the extent of matching of the learning outcomes for professionalism
covered in Vocational studies with the guidelines laid by the GMC in their document Tomorrows doctors 2003 and to
determine, what issues need to be addressed to respond to GMC Tomorrows Doctors 2009. A qualitative study
design was used which involved content and thematic analysis of the curriculum documents with the
purposive/judgemental sampling technique. The GMC documents 'Tomorrows Doctors' were used as point of
reference. The coverage of all the outcomes related to professionalism was between 10-20%, scattered throughout
the course in different domains of the VS, giving a balanced weightage to each learning outcome. The VS course
needs to be rearranged with few changes to make it according to the new guidelines by the GMC.
Oral Presentations

26
A paradigm shift from institutional to Community based
learning – SCM's experience

Farah Rashid Siddiqui*, Saima Iqbal

Assistant Professor, Community health sciences,
Shifa College of Medicine, Islamabad

Background
Community -based education (CBE) is getting recognized as an effective strategy for learning in medical education.
It provides students an opportunity to interact and learn from the community and equip them with the competences
which they would never learn otherwise.CBE may contribute to the solution of the problem of inequity in service
delivery by producing doctors who are willing and able to work in the underserved areas, particularly rural
communities.

Objectives
To share the experience of development and initial implementation of integrated community health clerkship in
community setting

Methods
The 8-weeks co-ordinate and coherent clerkship of community health sciences was developed through integrated
approach with family medicine. The basic approach of the program was to encompass preventive and curative
approaches and to introduce students to the community and the patients simultaneously at the primary health care
level. The clerkship day started with morning sessions mainly based on preventive topics followed by seeing
patients at rotary clinic – a community based primary health care centre. A practical note book has been introduced
in which each student has to explore at least five health related queries in psychosocial domain which allows them to
learn about the person with disease in respect to social, cultural, ethical and preventive aspects. Students also
encouraged to conduct community based survey of public health significance and carried out different activities like
awareness raising campaign, delivered health education sessions and developed health education material in
national language and displayed in centre.

Results
Three focus group sessions will be conducted to analyze the effectiveness of CBME. Each group will be consisted of
6-8 students male female both. The initial discussions reveal that community exposure and research based activity
enhances the student's learning capacities

Conclusion
It is evident from the research that experiential learning enhances student's interest and motivation towards
learning and the best way to teach community medicine is in community setting

Characteristics of a capable university teacher from the students' point of view

Ali delpisheh*
Professor
Ilam University of medical sciences. Ilam. Iran.

Introduction:
Determining factors affecting teacher's evaluation from the students' point of view (learners) could greatly influence
the quality of education.

Aim:
This study aims at identifying those characteristics which qulify a university teacher cabale in students' opinions.

Methods:
In this descriptive, cross – sectional study, in 2009-2010, 800 students of Ilam University of medical sciences were
selected. Multi – stage stratified random sampling was used for sample selection. A standard questionnaire was
used for data collection, and data were analyzed afterwards.

Results:
Oral Presentations

68% of the students were female and 52.7% were undergraduates/PhD candidates. The mean for teaching style,
interpersonal relationships, the teacher's personal characteristics and the knowledge seeking attitude of the teacher
were 83.8±11.3, 83.7±13.9, 81.9±11.2 and 71.6±11.3, respectively. There was a significant relation between
students' viewpoints and sex, their field of study, educational level and faculty

27
 Twelve tips for designing and integrating a curriculum for undergraduate
medical professionalism

Usman Mahboob*, Phillip Evans Philip Cotton, Nicki Hedge

Medical Education Scholar, Director of HPE
Khyber Medical University University of Glasgow

Background:
Professionalism as a topic should be delivered to the students in their undergraduate medical degree. Initially, the
topic was considered to be part of the hidden curriculum and the teaching faculty used to teach professionalism by
role modeling. The faculty members have an important role in managing changes and designing the curriculum for
professionalism as they have to do all the mapping of the curriculum.

Aim:
The aim was to identify the role of faculty members in designing and integrating the curriculum for professionalism in
School of Medicine, University of Glasgow.

Methods:
A qualitative approach was used to know about the ethos of the medical school. Senior faculty members from
different departments who deal with curriculum of professionalism were interviewed and a thematic analysis was
done.

Results:
The thematic analysis identified 12 tips for designing and integrating curriculum for undergraduate medical
professionalism. Professionalism can be delivered explicitly and implicitly to the students. Efforts are being made to
make the topic more explicit by writing its learning outcomes and to map those learning outcomes to suitable
assessment and delivery methods.

Conclusion:
The teaching and learning of professionalism is not limited to inside the classrooms but teacher's actions outside the
classrooms are also observed and absorbed by the students. An effort can be made to develop professionalism in
the teaching doctors through CPD workshops on professionalism so they can convey a good professional message
to the students by the implicit hidden curriculum.

Why Does Mentoring Matter

Kamran Sattar * Durdana Siddiqui

Co-chair professionalism course,
Department of Medical Education King Saud University. Riyadh. Saudi Arabia.

Objective:
This article is an in depth approach to formulate a reliable and valid answer for this important question, “what actually
Mentoring is and Does it Really Matter”?

Design:
Author reviewed literature to have in depth and updated knowledge about Mentoring, focusing on argument that are
in favor and against its application worldwide, especially in medical education.

Discussion:
It's a relationship that involves interaction between two people (mentor and mentee) normally working in a similar
field or sharing similar experiences. Significant benefits are associated with mentorship. Effective mentorship is
crucial to career success in academic medicine. 14-18

Conclusion:
It's recommended that in the light of the apparent and proven important benefits that have been achieved and well
appreciated, academic medical leadership should pay particular attention to mentoring of medical students, medical
staff, clinician-educators, research track faculty, and senior faculty.
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28
Learning through Service: 'Shifa Homes'- a lifetime experience

Farah Rashid*, Dr Hamid Shazad, Senior Instructor, Shifa Umar, Obaid Ashraf
Shifa College of Medicine. Islamabad. Pakistan.

Objective:
To inculcate civic responsibility among physician's of tomorrow by rehabilitating flood victims of 2010: 'Shifa Homes'

Background:
Service learning is defined as an experiential learning opportunity that combines clear educational goals with service to the
community, has been broadly recognized as an effective method to engage medical students in active learning while
providing needed health services to underserved populations. Such community-based volunteerism is much needed
especially in time of a natural disaster like the Floods of 2010. Therefore students of Shifa College of Medicine initiated a
project called 'Shifa homes' for rehabilitation of flood victims 2010.

Methods:
Shifa Homes' a project of SCM for building homes for flood victims came into being in January 2011. The aftermath of the
unprecedented flood of summer 2010 was in front of us more than 20 million people were affected and the survivors were
shelter less. The idea of building homes for flood victims was proposed by the students to the faculty. With the generous
donations of the faculty and students of SCM Rs,2700,000 were raised within a year. A community of 26 (15 x 18 ft) houses
was built in Darya Khan, Bhakkar (flood affected area) under the name of 'Shifa Homes'.
Team of student volunteers and faculty members visited the 'Shifa Homes'. The aim of these visits was to implement
a Health Education Campaign and provide medical students an opportunity for community based volunteerism.
Following are the events of these visit:
? Key distribution
? Distribution of Dengue, hygiene and educational kits
? Community health education, with primary focus on:
? Oral hygiene
? Hand washing techniques
? Dengue/Malaria Prevention
? ORS
? Hep C prevention
? Maternal and child health
Results:
26 out of 100 homes have been built so far. Over all 56 students are involved in the project. Students from focus group
sessions reported that 'Shifa Homes' experience enhanced social awareness, compassion, empathy, team work,
confidence building and better understanding of social determinants of health.

Conclusion:
'Shifa Homes' is a success story of learning through service.

Teacher centered medical education in Ilam UMS

Gholamiparizad Es*, Ghazanfari Z Gholamiparizad El Aivazi AA HoseinyRad M
Ilam University of Medical Sciences Ilam Iran

Abstract:
Giving lectures has an old history dated back to 500 BC at the first Greek university. Even today, it is the most commonly
used teaching method in the world, especially in Iran. However, the strengths and weaknesses of such a method have not
been assessed comprehensively by the Iranian experts and students' viewpoints. The current study was aimed at meeting
such a need from the students view.

Methodology:
The survey was carried out in 2010 on 840 randomly-selected students of different departments of Ilam UMS, Iran. A
researcher-made questionnaire was employed to collect data, containing 28 items in three different domains namely
interaction condition, subject management and class atmosphere, and organizational tasks.

Findings:
Two-third of the participants were female (67%). In interaction domain, students' chance to pose questions, pre-readiness
toward the topic to be taught, and using library and internet were 42%, 34%, and 29.8%, respectively. In subject
management and class atmosphere domain, time used on each topic, happiness and freshness atmosphere of the class,
and understanding the topics taught were 41%, 45%, and 48.6%, respectively. In organizational domain, syllabi coverage,
the time used at each session, guiding and consulting role of teachers, and employing educational aids were 46.3%, 57%,
50.3%, and 50%, respectively. A significant relationship was observed between acceptability index and lecturing (p=0.03),
Oral Presentations

and also between acceptability index and study course (p= 0.001) according to chi-square test. However, no relationship
between the acceptability index and degree was seen (p=0.06).

Discussion and Conclusion:

Based on the results, despite the long history of such a lecturing method in education, rapid development of science and
technology, and increasing availability of educational aids, lecturing cannot meet students' satisfaction in most the
educational goals. Hence, it is necessary for educational policy-makers to improve it, or replace it with other proper
methods; all to fulfill educational goals of the country. 29
 Medical student's perspective about Role plays as a teaching strategy
in Community Medicine

Irum Manzoor*
Fatma Memorial Hospital, College of Medicine and Dentistry. Lahore. Pakistan.

Objective:
To assess the student's perspective about role plays conducted as a teaching methodology in Community
Medicine.

Design:
A Quasi experimental study

Place & Duration:

This study was conducted in Department of Community Medicine at Fatima Memorial College of Medicine and
Dentistry from July 2010 to November 2010.

Methods:
A probability technique of simple random sampling was used to collect 63 students from 3rd and 4th year MBBS and
were randomly distributed in four subgroups. A preformed questionnaire was distributed to collect student's
responses. The data was analyzed on SPSS version 17 to compare the responses. Chi square test was applied and
p value was fixed at < 0.05 as significant.

Results:
Sixty three students were selected as participants of this study in which 46(73%) belonged to 4th year MBBS and
17(27%) were 3rd year MBBS students. There were 13(20.6%) males and 50 (79.4%) female students. Role plays
were identified as most effective method of teaching by 25(37.9%) of the students followed by lectures 17(25.8%)
(p= 0.054). Fifty two (78.5%) admitted that role plays have improved their knowledge of subject, 55 (84.6%) said that
it will help them in their clinical performance. 59 (89.4%) found role plays interesting and 49 (74.2%) wanted to
incorporate role plays as a part of curriculum. 56(88.9%) of the participants agreed that role plays improved their
communication skills. The 21(31.8%) of the participants believed that it has helped in making acquaintance with
local situation. Forty six (76.7%) identified role plays as a feasible way of androgogy (p =0.005) and 48 (76.2%) said
that it has provoked critical thinking about the subject (p = 0.038). 54 (85.7%) students admitted that their attention
span was better in role plays as compared to lectures (p =0.047)

Conclusion:
Role plays were well accepted by the students as an effective teaching methodology and can be incorporated as a
part of our curriculum in teaching Community Medicine.

Key words:
Role Plays, Curriculum, Community Medicine.

Importance of Health Needs of Pakistan in medical education

Nasir Shah*
Associate Professor
FMH College of Medicine and Dentistry. Lahore. Pakistan.

Background:
The objective of medical education in all countries is to train doctors to respond to the health needs of the country. This
purpose of medical education has been emphasized by many international organizations and medical institutions are
considered responsible towards their social mission. So curricula of medical colleges are expected to clearly reflect the
priority health problems of the country.

Situation in Pakistan:
Medical education is mostly done in tertiary care hospitals and exposure to real life situation of communities is small. In real
life, doctors in primary care face a lot of complex clinical presentations and also a wide spectrum of diseases for which they
are not been trained. The training for managing common health problems is neither imparted in undergraduate nor in
postgraduate programs. By identifying the health needs of the country we will be in a better position to shape our medical
education accordingly and link up education with the actual health system.
Oral Presentations

Recommendations:
Pakistan Medical and Dental Council (PMDC) being the apex regulatory body of Pakistan has a central role in guiding
other institutions to adopt local health needs as objectives of curricula, and implement problems based learning using real
life cases in education. The PMDC may constitute a committee represented by primary care physicians, community
physicians, specialists, PMDC and health department to identify priority health needs and the competencies required to
meet those needs. To facilitate the process, departments of family medicine and medical education may be established in
30 all medical colleges.
Developing future faculty in basic sciences through accreditation and
examination in medical education: A Synopsis

Gulfreen Waheed* Samina Malik , Gul-e-Raana, Ayesha Maqbool

Vice-Principal,
Avicenna Medical College & Hospital, University of Health Sciences. Lahore. Pakistan.

Aims & objectives:

Development of future faculty & thus medical education via Accreditation & Examination program in Pakistani
medical colleges.

Background:
Recent explosive eruption of medical colleges in Pakistan has resulted into paucity of trained medical teachers.
There is a dire need to develop a faculty training program to prevent a raw exposure in demonstrations or lectures.

Introduction:
Most medical colleges in Pakistan are hiring raw and untrained staff in basic sciences. They lack in interest in
medical teaching, if their aim is to appear in a clinical exam. Also raw medical teachers just after M.Phil require some
training from a faculty mentor associated with faculty development program.

Material & methods:

Faculty mentor may be identified followed by agreement on training program & the course outline. Workshops may
be arranged in affiliated university or in mentor's own campus. A project on teaching may be developed by the
applicant that may involve attending lectures followed by lecturing. It may be web-based, video-based, print-based
or a combination. This may be followed by examination that may be based on delivery of applicant's experience
during the course in the form of lecture, poster, video or web-format. This may be followed by accreditation, i-e.,
awarding of certificate.

Study analysis:
Pre-test-post-test design may be applied.

Key words:
Faculty development, Accreditation, Examination, Medical Education.

Streamlining learning process through introduction of learner's log in medical

students of pre-clerkship years

Abida Shaheen1, Tatheer Zahra2, Sumreena Mansoor3*, Khurram Irshad Qureshi4, Ayesha Rauf5, Tara Jaffery5
Shifa College of Medicine, Islamabad, Pakistan.

CONTEXT:
Multiple factors have impact on student's learning. These include preparedness, active participation, team work and
professional attitude towards learning process. We designed a learner's log to optimize the learning process in pre-
clerkship years.

OBJECTIVE:
The objective of learner's log was to follow students' daily learning activities, ensure active participation in learning
process and provide immediate feedback to students, facilitators and course directors on daily performance. This
process can also help to reflect on the effectiveness of system-based integrated curriculum.

METHODS:
Learner's log was developed and piloted in three study groups (n = 35) of first year medical students and facilitators
(n = 9) of multidisciplinary modular team of Shifa College of Medicine (SCM), Pakistan. The learner's log focused on
developing the learner as a Scholar, Communicator, Collaborator, Manager, Health Advocate and Professional
(Adapted from CanMEDS Physicians Competency Framework). Students' and facilitators' questionnaires,
comprising of a series of statements and an option for open comments/suggestions, were designed and distributed
at the end of study.

RESULTS:
Oral Presentations

Analysis showed an appreciating attitude of students and mixed response of facilitators towards learner's log. They
agreed that this type of learning strategy could be a good tool for evaluation, self assessment and would strengthen
and accelerate learning process in pre-clerkship years.

CONCLUSIONS:
Learner's log was helpful in streamlining learning process of students through timely feedback in small interactive
sessions. This could reflect students' performance on daily basis and provide a motivational drive to do better.
31
 Simulation Based Learning The Icing in Medical Education
from Students perspective

Erum Khan*
Simulation instructor
Gulf medical University Ajman, United Arab Emirates

Background :
Medical education is constantly undergoing through series of facelifts; Shifting from the traditional teaching and
learning paradigms to better, more interactive, integrated and student centered methods. Not only educators but
students have also realized and accepted the social and educational value of small group, face to face teaching and
learning methods. The most popular of these methods are Case based Learning (CBL) and Problem based Learning
(PBL). But with the evolution of technology, Simulation based learning (SBL) has joined the league to climb the top.
SBL seeks to teach not only the psychomotor and affective skills; it in-fact reinforces and integrates it with the basic
science concepts in an interactive and realistic way. Students find simulation based learning superior to CBL and
PBL. The mere idea of working on a clinical cases in a real-time set up which accurately reflects the clinical
experience in terms of simulated patients, standardized signs and symptoms, clinical environment and equipments
is much more exciting and conducive to the learner. This error forgiving and non-threatening learning environment
delivered with adequate and timely feedback by trained clinicians and instructors allows the students to take control
of their own learning in terms of professional knowledge, skills and attitude. Gulf Medical University refreshed its
Undergraduate medical curriculum in 2008 and shifted slowly from a traditional discipline based to an integrated
curriculum ensuring both horizontal and vertical integration between basic sciences and clinical disciplines.The
curriculum was divided into organ system based units covered in 3 phases in a total of 5 years.Phase 1
corresponding to year 1, Phase 2 corresponding to year 2 and 3 and Phase 3 as year 4 and 5.

Objective:
To compare small group teaching learning methods (CBL, PBL & SBL) in the integrated curriculum from medical
students' perspective and feedback.

Materials & Methods:

A sample size of 60 students of Phase 2 (2nd and 3rd Year) of the integrated curriculum were exposed to all three
types of small group teaching learning methods i.e CBL,PBL and SBL during these 2 years. At the end of the learning
unit on each organ system, they were asked to evaluate and give feedback on the teaching Learning Methods
adopted in that particular course on a questionnaire (5-1 Likert Type Scale). Data was taken from 9 different end of
course questionnaires. Items pertaining only to CBL, PBL and SBL have been compared and analyzed for this study.

Results:
The mean average for item ” CBL session helped to acquire foundational knowledge in the context of clinical cases”
was 4.19, for “PBL session helped me to think critically to reach conclusions” was 4.27 and for “ Clinical skills
sessions helped me apply foundational knowledge” was 4.35. Conclusion: Simulation based learning is superior to
other small group teaching learning methods when analyzed in light of students own ability to apply foundational
knowledge to the learning of higher complex skills.

Hybrid model of integrated curriculum for MBBS In

Rehman Medical College Experience

Tariq Mufti*
Principal
Rehman Medical College. Peshawar. Pakistan.

A hybrid model oF integrated curriculum of MBBS was developed and executed on the first professional, part - 1
students of the newly commissioned undergraduate medical college. Development of the curriculum involved ice
breaking of the traditional faculty, actual write up of the curriculum after consensus on the level of integration,
instructional and assessment formats and approval by the academic council. The university was involved to get a
few changes in the syllabus and assessment details. The curriculum remained under constant adjustment to the
need during the session. Faculty and student apprehension on the results of this new model were alleviated.
External examiners were invited to evaluate the periodical internal assessments. University annual examination
results proved the exercise worth, whereby 1st and 2nd positions on merit of the university were bagged by the
students of RMC in addition to achieving a 76% pass rate, the best amongst the affiliated private institutions.
Oral Presentations

32
Analysis and Performance impact of Minicex exam on high stake
examination in ophthalmology

Dr. Saadia Farooq*, Sulman Jaffar , Ali Tayyab

Associate Professor Ophthalmology
Shifa College of Medicine Islamabad. Pakistan.

Objectives:
To analyze mini clinical evaluation exercise for the performance and satisfaction level of the students. And to
look for its impact in improving outcome in subsequent eye clinical examinations.

Study design:
Cross sectional study

Date & place:

4th Year students Shifa College of Medicine, Islamabad in 2010

Methodology:
An analytical study was carried on mini clinical evaluation exercise (minicex) that was conducted for all the 4th year
students (n=94) of Shifa College of Medicine (Islamabad), in 2010 in groups over the whole year. In four weeks of
eye clinical rotation program students were exposed to this evaluation in third week. Afterwards they were expected
to improve on the highlighted guidelines. Clinical examination was conducted at the end of four weeks and
Professional examination was taken at the end of the year. Results of the minicex proforma were analyzed to see the
performance and satisfaction of the students in the given areas. Areas where students are found most deficient are
noted. Impact of feedback is noted by looking at the performance of the students in the subsequent end clerkship
and then professional examination

Results:
Total number of students who appeared in the three examinations in 2010 is 94. Mean score of minicex examination
is 57.13% (±8.63) with minimum score 30 % and maximum 80%.Mean score of Clerkship clinical examination is
71.91% (±11.06) with minimum score 33% and maximum score 93%. Mean score of professional clinical
examination is 65.78% (±6.54) with minimum score 37% and maximum score 81%. Considering minicex
examination as the dependent variable and looking for its correlation with other Gold standard examinations
(clerkship and professional), linear regression analysis was done (R2=0.196, p=.000).

Conclusion:
Minicex Exercise is worthwhile for all clinical disciplines, and may be used as a good analytic and feedback tool
before final assessments.

Oral Presentations

33
 Dow University of Health Sciences MBBS curricular innovations.

Salahuddin Afsar*
Dean, Faculty of Medicine, Chairman Curriculum Committee,
Dow University of Health Sciences, Karachi. Pakistan.

Introduction:
Innovations in medical curriculum are essential for progress so that doctors of the future can provide quality
healthcare to their patients. Since establishment of Dow University of Health Sciences in 2004,many avenues were
explored to achieve our vision and one of the first tasks was to do Needs Assessment of our existing MBBS
curriculum. Changing from the traditional perspective a constructivist approach was taken with principles of adult
learning as the main focus. All three medical colleges i.e. Dow Medical College, Sindh Medical College and Dow
International Medical College were included.

Innovations:
All changes were planned and implemented over the last 7 years in a gradual manner from the 1st year class so that
academic and administrative issues were kept to a minimum.
? Semester System with 16 weeks of teaching, 2 week break and then summative examination. Total of ten
semesters for the MBBS program with re-take examinations after every even numbered semester.
? Faculty-student mentoring was started.
? Introduction of One Best MCQ's, OSPE and OSCE.
? Examination result transcripts in Grade Point Average (GPA) format.
? Ophthalmology and Oto-Laryngo- Rhinology examined in 4 year MBBS ( 7th and 8th Semester respectively)
? Half the class was assessed in Surgery and Gynae-Obstetrics in 9th Semester and in Medicine and
Paedriatics in 10th Semester and other half vice-versa.
? Professional Development Center's Skills laboratory was used to teach skills like Heart and Breath
Auscultation, Intravenous access etc on mannequins from first year.
? Elective clinical rotations outside the university hospitals were encouraged for clinical year students.
? Research project for students in 4th year (7th& 8th Semester) clinical groups under supervision of faculty.
Presentations given by each group and judgment panel included Dean and Principals. Annual research day
was organized to showcase these project and same were published.
? Case based scenarios (CBL)introduced from first year where the Interactive Lectures were used to deliver
the knowledge content and then small group format was used to develop problem solving ability in learners.
Faculty training was done to facilitate these sessions.
? Module based teaching with focus on systems (Respiratory, Renal, CNS etc ) was started with involvement
of Basic and Clinical Sciences in formatting and developing the modules. Certain themes longitudinally
incorporated like Ethics (Behavioral Sciences). This year Pathology and Pharmacology was incorporated,
as appropriate, into the modules.
? Research methodology now part of 1st year through e-learning module in Digital Library.
? Curriculum Evaluation done in 2011 as per World Federation for Medical Education (WFME), Global
Standards for Quality Improvement and for students the Dundee Ready Education Environment Measure
(DREEM) inventory was used.

Future Directions:

? More integration in the curriculum with focus on Trans-disciplinary approach.

? Increased use of different tools (e.g. Extended Matching, Mini-Cex) for more robust assessment.
? Increased use of teaching aids like computer and internet for developing e-learning modules.
? Faculty development in areas like shared lectures etc
? Portfolio development for students' assessment.
? Accreditation of curriculum at local and global level.

Sources:
? Harden R M The integration ladder: a tool for curriculum planning and evaluation MEDICAL
Oral Presentations

EDUCATION 2000;34:551-7
? Basic Medical Education WFME Global Standards for Quality Improvement available from
http://www.wfme.org/

34
Evaluation of learning style for nursing students of Dow University
MHPE-DUHS student

Raza ur Rehman*
Professor, psychiatry
Dow University of Health Sciences, Karachi. Pakistan.

Introduction:
In Pakistan, there is a need to find effective ways of assisting nursing students for achievement of their academic
goals. To achieve this we plan to identify how these students learn. Such analyses can inform students about their
own learning processes and enhance their capacity to process complex information and nurture their development
as critical thinkers. Teaching methods that intentionally combine information processing across learning styles may
have the greatest potential for supporting academic success for students.

Methods:
This cross sectional survey was conducted at Institute Of Nursing (ION), Dow University of Health Science (DUHS).
On the selected day, structured questionnaire containing demographic data and Learning Style Inventory (LSI) was
completed by all students present on that day. The researcher facilitated the students in filling the questionnaire. All
ethical issues were taken into consideration and students were given incentive of providing and discussing their
report.

Results:
The sample of 150 nursing students was dominated by females (n=80). The dominant learning style in this sample
were visual (66%) followed by active (64%), sequential (56%) and sensing (51%). The strong correlation between
active and visual learning was observed(r=1, p>.000).

Discussion:
The results of present study are similar to studies conducted at other institutes where preferred mode of learning was
active and visual. These learning styles are disadvantageous in traditional lecture settings. Traditional-style lectures
favor students who are reflective, intuitive, verbal, and sequential learners. To address these different learning
styles, effective teachers need to use a variety of teaching styles in classroom as pointed out in some of studies.

Conclusions:
The learning style of nursing school classroom at ION, DUHS is not suitable for traditional lecturing. More teaching
strategies need to be added to help the majority of the learners.

Introduction of “study skills” as a longitudinal theme in the

undergraduate medical curriculum

Ayesha Rauf* Tara Jaffery

Coordinator Medical Education
Shifa College of Medicine, Islamabad Pakistan

Introduction:
Evidence shows that high achievers are self regulated learners with high metacognitive skills and use appropriate
strategies to facilitate learning. Formal sessions on management of learning, and guidance to the use of appropriate
strategies, have been found to facilitate volitional control and hence learning.
“Study skills” as a course is unique to the undergraduate curriculum in Pakistan. It has been incorporated as a
longitudinal theme in the integrated modular curriculum, at Shifa College of Medicine (SCM), which starts with the
Foundation of Medical Practice (FOM). The objective of the course is to formally and continually address the
learners' learning difficulties, build their self efficacy and make them adept at applying appropriate learning
strategies to suit their learning needs.

Methods:
The course was developed by the faculty of the DME. Concepts of metacognition and self efficacy were introduced in
the FOM module. In the later module; activity sheets were distributed in which students identified their personal
goals related to their performance in the end of module exam. They also identified controllable and uncontrollable
factors that would affect their goals. Once the results of their exams were available, the students reviewed their
previously recorded goals and identified learning issues that affected their learning and performance.
In the forthcoming module strategies to address these learning issues will be introduced followed by a questionnaire
Oral Presentations

to evaluate the usefulness of the sessions.

Results:
The formal undertaking of study skills is a longitudinal ongoing activity, the results of which can only be presented at
the end of the year long exercise. Preliminary data of application of the concepts to exams will be presented at the
conference.

Conclusion:
Formal and contextual teaching of study skills help students identify and address their learning issues. 35
 Comparison of marks obtained in MEQ's, SEQ's and MCQ's in Biochemistry
modular exam and their impact on students' overall theory score

Mukhtiar Baig*
Professor of Biochemistry
Bahria University Medical and Dental College. Karachi. Pakistan.

Introduction:
This study was designed to compare the marks obtained in modified essay questions (MEQs), short essay questions
(SEQs) and multiple choice questions (MCQs)in Biochemistry modular exam and their impact on students' overall
theory score at Bahria University Medical and Dental College Karachi. We also wanted to identify the tool of
assessment (among these) in which students' performance was the weakest.

Methods:
The study design was descriptive and non-probability, purposive sampling technique was employed. This study
compared the records of 88 second year MBBS students' who appeared in the modular exam in 2010.

Results:
There was an average score of 35% (SD 2.40) in MEQ's, 36.66% (SD 3.38) in the SEQ's, 71.64% (SD 3.38) in the
MCQ's and 53.8% (SD 6.63) in overall theory exam. By analyzing each component of theory assessment it was
found that only 27.27% students' cleared MEQ's exam while 34.09%, 93.19% and 71.59% cleared SEQ's, MCQ's and
overall theory exam respectively.
Regression analysis showed that MEQ's have a non significant correlation (r=-.017, p<.437) with SEQ's and
significant correlation (r=.309, p<.002) with MCQ's and with overall marks in theory (r=.534, p<.000). SEQ's have a
non significant correlation (r=-.017, p<.437) with MEQ's and significant correlation (r=.299, p<.002) with MCQ's and
with overall marks in theory (r=0.686, p<0.000). Regression analysis also showed that MCQ's have a significant
correlation with MEQ's, SEQ's and overall marks in theory (r=0.812, p<0.000).

Conclusions:
The results of the study indicate that students' score was independent of testing format and there is need to review
MEQ's and SEQ's to further improve students' theory score.

Recommendations:
Further studies are needed in other subjects with larger sample size.

On-Job Surgical Training in Operation Theater

Ata Ur Rahman*,
Professor, Orthopedics
Dow University of Health Sciences Karachi, Pakistan

Introduction:
Learning professional skills is the focus of every trainee's desire and if this process is impaired, he/ shes hows signs of
dissatisfaction, dejection and frustration. Most of the faculty and resident time is spent in service delivery with minimal
emphasis on teaching and learning. Many hospitals solve this issue by incorporating the concept of on-job-training
(OJT). By definition OJT is “Training at the place of work while trainee is doing the actual job”. OJT may be achieved
during the day-to-day experiences and is supervised by an expert. This may lead to fusion of service and training,
maximizing learning opportunities.

Objective:
the main focus of this work is to outline what literature says regarding the feasibility and implementation issues related
to OJT. It goes on to make suggestions of how OJT may be incorporated in teaching hospitals within Pakistan. This
presentation will also describe reports of a simple survey conducted to find how trainees spend their work time.

Methods:
Descriptive study Literature search was done through Google Scholar and Pub Med. It was limited to only English,
journal and books. It was also limited to last 15 years. 25 articles were selected to read and 10 were selected for
referencing. Quest criteria were used for further vetting.

Results:
The data collected from Surgical and allied residents of FCPS Part II and MS students indicate that only 14-21 % of
Oral Presentations

the resident's time is consumed in learning process.

Discussion and Conclusion(s):

Service frame is very rich in opportunities for training. Every minute of Service where Trainer and Trainee are in touch,
has a potential for fusion of service and training.

Key words:
36 On job training, Surgical training, work based learning.
Measurement of self-efficacy using student self-perception as an indicator:
instrument validation.

Azam S. Afzal*,
INSTRUCTOR, DEPT. of Medicine/ Educational Development, Faculty of Health Sciences, Medical College, Aga
Khan University, Karachi. Pakistan.

Introduction:
Social cognitive theory states that, the quality of one's life is to a large extent controllable. Bandura calls this form of
objective self-perception in one's capability to achieve a goal or outcome, self-efficacy. In academics, self-efficacy
has been found to translate into academic success and motivation. Students with a strong sense of self-efficacy are
more likely to engage in challenging tasks and be intrinsically motivated. These students will put in greater effort in
order to meet their learning goals. Students with high self-efficacy also recover quickly from setbacks, and are more
likely to achieve their personal goals. One of the outcomes of this study was to determine construct validity of the
measurement instrument.

Methods:
Self-efficacy may be measured by questioning participants on their beliefs about the underlying variables which
contribute to its contextual development. 144 students from 3 campuses of Dow University of Health Sciences were
given, a 12 item questionnaire from a modified Dundee Ready Education Environment Measure (DREEM)
questionnaire which asked about students' social, academic and learning self-perceptions. Items were scored using
a 5 point Likert's scale. The analysis for instrument validation consisted of factor analysis, reliability analysis and
inter-item and sub-scale correlation.

Results:
Analysis of the questionnaire item scores revealed, a Chronbach's alpha of 0.721 with subscale reliability being
0.697. Factor analysis revealed 3 components which correspond to the 3 latent variables mentioned earlier. The
correlation of the self-efficacy score with academic self-perception and learning perception subscales was 0.79 and
0.83 respectively, individual item correlation varied from 0.2 to 0.68.

Conclusion & Discussion:

The instrument is fairly reliable and has construct validity. Further analysis of the relationship between self-efficacy
score and academic performance is required to evaluate predictive validity.
This instrument will help teachers measure students' self-efficacy and identification of specific areas of
development. Its use will help teachers diagnose problem areas for low achieving students.

How did we start e-learning in Dow University of Health Sciences:

opportunities and difficulties – a case study

Dr. MasoodJawaid *
Assistant Professor Surgery
Dow University of Health Sciences. Karachi. Pakistan.

ELearning has the potential to shift the paradigm from passive teacher-centered learning to active student-centered
learning. Constructivism, one of the learning theories, is often associated with e-learning.

How and what we did

In December 2011, Dow started first six weeks eLearning Module of Research for the 1st year students in all three
medical colleges. All colleges have digital libraries equipped with computers with networking and internet facility.
The initial plan was to use Moodle (LMS) but because of some problems 'Articulate' was used to make flash based
presentations with interactions followed by assessment with the use of kwik surveys (a free resource on internet
which was used to make assessment method comparative to some costly commercial services). This presentation
will present SWOT analysis of the university in terms of eLearning, students' evaluation of this eLearning module
which comprises of both open ended and close ended questions. Our experience will be helpful for other institutes as
well, who are looking ahead to start eLearning in their medical curriculum.

What next – Implementation of further improvement and its challenges

We plan to conduct training workshops of eLearning for the faculty members to prepare eLearning modules both on
Oral Presentations

campus and off campus in basic and clinical subjects as well as using this modality in blended form. A dedicated
server equipped with LMS will be used for this purpose. Faculty motivation and IT support will be needed much more
for this implementation.

37
 Key Feature Problems”: should Pakistan medical and dental council (PMDC) use
this assessment tool for its licensing exam for international medical graduates?

Mohammad Idrees Adhi*

Student MHPE,
Dow University of Health Sciences. Karachi. Pakistan.

Background:
Key Features (KF) problems are useful to assess clinical decision-making that requires not only medical knowledge
but also the ability to apply that knowledge. KF problems offer challenges, critical steps, decisions, or actions in the
resolution of clinical problems.

Objectives:
? review the literature on Key Features
? compare psychometric properties of KF with those of One Best Multiple-choice questions (MCQs) or
Extended Matching Questions (EMQs)
? discuss the pros and cons of using KF as assessment tool in licensing examination of Pakistan Medical and
Dental Council (PMDC)

Methods:
This is a position paper to study the available evidence for KF questions. Literature review was made using Pub Med
and Google Scholar. Feasibility, validity and reliability of KF based on number of questions and time allotted to the
test was studied. Comparison of qualities of KF with other assessment tools was also studied.

Results:
KF problems assess effectiveness, not thoroughness, and permit broader sampling of problems to address “case
specificity” with potential reliability of 0.8 in 4 hours of testing. They are feasible to develop, have high face validity
and content validity. KF questions measure problem-solving ability, without loosing too much reliability, and have
modest correlation with other measures of clinical knowledge and clinical competence. The flexibility in allowing for
more than 1 correct answer mirrors real-life practice more closely than is possible in one best MCQs or EMQs. KF
problems are in practice in several countries of the world including Canada, Australia and Switzerland.

Conclusion:
Including KF problems to the existing theory examination is possible. This assessment tool is reliable with known
construct validity and hence may be implemented as one component of doctor's assessment in licensing
examination of PMDC for international medical graduates for medical practice in Pakistan.

Assessment techniques for undergraduate

at Al-Tibri Medical College & Hospital Karachi.

Razia Iftikhar*
Professor Gynae/ Obs
Al Tibiri Medical College & Hospital, Isra University. Karachi. Pakistan.

Objective:
Introduction of a modified assessment programme for undergraduate at Al-Tibri Medical College.

Place & duration.

Al-Tibri Medical College & Hospital Of Isra University Karachi.

Method:
We have 100 students in the first batch of Al-Tibri Medical College Karachi. We are following a combine approach of
summative and formative assessment technique in order to assure that the candidate meats the predefer mined minimal
qualification .The purpose is to identify the students who achieve the level of objective in terms of knowledge and skills
,generating performance profiles of student`s strengths and weaknesses and allowing the students to monitor their own
learning.
Our assessment program includes : Portfolio, Projects and Research, OSPE (Objective Structured Practical Exam), PBL
(Problem Based Learning), MCQ`S (Single Best Type), modified essay questions including Long essay & short essay type
of questions and continuous assessment technique (CAT).
Progress of each student is assessed and maintained as a record to measure the students growth towards the defined
outcome. We are also conducting resist examination after one month of final exams. Extra classes are also arranged for
weak students.
Oral Presentations

RESULTS:
98% of our students clear the examination successfully.

Conclusion:
It is an ideal system of assessment for undergraduates.

38 Key Words:
Assessment, summative, formative.
A Comparison of the methods adopted for teaching Behavioural Sciences by undergraduate
medical schools of Pakistan vis-à-vis other countries: A systematic review.

Iram Khursheed*
Senior Instructor and Educational Coordinator,
Department for Educational Development, Family Medicine and Psychiatry,
Faculty of Health Sciences, Aga Khan University, Karachi. Pakistan.

Introduction:
Teaching Behavioural sciences (BS) at undergraduate level fosters the development of caring & competent doctors.
Medical schools throughout the world are striving to increase the effectiveness of BS instruction. Realizing its
importance, Pakistan Medical & Dental Council introduced the subject of BS in 2005 & provided the course content
for the two preclinical years.
This study aims to compare strategies used for teaching BS in the undergraduate medical schools in Pakistan with
other countries, identify gaps and propose improvements.

Methods:
Google-scholar & Medline database were used for systematic literature search from 2000-2011. The pre-specified
form of inclusion/exclusion criteria was developed for literature screening. QUESTS-criteria were used to assess
quality of the selected articles followed by data extraction.

Results:
A total of 12 studies met the selection criteria. There was considerable variation in the extent of teaching, teaching
methods used and course design, both nationally and internationally. The main findings indicate lack of consistency
in how undergraduates are taught about BS across various medical schools.
In general, lectures were found to be the commonly used teaching method across various countries. However, there
is an increasing trend of switch over to other more effective teaching methods & integrated teaching approaches
world over in comparison to Pakistan.

Discussion and Conclusion(s):

Few relevant published studies are available on teaching of BS at undergraduate medical curricula in Pakistan. BS is
taught as a selective course, a lecture-program or integrated into the existing courses across various institutions.
It is proposed that national guidelines are developed for uniformity in instruction with emphasis on vertical and
horizontal integration and students' centeredness.
More research is needed to determine which teaching methods and to what extent are to be associated with
improvements in outcomes. Thus evidence based published data, is strongly recommended to augment structured
course planning in BS.

A need to develop national consensus for CME accreditation system

Muhammad Aslam,* Mati-ur-Rahman and Mobeen Iqbal

Shifa College of Medicine. Islamabad. Pakistan.

Introduction:
The undergraduate/ postgraduate medical education, continuing professional development [CPD] and continuing medical
education [CME] is a continuum. Currently, the national CME accreditation program is non-existing. The purpose of
accreditation in CME is to improve medical education to changing conditions in the health care delivery system and to
prepare doctors for the needs and expectation of the society.

Discussion:
Accreditation is a risk reduction strategy. The value of accreditation is that it provides a process of improvement and
development of the system. Standards and indicators must be identified, but achieving consensus on standards is the
greatest challenge. Accreditation is primarily concerned with standards, whereas, quality assurance means “fitness for
purpose” but, both complement each other. The accreditation system is required to be standardised, independent,
transparent, non-profit making, accountable, efficiently administered and to possess adequate human, material and
financial resources. The accreditation system needs to have a national legationary to make it credible and valid. It is
equally important to develop a national consensus of the CME accreditation system by taking all stake holders on board
including public [in general], patients, government, health regulators, health-service entities, funding agencies, students,
licensing bodies [PM&DC, PNC, CPSP & the like], the medical teachers, universities, higher education commission,
medical/ dental/ nursing/ pharmaceutical/ para medical colleges, medical professional societies and other health
professionals.
Oral Presentations

Method:
It is suggested that a task force for CME accreditation be made which may from various committees and sub committees to
formulate pathways and procedures about the governance, accreditation, quality assurance, professional licensure,
national legitimacy, practicability and its fund raising.

Conclusion:
In conclusion, the development of national consensus of CME accreditation is required to formally recognise CPD
providers/ organisers according to the standard criteria. This system would improve health care status of the population. 39
 Cent Percent Result of the Very First Batch: An Innovation in Medical Education

Abdul-Waheed Sheikh*, Gulfreen Waheed, Samina Malik

Chairman, Avicenna Medical College, University of Health Sciences. Lahore. Pakistan.

Background:
University of Health Sciences is affiliated with most of the medical colleges of Punjab, including its new offspring
“Avicenna Medical College, Lahore: A private medical school. This institution stands for its innovating outcome of
cent percent result of the very first batch.

Objective:
Not to sell the dream of raising the institution to distinction by self-monitoring with commitment.

Subjects & Methods:

A total of 100 students were inducted in the first batch under time constraint after necessary procedures of PM&DC
recognition & UHS affiliation of the institution. The seed we received was the one that was not accepted by any other
medical school. Around 75% of them chose to board at on campus hostels. Free evening classes were arranged to
facilitate the morning classes for boarders as well as day scholars. Progress of each student was closely monitored.
Motivation & counseling classes were also provided side by side. Students were trained regarding how to attempt
MCQs & SEQs by subjecting them to tough standard frequent tests followed by discussion on the key points. The
test questions & key was subjected to discussion followed by final approval by the Vice Principal. They were
categorized into white, pink & red lists, depending upon passing the tests of the 3 basic science departments
completely, partially or not at all, respectively. They were then motivated & facilitated to get themselves enlisted in
white list. White-listed students were allowed to self-study if the progress continued. Parents were sent monthly
progress reports. Attendance was strictly monitored & remained cent percent. Students were also exposed to
clinical scenarios constructed by dedicated faculty & were exposed to cases related to their curriculum. None of the
students was allowed to get involved in student union or an affair. Their physical, mental & spiritual health was looked
after. They were subjected to keep their cell phone off while on the campus. OSPE training was conducted during
each individual practical class.

Results:
This innovation in medical education rendered a moral-boosting cent percent result in the first as well as second
annual examination of the first batch.

Conclusion:
Success is mandatory if such an innovating medical education system is adopted.

Key words:
Innovation, Medical Education. Cent percent result.
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40
Does clinical decision making improve with surgical training
in FCPS Surgery trainees?

Shams Nadeem Alam*

MHPE-DUHS student
Professor, Surgery
Incharge Surgical Unit VI
Dow Medical College, Civil Hospital. Karachi. Pakistan .

Introduction
Clinical reasoning is the thinking and decision-making processes associated with professional practice. Errors in
decision making do happen and trainers continue to ponder how to minimize these errors. Studies have been carried
out to measure its reliability and validity. This study aimed to measure the clinical reasoning skills of Pakistani
Postgraduate Surgical Trainees using the Diagnostic Thinking Inventory (DTI) developed and validated by Bordage,
Grants &Marsden.

Research objective:
Compare the flexibility of thinking score in residents who have passed intermediate module with the flexibility of
thinking score in residents who have not yet attempted intermediate module.

Methodology;
Study design: Cross-sectional comparative study.

Sample size: A total of 60 trainees

Sampling procedure: Purposive Non-Probability

Setting: Civil Hospital Karachi, Dow University of Health Sciences

Subjects: Comprised of 1st to 4th year FCPS Surgical Trainees who were divided into two groups; GROUP A had
passed FCPS Part One but had not appeared for the Intermediate Module (IMM) surgery exam (1st and 2nd year
residents) and GROUP B had passed the IMM examination and had not sat for the Final FCPS examination (3rd and
4th year residents).

Three simulated cases were given to these FCSP trainees in General Surgery and were asked to fill the Diagnostic
Training Inventory.

Inclusion/ exclusion criteria:

Data from any candidate who did not fill the complete inventory was not included in the final analysis.

Statistical analysis: Main variables were grouped into two sets under flexibility in thinking and evidence for
structure in memory. Since the questionnaire produced ordinal data Chi-square was used. P-value of 0.05 was taken
to be significant. Descriptive analysis of age, sex and number of attempts of FCPS Part I and IMM was done and also
type of schooling i.e. FSc or A levels was looked at. All analysis was done on SPSS 17.

Results & Conclusions:

To be presented at the conference. Oral Presentations

41
 Student perception on curriculum of anatomy

Shazia Babar*
Lecturer in Anatomy
Bahria University Medical and Dental College, Karachi Pakistan

Introduction:
Traditional medical education programs have been under consideration due to many reasons including
overemphasis on some subjects, presence of relatively non relevant topics, dissociation between basic and clinical
sciences and repetition of lectures. The inclusion of detailed anatomy course in undergraduate medical school
curriculum has also been a concern for students. The objective of this study is to explore the medical students
perception towards anatomy curriculum taught to them in the preclinical years and its clinical application.

Methods:
A descriptive cross sectional study was done. A 28 item Likertscale questionnaire was distributed among 103 Third
Year MBBS students of Bahria University Medical and Dental College. Three incomplete forms were discarded. Data
obtained was transferred on SPSS version 16.

Result:
Out of 100 third-year students 43%were male and 57% were females. Only 34% responded that anatomy should be
taught in third and fourth year MBBS. Most of the students agreed that clinical examination and applied anatomy
taught by clinicians make them understand better. 77% responded that seminars on clinical problems improve their
understanding of anatomy. Students agreed that clinically correlated anatomical teaching were relevant to clinical
practice and helped them during their clinical placements.

Conclusion:
The PMDC supports the principle that curricula should aim for application of knowledge and problem solving rather
than recall. Also, curricula should emphasize on areas that the student must know, incorporate new fields of
knowledge and yet ensure that the student is not overburdened and therefore eliminate redundant topics. Anatomy
courses worldwide have undergone changes bringing newer methods of teaching and learning. It is high time that
medical schools in Pakistan follow and implement modern educational principles. One main method of knowing is to
find out how students perceive a particular course and then to implement the suggestions as much as possible.

A review of study habits of medical students

Tariq Chundrigar*,
Consultant General Surgeon,
Armed Forces Hospital, Al Hada, Taif. Saudi Arabia.

Objective:
To review literature on study habits of medical students, the impact on acquisition of knowledge and on graduation. To
identify methods given in the literature used to develop, improve and facilitate study habits of medical students and
residents.

Methods:
A literature search using the terms 'medical student', 'study habits', 'learning skills', 'knowledge acquisition',
'developing study habits', 'facilitating study habits' and 'improving study habits' was performed on Proquest,
Ebscohost, Medline, and Google Scholar. Articles were studied for relevance to our objectives, and were twenty-four
were selected for this review.

Discussion:
Study Habits of students are one determinant of acquisition of medical knowledge. Much work has been done on
study habits of medical students, residents in training (in various fields) and doctors in practice. Factors that impact on
these habits, and how the study habits influence performance have been studied, leading to suggestions of
modification of instructional strategies, learning environment and even curricula to optimize study habits. Time
available for self-study is related to graduation rate and study duration. It appears that 'securely attached' people
study more and that there is less studying among 'avoidant' people. Study habits and skill measures improve
prediction of academic performance more than any other noncognitive individual difference variable examined.
Students in clinical clerkships spend significant amounts of time reading online sources during their medicine
Oral Presentations

clerkship, especially Up To Date. Similarly, medical students also use Personal Data Assistance (PDA) resources.
There is support for the development of educational programs to promote student knowledge about organizational
information. There is, however, no clear road-map in the literature about how to develop or improve study habits.

Conclusion:
Study habits determine knowledge acquisition and graduation rates. Medical students increasingly use electronic
resources for knowledge acquisition. There are no recommendations on how study habits can be improved and
42 developed.
Gateway to international Accreditation- Shifa's first step

Farah Rashid, Sameena Ghayur*, Asna Haroon Khan, Ms Humera Yasin Khan
Shifa College of Medicine. Islamabad. Pakistan.

Background:
Quality assurance in Medical Education is extremely important to achieve intended outcomes. Liaison Committee
on Medical Education (LCME) and World Federation for Medical education (WFME) provide framework for quality
assurance in Medical Education (ME). In recent years there has been an international movement to apply these
standards on various stages of ME. Pakistan has recently joined WFME and PM&DC is currently a member of
WFME. Education commission for foreign Medical graduates (ECFMG) has also determined that from 2003 FMGs
applying for certification will be required to have graduated from a medical school that has been appropriately
accredited.
In this National and International scenario we at Shifa have decided to move towards formally adopted WFME
standards for undergraduate ME.

Objectives:
To sensitize faculty members of Shifa College of Medicine (SCM) and Shifa College of Nursing (SCN) about
medical education standards and institutional self-review as a first step towards international accreditation.

Methods:
As a capacity building measure four faculty members from SCM completed distance learning courses offered by
Open University-FAIMER under theme of “self review and accreditation”. Two consecutive faculty development
workshops were arranged for all faculty members of SCM and SCN. In the first, faculty members were updated on
process of accreditation and self review by a PowerPoint presentation. A small group activity included assessing the
educational program, target outcomes and steps to achieve them. In the second, selected LCME standards and
current practices at SCM were distributed to the faculty members for self-review. Divided into groups they were
asked to identify areas of improvements and device strategies for achieving the standards. In future a working group
would be formed from the faculty to work on the process to achieve the standards.

Results :
A feedback was obtained from the faculty through a structured questionnaire and two focus groups will be conducted
to explore the effectiveness of the self-review activity. Quantitative data will be analyzed through SPSS and FGDs
will be through content analysis to identify the themes.

Conclusion:
Faculty at SCM has recognized the importance of applying these standards in achieving quality assurance in
Medical education and accreditation. We expect to achieve these goals in the next 5 years in terms of basic and
advanced standards.

Psychometric Analysis of MCQs used in assessing the first step of entering

into a Medical College

S Shoaib Shah* M Sabir Tabbasum

Professor & Principal
Rawal Institute of Health Sciences. Islamabad, Pakistan.

MCQs are used in assessing students while entering into medical profession at Rawal Institute of Medical Sciences,
Islamabad. The questions are generated by the subject experts and vetted at central level. The used MCQs are
tested and analysed in terms of psychometric properties i.e. reliability, validity, difficulty and discriminating indices.
Kuder Richardson 20 formula is used to test the reliability. A total of 230 students appeared in the test. The students
attempted 100 MCQs of one best response type with 5 options. The data was analysed on OMR (Optical Mark
Reader) and SPSS version 16 for windows. The whole test results were classified on the basis of point-biserial and
p-value, as Easy items ranging from P-value>0.70 & Point-biserial<0.20, Moderate items ranging from P- value
(0.31 to 0.69) & Point-biserial <0.20 and Hard items ranging from P- value<0.30 and Point-biserial<0.20 and items
having negative Point-biserial. The results showed that 48% items were Easy, 22% items Moderate, 21% Hard while
9% items showed Negative Point-biserial. The internal consistency for the whole sample was 0.72. The overall test
was reliable with a logical mix of Easy, Moderate and Hard MCQs.
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43
 Windowed chicken egg- a biological simulator for academics and research.

Nusrat Zareen*.
Associate professor Anatomy.
Al Nafees Medical College. Islamabad. Pakistan.

Introduction:
Fantasying the embryological development stages has always remained a problem for under and post graduate
medical students. Unlike the adult cadavers, embryos are not easily accessible for teaching purposes. Therefore
other than a few museum specimens, embryology teachings rely mostly on models or animated videos. These tools
don't provide an easy understanding of the subject and fail to give an exact picture of the dynamic events of
embryogenesis.
Keeping in view these educational hindrances, live biological simulators of chicken embryos were developed using
windowed egg technique for study and research purposes. Embryogenesis in chicks involves developmental
processes equivalent to those occurring in mammals, but takes place at higher rate. These model systems
therefore, not only prove to be a realistic approach to the subject of embryology but also provide an ideal
experimental medium for research.

Materials & Methods:

In this descriptive laboratory research, freshly hatched fertilized chicken eggs were collected from the Poultry
Research Centre, Rawalpindi. Using scissors, small windows were made on the shell of the eggs, leaving one edge
hinged to the shell. The eggs were then incubated under standard conditions. The developing embryos were daily
taken out and day wise development was studied by just lifting the lid without sacrificing the embryo.

Results:
Formation and growth of the embryonic structures were directly observed and the developmental time line also
traced.

Conclusion:
The windowed eggs model system provides for a biological simulator for naked eye observation of embryogenesis.
This model system can also be of much interest to the researchers as media for in ovo experimentation without much
manipulation to the natural environment.

Faculty experience of practicing ebm to promote undergraduates'

learning through case write-ups.

Humera Yasin Khan *, Tara Jaffery ,Ayesha Rauf , Mobeen Iqbal

Shifa College of Medicine. Islamabad. Pakistan.

Introduction
At Shifa College of Medicine, case write-ups are used as a learning strategy to promote EBM practice. Students
write detailed case history, formulate related questions, answer a desired question using evidence retrieved from
literature and apply it to their patient.

Methodology
Through open ended questionnaires clerkship faculty's level of understanding, possible barriers and solutions for
practice of EBM and their acceptance of case write-ups as an effective strategy for EBM learning, were identified.
Responses were coded and analyzed using SPSS.

Results
64% faculty members were beginners in EBM practice. 80% had time limitations to practice EBM. 76% used primary
while 52% used secondary resources. 68% was concerned about availability of resources.60% said required
resources needed to be improved. 48% agreed that case write-ups promoted students' thinking and enquiry. 48%
stressed that assessment of case write-ups stimulate students to explore further. 56% emphasized on faculty's
training while 24% identified checklists to standardize evaluation of case write-ups.

Conclusion:
Most of the faculty were beginners to EBM and perceived case write-ups as useful strategy to promote EBM practice
Oral Presentations

in students and emphasized on training and resources.

44
Student's perceptions regarding educational environment

Shamsunnisa Sadia*Raheela Yasmeen, Masood Anwar

Associate Professor
Islamic International Medical College, Rawalpindi. Pakistan.

Introduction:
Students perceive the educational environment of the overall medical college as the climate. The educational
climate in turn influences the behavior of the medical students. Multiple elements such as teacher's skills, teaching
methods, class rooms, timetable, assessment methods, library and leisure facilities have an impact on how the
environment is perceived. School climate shows a significant positive correlation with student performance, staff
retention, staff-student satisfaction indices and the ability of institutions to introduce positive changes. The
importance of conducting climate assessment activities cannot be understated. It is a fundamental part of good
administrative and teaching practice, essential not only for the survival of an institution but also for its advancement.
We therefore, sought to describe the perceptions of graduating medical students regarding their educational
environment.

Methods:
Freiberg's (1998) four questions were asked of fifty ninegraduating medical students to elicit information about the
environment. The questionnaire was distributed and students answered the questions regarding what they liked
about their medical college, most memorable experiences, areas of improvement and the message they will give to
their teachers.

Results:
The students liked the medical teaching in Islamic perspective and professional attitude of teachers the most. Sports
week, result day and clinical experiences especially in operation rooms were considered to be the most memorable.
But the thought provoking finding was that the students felt that the teachers were authoritarian and major effort was
needed to upgrade hospital infrastructure such as lecture halls, cafeteria and common rooms. Students strongly felt
the lack of extracurricular activities during their college life.

Conclusion:
It is evident from our study that to make the learning experience pleasant for the students there is a need for
makeover in approach of the teachers, increasing extracurricular activities and improvement in infrastructure of the
teaching hospital.

A preliminary evaluation of factors affecting women's career advancement

and Gender Equity at Shifa College of Medicine
Tara Jaffery*, Ayesha Rauf, Zareen Zaidi
Shifa College of Medicine, Islamabad. Pakistan.

Background:
Shifa College of Medicine (SCM) is a proponent of equal opportunity. Presently, there are 117 faculty members, 60 %
being women. Curriculum changes have produced new leadership and roles, influenced progress of women faculty,
with increasing number advancing in Medical Education. Concurring with international trends in medical education,
women progress more slowly through academic ranks with few women in leadership positions. We believe
measures to promote career building in women will promote institutional development. Gender Equity (GE)
evaluation is fundamental to facilitate the professional development of women faculty.

Methodology:
In order to ground the preliminary evaluation in our social, cultural and institutional context, a focus group discussion
was conducted with a purposive sample of ten mid-career women to identify the challenges faced and strategies
developed for career success. As the first step, qualitative analysis of the focus group data was done. Responses
were analyzed, coded and categorized independently by three investigators. Manifest and latent themes were
identified, using an inductive approach. Final agreement was reached by comparison of the independently done
thematic analysis by the researchers. Trustworthiness was ensured by member check done with two of the focus
group participants who reviewed the themes for validity.
The identified issues and solutions were then examined using the Integrated Framework: The Leadership
Continuum and Institutionally Based Approaches for Women's Advancement proposed by Morahan et al.
Oral Presentations

Results:
Themes identified from the initial qualitative analysis were categorized under two categories; “Challenges to
Academic Advancement “and “Enabling Factors for Academic Growth”. Additional appraisal using the Integrated
Framework helped organize issues into suggestions for women's' advancement and GE.

Conclusion: identification of issues related to women's advancement can serve as a useful initial step for GE
evaluation. Involvement of both men and women faculty in this dialogue will be our next step in GE evaluation. 45
 Towards a competency-based dental education framework:
defining competencies

Dr. Junaid Sarfraz Khan*, Saima Tabasum, Osama Mukhtar

Department of Examinations,
University of Health Sciences. Lahore. Pakistan.

Introduction:
In the last two decades with increasing public, peer and industry accountability, rising cost of higher education,
information overload and an emphasis on improving healthcare delivery in an ever-deficient global healthcare
system, there has been considerable pressure to apply competency-based education reform models to
undergraduate education.

Objective:
The objective of this study was the validation of competencies by all stakeholders and to group them into
manageable, measurable, reproducible and identifiable dental graduate capabilities.

Methodology:
Dental faculty, students of all academic years in institutions affiliated with University of Health Sciences and the
public were administered a 30 item questionnaire listing the graduate dental competencies in 2011. Data was
entered into Statistical Package for Social Sciences (SPSS) v.16 and analyzed by using Confirmatory Factor
Analysis (CFA) with Varimax Rotation under the conditions of Eigenvalues > 1 and loadings ≥0.2. Parametric tests
were applied to the responses of all stakeholders. 'Agree' response was given a score of '1' and 'disagree' was given
a score of '0' for each question/characteristic. These scores were added up to compute a new variable as total score
of the respondents. p< 0.05 was considered as significant.

Results:
2037 questionnaires were collected (1789 from students, 88 from faculty and 160 from the public. The value of
Kaiser-Meyer-Olkin (KMO) was 0.924, where Bartlett's Test of Sphericity was significant (p-value<0.05). In
Confirmatory Factor analysis (CFA), five components were extracted with Kaiser Eigenvalues greater than 1
accounting for 40.58% of variance. Total 30 items had internal consistency reliability of 0.876 (Cronbach's Alpha).
Analysis of Variance (ANOVA) showed a significant difference in Response scores of various stakeholders
(F=113.2, p<0.05). Post Hoc Tukey Test revealed that General public scored significantly lower than the students
and Faculty.

Conclusion:
Graduate dental outcomes are not wholly generic; there are cultural, societal and structural variations that affect the
desired regional final competencies. It is therefore important for Pakistan to design its own outcomes for the program
rather than to import them from the West.

Keywords:
Competency-based dental education, outcome-based curriculum, competencies, baccalaureate of dental surgery
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46
Redefining the Medical College admission criteria in Pakistan
on literature based valid and reliable evidences
M Rafique Gooda*
Professor ENT
Institution: Hamdard College of Medicine and Dentistry

Background:
Medical community in Pakistan, of late, is faced with a spate of violence directed against medical professionals.
Reasons may be political but lack of professional values is frequently cited as a cause. The society wishes to be
treated by a competent doctor with humane qualities of heart and mind. It is rightfully asking whether medical
colleges are selecting students capable of acquiring the right competencies. An ideal admission process selects
students with traits vital for success in Medicine and rejects those with dysfunctional tendencies. Student's school
marks have recently become suspect because of deteriorating academic standards hence multiple valid and reliable
cognitive and non-cognitive criteria need to be found to assess the suitability of student's admission to medical
colleges.

Methods:
A literature review of the various criteria used for students' admission to Medical Colleges in Europe, North America
and Australia was made. Following search engines were used: PubMed-NCBI, Google Scholar, ERIC (peer
reviewed). Academic Medicine, a peer reviewed journal was also accessed. Valid and reliable admission criteria
used in medical college admission in North America, the UK and Australia were reviewed and discussed.

Results:
Intellectual ability is best reflected by exam score which has both validity and reliability, despite limitations. Both
cognitive and non-cognitive abilities should be assessed using valid and reliable tools and only those students be
selected who fulfill those criteria and hopefully can complete medical school and fulfill professional demands.

Conclusion:
In Pakistan, medical colleges use only cognitive traits to select medical students for admission. Students should be
admitted to a medical college using valid and reliable cognitive and non-cognitive criteria which correlate
significantly with success in medicine. This is a worthwhile investment to improve professional values and prevent
student loss during the course.

Medical and dental research at undergraduate level:

evaluation of opportunities and barriers

Asrar Elahi* Muhammad Azhar, Waqar Jeelani, Sanaa Masood Aslam, Usman Ahmed, Memoona Khokha,
Mehmood Asghar Bhatti
Army Medical College. Rawalpindi. Pakistan.

Background:
Medical and dental research at undergraduate level improves the understanding of students, making them
appreciate the discovery process and master skills for critical analysis of the published literature. Although there is a
general agreement on the importance of promoting research understanding and skills at the undergraduate level,
little has been done to assess how it can be achieved. This study was conducted to evaluate opportunities available
and highlight the barriers faced by undergraduate medical and dental students of Rawalpindi and Islamabad in
carrying out a research project.

Methods:
It was a descriptive cross-sectional study conducted in all of the recognized medical and dental colleges in
Rawalpindi and Islamabad. A pre-tested, structured questionnaire was self-administered to 350 medical and dental
students. Opportunities and barriers for undergraduate research were recorded on a scale graduated in percentage.

Results:
The mean score for “Availability of Research Promoting Activities” was 39.8% (47.1% for medical and 25.0% for
dental students) and the mean score for “Barriers Faced” was 81% (77.7% for medical and 84.7% for dental
students). 58.7% of all students notified lack of encouragement by faculty and 71.9% reported that administration
was not supportive in carrying out research projects at their institutes. The score for publicity of research
opportunities was 39.4% through faculty members/colleagues/friends, 28.1% through internet, 24.9% through
newsletters, 22.3% through pamphlets and 22.3% through posters. 14.6% of students (of which 80% were medical
Oral Presentations

students) reported the presence of student research office at their institution. The score for availability of adequate
funds for research was 15.7%.

Conclusions:
The majority of undergraduate medical and dental students in Rawalpindi and Islamabad faced more obstacles in
comparison to limited opportunities in planning, conducting, writing and publishing a research study. Opportunities
and barriers are almost equal in medical and dental institutes of government and private sector. However, dental
students were found to have fewer opportunities and more barriers in comparison to the medical ones. 47
POSTER
PRESENTATIONS
The relationship between Meta-cognition and students achievement

Maryam Khajavi*

Introduction:
Meta-Cognition( M-C) is the acknowledge of how people learn . Lots of studies in the field of the effect of m-c ability
usage rate on students achievement , mental health and learning skills is done , but the relation between this ability
and mental-educational situation of students is scarcely discussed .
The aim of this project is to estimate the effect of having m-c ability on students achievement in order for educational
planners to know what causes effect on students educational situation .

Methodology:
in order to handle this research 50 professional doctorate and B.A student in various field of medical sciences in Iran
university were chosen in clusteric method the students m-c skill was examined by Cartwright and Hatton 1997
creditable questioner which has been translated into Persian at 2000( Cronbach's alpha coefficient 0/72 ÊÇ0/89) .
Students achievement according to their marks in 3 different theoretical courses in 3 continual years determined.
The relation between variables concluded by person correlation and independent T-Test .
Confounding factors as the sameness of course program , teacher and gender of students in different investing
years was controlled .

Result:
Students that was better skilled in m-c, caught better marks in research courses (p-value=0.012). Girls was better
than boys (p-value=0.012), but no distinctive difference was seen in their courses marks .

Conclusion:
Based on research outcomes it can be said that awareness of m-c and learning it cause students to correlate their
success and failure in learning to their toy , planning and supervision instead of their chance and talent and increase
their self confidence .

Gá12 is required for Thromboxane A2 to regulate tumor cell motility

Babar Malik
Sindh Institute Of Urology And Transplantation

Introduction:
Thromboxane (TX) A2 is a prostaglandin produced by metabolism of arachidonic acid through cyclooxygenases and
thromboxane synthase. TXA2 is active through activation of its cognate, seven transmembrane, G protein coupled
receptor.

Objective:
This study aims to identify Gá protein(s) involved in thromboxane A2 signaling in tumor cell motility.

Place & Period of Study:

Department of Medical Microbiology, Immunology and Cell Biology, SIU- School of Medicine and The Simmons
Cancer Institute, Springfield, IL.

Methods:
The expression of Gá proteins in the PC3MM cells was studied by real time PCR. Cell contraction assay was
performed by staining cells with TRITC phalliodin. Tumor cell motility and invasion was evaluated using wound
healing assay and Boyden Chamber assay. We also depleted Gá protein expression by shRNA and examined
subsequent changes in cell contraction and migration. Role of Gá12 in cell proliferation was studied by BrdU
Incorporation assay, Cell proliferation assay and cell cycle analysis. Quantitative analysis of the EMT associated
genes was performed by RT-PCR.

Results:
Poster Presentations

PC3 MM cell line had the endogenous level of all the Gá protein (Gá12, Gái1, Gá11, Gá13), but not Gáq.
Overexpression of Gá12/13 increased cell contraction after activation of TXA2 receptor with U46619.Depletion of
Gá12 via shRNAs reduced cell contraction. Tumor cells with depleted Gá12 had shown decreased tumor cell
motility, invasiveness and cell proliferation. Cell cycle analysis showed that Gá12 depleted cells exhibit G1/G0
arrest. Quantitative expression of EMT associated genes was reduced in Gá12 depleted cells.

Conclusion:
Silencing of Gá12 with shRNA may provide a promising therapeutic strategy for prostate cancer patients. 49
 General Impact of Modular System of Education on Students of
Peshawar Medical College, Peshawar.

Muhammad Salman Haider Qureshi*, Hamza Zaffar

Peshar Medical College. Peshawar. Pakistan.

Introduction:
Modular System of Education or Integrative System of Education refers to the integration of various subjects into a particular
module. In Wikipedia, Integrated Medical Curriculum is defined as, “Integrated curriculum refers to a non-
compartmentalized approach to basic science learning.”
In other words, In Modular system of education taught in PMC, one particular theme is taught at one time covering its various
aspects of Anatomy, Physiology, Biochemistry and co-relating it with the Clinical Sciences. While in Conventional System of
education, the subjects of basic sciences are compartmentalized and different topics or themes are taught in various subjects
at the same time. Further, the correlation of Basic sciences with Clinical sciences is also not performed in Conventional
System of Education.
AIM: To study the overall impact of recently introduced Modular System of Education on students of PMC.

Objectives:
1. To determine the level of satisfaction of first and second year medical students through structured interviews with the
current system of modular education.
2. To determine the level of satisfaction of third year medical students through structured interviews with conventional
system of medical education.
3. To compare the level of satisfaction with system of education of modular students with conventional students.
4. To seek comparative opinion of faculty experienced in both modular and conventional systems of medical education.

Methodology:
Design:
Cross-sectional
Setting:
Peshawar Medical College (PMC), Peshawar.

Subjects:
Survey was conducted among the MBBS students of 1st and 2nd studying under Modular (Integrated) System of Education and
rd
3 year studying under conventional system of education. Total 60 modular students (30 students from each class and 3
students per batch) and 20 conventional students (5 students per batch) were interviewed through structured questionnaires
rd
designed separately for modular and conventional students. While taking the views from 3 year students, they were
requested to fill the questionnaire while keeping in view their past study schedules / routine / activities/ performances made in
st nd
1 and 2 Year MBBS.
Total 11 experienced Faculty Members (including Dean, Vice Dean, 2 Professors/Associate Professors from each basic
sciences department, 1 Lecturer from Clinical Sciences department, 1 Demonstrator and 1 Theme facilitator) were also
interviewed through specially designed structured questionnaire.
The duration of entire project was about one month. Moreover, Ethical Consideration was also taken into account.

Results:
After analyzing the data it was revealed that 76% of Modular students, 73% of Faculty members and 30% of Conventional
students were in the favor of Modular System of education introduced in PMC.
About 90% of the faculty was of the view that by the introduction of this Modular System, the confidence level of students has
increased and similarly, 73% Faculty thought that Modular System has also played positive role in the personality building of
the students. 73% Faculty believed that students have gained more interest in their studies by the introduction of Modular
System. 45% Faculty were of the view that Modular Students give better outcome while 27% believed that Conventional
Students show better results. As concerned to the participation of students in various co-curricular activities, the view of
Faculty for Modular and Conventional students was 50/50, Faculty also observed that Modular students are studious, hard
workers, inquisitive, focused and integrators, however, 9% faculty did not observe any inspiring feature in Modular students.
50% Conventional students observed that Modular students are very studious and hardworking while 10% claimed that they
do not work hard. 45% students believed that Modular students have more knowledge as compared to Conventional students
while 11% were against this view.
By comparing the two systems of education, the most interesting educational system claimed by students was Modular
System while the most boring among the two was Conventional System. However, Modular Students seemed to be more
confused with their system as compared to Conventional students. Majority of the Modular students claimed that in this system
they are compelled to study on daily basis while Majority of the Conventional students said that they can cover their course in
last few months before annual exam even though they do not work hard on daily basis. It was also revealed that 60% Modular
students study 2 or more hours per day while 75% Conventional students studied 2 or less than 2 hours per day(in their 1st and
nd
2 Year). On the question that, which system would they advise to others, the reply of 48% students was Modular while 31%
was Conventional System.
83% Modular students and 64% Faculty staff members credited Modular System of Education for clarification of concepts. To
sum up, Total 60% subjects were in the favor of Modular System of Education in PMC, 19% were against it while 21% were
unable to analyze.
Poster Presentations

Conclusion:
After evaluating results, it can be concluded that more than half of the subjects are in the favor of Modular (Integrated) System
of Education in PMC while less than quarter are against it. Further, Modular System has played a very positive role in the
concept clarification of students and has compelled them to work hard. The system has also enhanced their confidence level,
interest in studies, integrating capacity and focusing power as compared to Conventional System of Education. However,
Modular System introduced in PMC seemed to be more confusing for students as compared to the Conventional System.

Keywords:
50 Modular (Integrated) System of Education, Conventional System of Education, Peshawar Medical College (PMC).
Use of case studies for teaching health care ethics to nursing students

Farida Zahra Khairunnissa *

Assistant director, director, senior instructor
Shifa College of Nursing Islamabad, Pakistan

Back ground:
Shifa College of Nursing-Pakistan has initiated teaching of health care ethics using case studies. The previous
curriculum included lectures on ethical principles; patient's rights and ethical theories. Course feedback was not
encouraging and students found it complicated and boring, therefore, the course content and methodology were
revised. Summary of work: Case studies were introduced reflecting moral dilemmas which nursing students
encounter regularly such as honesty, professional identity, empathy, responsibility/ accountability, negligence and
autonomy. Before the sessions, a Pre-test was given to the students present (N=19). In each session students
discussed six cases having similar concept in smaller groups, which were later presented in plenary. Students had
question answer session facilitated by the instructors. At the end, post-test and course evaluation were conducted.
No grades were assigned to students for this course; however understanding of ethical concepts were assessed on
clinical through checklists.

Summary of the results:

Most students commented that sessions were highly interactive, and they can easily integrate these values into
practice. Mean difference from pre (mean= 6.2) to post (mean = 10.4) test was 4.2.

Conclusion: The revised curriculum is now institutionalized.

Take home message:

For the beginner level nursing students, abstract concepts like morals and values can be best taught using real life
scenarios written in simple language.

Cross Sectional Comparative Study People with the height above 5 ft 7 inches
are more at the risk of developing postural low backache

Muhammad Fahad Siddique*

Lecturer
University Tunku Abdul Rahman Malaysia Faculty of Medicine and Health Sciences,, UTAR, Bandar Sungai Long,
Kajang, Selangor. Malaysia.

ABSTRACT Postural back pain in the lumbosacral area is main type of commonly occurring back pain due to poor
posture adopted during any work or exertion. According to statistical calculations every second person in US is
suffering from it. The community has to face a loss of 700 million dollars due to back pain mainly due to posture. The
association of height with the postural low back pain has been tested. The reference height taken for these results
was 5 ft 7 Inches considering the fact that in Pakistan it is the average height of a person. Some other factors
associated with the development of postural low back pain which can help the community and the therapists have
been calculated. 50 patients reporting in the physiotherapy department of Mayo Hospital Lahore and concluded that
a height plays an important role in the development of postural low back pain. It is more common in the taller persons
or the persons who have height more than 5 ft 7 inches. “Chi – square” method has been used to conclude the
results. So we reject the null hypothesis in favour of the research hypothesis. So height plays an important role in the
development of postural backache and the people who have height more than 5' 7" are more at the risk of developing
postural back pain or it is more common in tall people i.e. who have height more than 5' 7" than the persons who have
height less than the required limit of height The taller person when tries to adjust himself in any environment which is
not suitable for him often develops the bad posture which eventually results in the postural back pain.. As in Pakistan
the average height of a person is 5ft 7". When taller person tries to fit himself in its society, he may be more at the risk
of postural back pain than the average height person here. It can also be concluded that males are taller than
females on the average. So males are more at the risk of developing postural back pain.
Poster Presentations

51
 Job satisfaction in public health professionals working in public sector
of Islamabad, Pakistan: A mixed methods

Ramesh Kumar*
Instructor
Health Services Academy. Islamabad. Pakistan.

Study Background:
Job satisfaction greatly determines the productivity and efficiency of human resource for health. It literally means:
“the extent to which Public Health Professionals like or dislike their jobs”. Job satisfaction is said to be linked with
employee's work environment, job responsibilities and powers and time pressure among various health
professionals and as such it affects employee's organizational commitment and consequently the quality of health
services.

Objective:
The objective of the study was to determine the level of and factors influencing job satisfaction among public health
professionals in public sector of Islamabad.

Methods:
This was a mixed methods study containing both quantitative and qualitative portions. The study was conducted in
federal capital; Islamabad. Sample included 73 public health professionals, with postgraduate degrees in or working
in public health organizations of Islamabad with either a post graduation qualification or experience in public health
field. Structured questionnaire was used to collect data

Results:
Overall about 16% of participants were highly dissatisfied with their job, while 43% were just not satisfied. Those who
were not satisfied with work environment, responsibility given at workplace and time pressure were also not overall
satisfied with their jobs. Qualitative findings were also consistent with quantitative results and the factors which
influence the job satisfaction included; poor work environment, low salaries, lack of training opportunities, proper
supervision, time pressure and financial rewards reported by the participants.

Conclusion:
Our findings state a low level of overall satisfaction among workers in public sector health care organizations in
Islamabad. Most of this dissatisfaction is caused by poor work environment, unbalanced responsibilities with little
overall control, time pressure and lack of opportunities for professional development. Measures need to be taken to
enhance working conditions of the employees in public sector health care organizations in Islamabad as well in other
similar settings in developing countries. Satisfaction level among these employees will improve through regular
increase in their remuneration, designing proper job description, considering due promotions, giving responsibility
with associated authority and expecting humanly possible product from the employees.

Key Words:
Job, satisfaction, public, sector, health, professional, work, environment, pressure, responsibility

Awareness and acceptance of evolution and evolutionary medicine

among medical students in Pakistan

Amina Nadeem*
Assistant Professor
Dept of Physiology Army Medical College Rawalpindi National University of Sciences and Technology. Rawalpindi.
Pakistan.

Evolutionary medicine is a perspective on medical sciences derived through application of theory of evolution to aid
in therapeutics. This study sought to determine the level of knowledge and acceptance of evolutionary theory in
medical students along with their attitude toward teaching evolutionary medicine as a part of their undergraduate
course. Factors that are likely to cause difficulty in teaching evolutionary medicine were also identified. A cross-
sectional study was carried out at Army Medical College, National University of Sciences and Technology, Pakistan
in which 299 medical students were selected by non probability convenient sampling technique to participate in the
study. Participants' views were obtained by a structured questionnaire comprised of three sections: appreciation of
Poster Presentations

evolutionary medicine, acceptance of evolutionary theory, knowledge of volutionary theory. Medical students had a
low acceptance [mean measure of acceptance of theory of evolution (MATE)=58.32] and a low knowledge (mean
score of 5.20 out of a total ten marks). Students believed that religious beliefs, lack of resources, and an existent
extensive medical curriculum would cause difficulty in imparting such an education despite its potential to improve
medical research and clinical practice. Only 37.2% agreed that the subject should be taught in medical schools as an
individual subject.

52
Educating women of reproductive age about iron deficiency
anemia through Service Learning

Dr. Rukhsana Ayub*

Assistant Professor
Shifa College of Medicine, Islamabad Pakistan

Objectives:
1.To educate women of reproductive age about causes, effects and prevention of iron deficiency anemia (IDA). 2.
To develop communication skills of students.3. To increase civic responsibility in college students

Introduction
Service learning (SL) integrates community service with academic learning develops civic responsibility and
strengthens communities.

Material and Methods:

Thirteen female students of third year volunteered for the SL project. They had interactive communication skills
sessions with a facilitator and also learnt about IDA. A pre and post test of their perceptions regarding their
communications skills, civic role and knowledge about iron deficiency anemia was done. The students developed
educational interventions to educate community women about IDA. Sixty five community women participated in the
program and their understanding of the causes, signs, symptoms and preventions of IDA before and after the
educational intervention were tested. A focus group discussion was also conducted for the students.

Results:
There was an increase in the knowledge of community women about IDA, especially its causes, effects and
prevention strategies. Improvement was seen in their perceptions of their communications skills. The students
showed statistically significant improvement on measures of connection to community (p-value 0.013). Civic
awareness and attitude (p-value <0.001) and civic action and efficacy (p-value <.001) also showed improvement.

Conclusion:
S L can be used to develop health education interventions leading to increased awareness of WRAs' knowledge
about an easily preventable disease like IDA. SL also increases students' sense of civic responsibility and also
improves their communications skills

Key words:
Service Learning

Insight and theory for evidence based medicine in medical curriculum

M Faisal Rahim* Waqar Saeed

Director Clinical Skills and Health Informatics Section
Ziaudin Medical College Ziaudin University , Karachi Pakistan

For those who are familiar with Evidence based medicine / Practice is defined as recognition of the patient's problem
and construction of a structured clinical query, thorough search and retrieve the best available evidence to answer
the question, critical appraisal of all available evidence, Integration of the evidence with Patient circumstances and
preferences with clinical practice. Various Medical Curriculum now includes evidence based medicine as a part of
their Modules and encourages medical Students to know the basics of Evidence Based Practice. In Pakistan EBM is
something new especially in Medical Curriculum, so we have tried to introduce a Introductory Module of Evidence
based Medicine in 3rd year Clinical Skills Clerkship program, This one week course comprises of development of
PICO Sheet (Patient- Intervention-Comparison and Outcome ), Pubmed literature search through informatics Lab ,
Critical Appraisal and Final Presentation. Duration of course is one week in each groups for 3rd year M.B.B.S Clinical
Clerkship Program. Tool used to evaluate the acquisition of knowledge and skills needed to practice EBM was
developed in a form of Questionnaire (Table 1) . We have given a questionnaire to 3rd Year students about students
perception EBM and its impact on their Clinical Practice. Results were calculated through Mean ,Standard Dev and
Paired t-test In results we found there is significant difference in the knowledge level in medical students before and
after attending course and most of the students after attending the course were inclined towards EBM practice when
Poster Presentations

they tackle clinical problem in their clinical practice.

53
 To explore the perceptions of third year nursing students regarding the
ethics module at Shifa College of Nursing, Islamabad, Pakistan

Farida Himat Khan

Assistant Director
Shifa College of Nursing. Islamabad. Pakistan.

Aim:
This study aimed to explore the perceptions of third year nursing students regarding the ethics module at Shifa
College of Nursing, Islamabad, Pakistan.

Methods:
Third year nursing students (n=26) completed a retrospective pre-post survey rating their knowledge before and
after the ethics module. Focus group discussions (FGDs) addressed the importance of ethics teaching in nursing,
the content of and teaching in the module; and application of the concepts learned in the classroom to clinical
practice.

Results:
Participants rated their knowledge higher in the post test (48.00) than the pre-test (27.19) (p=0.000). The main
themes identified during the FGDs were: understanding the student's own responsibilities and the patient's values;
ethics teaching as an integrated or a separate subject; use of personal reflections and case studies; applicability to
the clinical setting; and the role of student nurses in ethical decision making in the clinical setting.

Conclusion:
The participants valued the ethics module and its applicability to the clinical setting.

Quality Assurance in Medical Education The pathway to excellence

Najam Siddiqi*
Associate Professor
Oman Medical College. Sohar. Sultanate of Oman.

Introduction:
Quality assurance (QA) is the term used to ensure that the process involved in either manufacturing industry or
service delivery system is being accurately implemented as per international best practices guidelines. Medical
schools can be compared to an industry producing doctors. It is essential to have quality assurance programs to
monitor not only that this education industry is running well, but also to ensure that the product who is a doctor is fit for
his job, evolving and up to date.

Methods and Material:

In this paper, we describe the QA model of Oman Medical College, which is a privately funded medical college in the
Sultanate of Oman. There is a separate department of Quality assurance headed by a faculty which works
independently as a separate entity. Quality assurance committee includes a chairman and members each from the
Curriculum committee, Learning Resources committee, Examination committee, Staff development committee,
Promotion Committee, Students services committee, Academic standards committee. Quality assurance in OMC is
structured mainly on the basis of evaluation, viz, Evaluation of sources and Evaluation of activities. For this purpose
both self and external evaluation is relied on. Properly designed evaluation forms are administered to the
stakeholders, which are then analyzed and the reports send to the HOD of the departments concern and the Dean.
Finally, all the strengths and weaknesses are deliberated in the Dean's council and measures are taken to rectify
those short comings.
Poster Presentations

Discussion:
In UK, General Medical Council (GMC) has developed a program know as Quality Assurance of Basic Medical
Education (QABME). In Oman, the Oman Academic Accreditation Council (OAAA) is responsible for this job. An
effective QA system, through its system of measuring, planning, implementing, monitoring and reviewing, can
transform the quality of an institution to a higher level.

54
Continuous Quality Improvement: Using OSCE Scores for Formative Evaluation
of the Clinical Skills Curriculum
Naveed Yousuf*, Rukhsana W Zuberi
Senior Instructor
Department for Educational Development
Faculty of Health Sciences, Aga Khan University. Karachi. Pakistan.

Introduction:
Regular analysis of assessment scores can provide useful information for continuous improvement of the students'
performance and the curriculum. These assessment scores are often used for providing feedback to the students
but rarely used for formative evaluation of the curricula.
Clinical skills are commonly assessed through Objective Structured Clinical Examinations (OSCEs) using itemized
instruments with a checklist or a rating scale. The usually recommended analysis methods for OSCEs are complex
and hence, the opportunity for utilizing such data is usually missed.
The objective of this study is to improve the clinical skills curriculum through in-depth analysis of student's
performance on OSCEs using simpler statistical methods.

Methods:
End-of-Year OSCEs administered to MBBS Year 2 students in the Years 2009 to 2011 were studied. Each
examination comprised of 15 OSCE stations and was administered to an average of 97 students (n=292). The
students' performances were assessed using a 7-point rating-scale. Descriptive statistical and reliability analysis
were done for all stations in each examination. The results were shared with the clinical skills committee each year,
areas needing for improvement were identified and worked upon.

Results:
The reliability of the stations ranged between 0.5 and 0.9. The descriptive statistical analysis of OSCE stations were
very useful to identify areas for improvement. Sharing the results with the clinical skills committee resulted in
continuous improvement of the curriculum, also evident from students' performance over these years. The results of
detailed reliability and descriptive analysis concurred for many findings.

Discussion and Conclusions

Even simple analyses of the students' performance on OSCE senabled to identify gaps and thus resulted in
continuous improvement of the clinical skills curriculum. These statistical methods are easy to use by all involved in
students' performance assessments.
This study also highlights the importance of analyzing students' performance for formative evaluation of the
curricula.

Obstructed paraumbilical hernia with pseudomyxoma peritonei-

a very rare clinical presentation

Ghulam Mustafa*, Junaid Khan Lodhi, Ghulam Akber, Khayam Shamshir, Muhammad Mutahar, Aasim Malik
Assistant Professor of Surgery, FMH College Medicine & Dentistry. Lahore. Pakistan.

Pseudomyxoma Peritonei(PMP) is a rare and challenging clinical entity in which abdomen is filled with gelatinous-
mucinous material. It primarily arises from ovary or appendix and involves the whole peritoneal cavity. Its
presentation is quite varied and very difficult to make a preoperative diagnosis. Patients can present with recurrent
abdominal wall hernias, abdominal distension, intestinal obstruction and signs of acute appendicitis. A case of
Pseudomyxoma Peritonei with obstructed Paraumbilical Hernia is presented here. A 71 yr old female presented with
obstructed paraumblical hernia. On opening the hernia sac it turned to be a case of Pseudomyxoma Peritonei. On
further exploration the primary was perforated appendix and biopsy showed a low grade adenocarcinoma of
appendix. Mayo's Repair of hernia was done. The recovery of the patient was uneventful.

Key Words:
pseudomyxoma peritonei, appendix, adenocarcinoma.
Poster Presentations

55
 Assessment of Usage of Information Resources by Medical Students in Pakistan

Muhammad Asif Shahzad ,Hafiz Mansoor ul Haq, Nauman Arif Jadoon*, Rehan Yaqoob, Ali Raza,
Muhammad Farhan Zahid, Mansoor Hussain.
Nishter Medical College. Multan. Pakistan.

Objectives:
The objectives of this study were to
1. Determine the IT skills of medical students.
2. Analyze the utilization of IT resources by medical students.
3. Investigate the application of IT in medical education and research.

Methods:
The study was conducted on a sample of 750 medical students studying at four medical institutions in Lahore. A self-
administered questionnaire was used to collect data which included questions related to demographic profile, IT
skills, utilization of IT and application in medical education and research. Data was analyzed using SPSS 16.

Results:
A total of 526 (70.13%) participants responded including 270 females and 256 males. The age of respondents
ranged from 18 to 23 with median age of 22. A majority of students (436 [82.89%]) owned a computer. Overall, 494
(93.92%) of the study participants could use computer. Most students learnt computer by self-learning (70.72%).
According to the criteria in the questionnaire, 342 students (65.02%) rated their computer skills as basic (can do
word processing & surfing), 101 (19.20%) rated their skills as intermediate (know basics and can use various
software) and 51 (9.70%) rated their skills as advanced (know about hardware, software, can troubleshoot and
advise others). Self reported use of internet was frequent (20.91%), regular (15.59%), occasional (48.48%) and rare
(15.02%). Students used internet for personal purpose (28.14%), professional and academic purpose (28.90%) or
both (42.96). Most of the students reported using internet at home (77%) while others did so at library (12.3%) or
cyber café (10.7%). 57.03% respondents reported that medical education and research will not be effective without
the use of IT tools and techniques. Almost all the students felt that the institution should provide free training in
medical informatics to enable students to use it effectively in education and research.

Conclusion:
The results show that a majority of medical students have basic computer skills and use internet occasionally to
augment their learning.

Moving towards quality teaching: Experiences of long term public health

programs of Health Services Academy Islamabad

Saima Hamid*
Assistant professor, Joint Ed, Executive Director
Health services Academy. Islamabad. Pakistan.

Health Services Academy, Islamabad Abstract Health Services Academy offered its first Master's program in public
health in 1996. In 2006, the program's duration was increased from 1 year to 2 years, so as to provide opportunities
to students for hands on practical training and to equip them with internationally recognized competencies in a public
health professional. An internal evaluation of the MSPH program was undertaken by HSA in December 2011, to
review the competencies desired in a graduate of MSPH program. Through thematic analysis faculty members
working in six groups presented the competency lists. A compiled list of competencies was thus generated. The
competencies included systems thinking, problem solving, leadership skills, communication and advocacy, ethics,
values and cultural diversity in disciplines as epidemiology, biostatistics, reproductive and child health, health
systems, disease control and social and behavioral sciences. This was followed by a review of the curriculum with
reference to the competencies identified. Thus, the gaps in the curriculum and needs of the teaching staff to deliver
the competencies were highlighted. The findings reveal that the MSPH program curriculum is in line with the desired
competencies with most courses needing updating of course materials to suit both online and onsite learning
methodologies. Online and library services available in the institution have a potential to be utilized for using new
approaches in teaching as blended learning for promoting participatory learning by students. A series of seminars for
Poster Presentations

the training the teaching staff to adopt new teaching styles is recommended to ensure quality in HAS's teaching
programs.

56
Medical Students' Utilization and Perceived Needs of Wireless Handheld Computers

Nauman Arif Jadoon*, Muhammad Farhan Zahid, Muhammad Asif Shahzad, Mansoor Hussain, Hafiz
Mansoor ul Haq, Rehan Yaqoob, Ali Raza,
Nishter Medical College. Multan. Pakistan.

Purpose:
The purpose of this study was to examine the use of pocket digital assistants and smartphones by undergraduate
medical students in Lahore.

Methods:
A cross-sectional questionnaire based survey of 526 undergraduate medical students studying at Allama Iqbal
Medical College, Services Institute of Medical Sciences, FMH College of Medicine & Dentistry and Sharif Medical &
Dental College, Lahore. Students were instructed about filling the questionnaire which was later collected. Consent
was taken before distributing the questionnaire.

Results:
Analysis revealed that 156 (29.66%) students were using PDA or smartphone. 97 students without PDA/
Smartphone reported that they will buy one in a year. On average, students had used PDA or smartphone for 3 years.
Of the students who reported use, about half were using handheld devices for academic related purpose. 65% of the
participants thought that PDA and smartphone are useful in acquiring medical information. Students were using PDA
and smartphone on an average of 5 times per week to retrieve medical information. The PDA and smartphone
functions reported to be useful in acquiring medical knowledge were scheduling/calendar, medical dictionary,
calendar, notes, medical calculator and drug information. The medical related software owned by students were
medical dictionary, pdb reader (iSilo), medical books, skyscape, pathology pictures software, ECG software and
encyclopedia.

Conclusion:
Although PDA and smartphone applications, functions and softwares were reported useful by students, they were
not being fully utilized. There is a need of increasing awareness among healthcare workers in Pakistan about the
possible applications of handheld devices in optimizing and improving healthcare delivery.

Patients' attitude towards involvement of medical students in their

gynecology and obstetrics care

Mansoor Hussain, Fawad Hassan Virk, Hafiz Irfan Mushtaq, Hafiz Azher Iqbal, Nauman Arif Jadoon*
Nishtar Medical College Hospital, Multan. Pakistan.

Objectives:
The objective of this study was to determine the attitude of patients towards involvement of medical students in their
care.

Methods:
Two hundred twenty consecutive patients presenting to gynecology and pbstetrics clinic in Nishtar Medical College
Hospital Multan were interviewed using a structured questionnaire to determine their attitude towards participation
of medical students in their care. Data regarding patients' age, education, parity, previous exposure to medical
students and past experience with medical students was collected.

Results:
The proportion of patients agreeing to medical students taking history ranged from 54.5% for all students to 92.7%
agreeing to female students taking history. Patients agreeing to presence of medical students during examination
were 40% and 92.7% for all students and female students respectively. Patients reporting feeling comfortable with
medical students examining them with a doctor present were 41.8% and 92.7% for all and only female students
respectively. However, the percentage fell to 16.4% and 65.5% when patients were asked about medical student
examining them in the absence of doctor. Only 5.5% of the patients believed that they have the right to refuse
medical student. A majority of the patients said that they prefer the examining student to be of the same sex. Only a
minority of patients (10.9%) reported previous exposure to medical students, half of whom (44.4%) said that their
Poster Presentations

experience was positive. Factors associated with negative attitude towards examination were younger age, rural
background, lesser number of children, no previous exposure to medical students and past negative experience
with medical students.

Conclusion:
A substantial number of patients reported acceptability for involvement of female students in their care, however,
patients feel uncomfortable with male student involvement in their care especially in examination. A number of
factors are responsible for this some of which can be addressed providing students with a conductive environment to
57
learn.
 Student seminar on smoking a novel way to introduce different perspectives
on smoking to medical students

Saima Iqbal*
Associate Professor
Shifa College of Medicine. Islamabad. Pakistan.

Introduction:
The Respiratory Module at Shifa College of Medicine (SCM) is delivered in 3rd year with emphasis on Respiratory
Pathophysiolgy and Respiratory Medicine. Smoking as a topic was introduced to emphasize the preventive aspects
of respiratory illnesses. An innovative approach to involve students in their learning was developed.

Method:

Two days were assigned for a smoking seminar. The class of 106 students was divided into 10 batches and each
batch was assigned a theme related to smoking. These themes were developed by the faculty and each theme was
related to a different perspective on smoking. Results Questions related to the usefulness of the activity were asked.
Students were asked to agree or disagree on a five point Likert scale. Most students agreed that this seminar was
informative and useful and encouraged creativity and teamwork. Skills related to presentation, counseling and
evidence based medicine were also enhanced.

Conclusions:
Seminars led by students have shown to be effective in breaking the monotony and generating an interest of the
topic. Such an activity serves as a small step to make our graduates more empathic, humane, competent and skillful.
Word count: 181

Key Words:
Medical education, student seminar, smoking

Comparison of public and private sector hospital in the quality of

maternity care services at Timergara Distt Dir Lower KPK

Mahboobul Haq*
Instructor
Shifa college of Nursing, Islamabad, Pakistan

Objective;
To compare the quality of maternity care services being provided by public and private sector hospitals.

Methods;
A comparative cross sectional study carried out to identify the quality of maternity care services in public and private
hospital at Timergara Distt; Dir lower. To obtain valid results data was received through an adapted Donabedian
model of quality which comprised of 1. Input. 2. Process and, 3. Out comes. Input and process were measured
through a quality assessment tool where as outcomes were measured through client satisfaction questionnaire with
closed ended question from the women admitted for maternity health care in public and private hospital from at least
24 hours. Cross tabulation and Chi-square test were applied with 0.05 as level of significance.

Results;
The facility assessment revealed that the quality of services was better in public hospital as compare to private
hospital. In the provision of accessibility and availability of services 69% were in public and only 31% in private,
Poster Presentations

Technical competence of health care providers 100% in public and 91% in private, continuity of care and follow up
100% in public, 75% private and support to health care workers 100% public, 72% private were available. The
patients visiting these facilities were of poor socioeconomic status and were educated up to primary level. Client
satisfaction appeared considerably higher at private facility (71%) most likely attributable to better factors such as
shorter waiting times.

58
Career Preferences Among Medical Undergraduates

Akram F*, Safdar CA

Professor of Pediatrics Surgery Army Medical College, Rawalpindi. Pakistan

Background:
The decline or crowding of a specialty can be anticipated by survey on the interests of medical undergraduates. The
factors determining their preferences need to be studied to correct false perceptions well before time and encourage
professional satisfaction and personal happiness. Many social factors influence specialty choices. The factors
discouraging an appropriate decision need to be identified.

Aim:
The study aims to determine the career preferences and the factors responsible for the inclinations and
disinclinations of students.

Methods:
Questionnaire based survey was carried out in Army Medical college Rawalpindi among MBBS students from 1st to
final year with questions regarding students career preferences and factors determining them. Descriptive statistics
were calculated and given as percentages.

Results:
A total of 208 medical students (56% females, 44% male) were administered the questionnaire. The main specialties
chosen were surgery 33%, medicine 27%, general practise10 %, and 10 % paediatrics. The main factors influencing
this decision were personal interest and direct interaction with patient. Seventy-six percent were certain about their
choice of specialty, and 81% definitely identified a specialty they would not like to join. Out of these 53% ruled out
gynaecology and 20% ruled out surgery. The main reasons given for this decision were lifestyle factors, long and
inflexible hours and frequent emergencies. Five percent females were doubtful that they would practise after
marriage and 7% male were doubtful if they would allow their spouse to practise medicine. There was a shift of
specialty choice in 34%. In the preclinical years 44% had chosen surgery, 26% chose medicine, 4% chose general
practise. But 28% chose medicine in the clinical years, choice of surgery fell to 27% and general practise raised to
13%.

Conclusion:
Surgery appeals to students of preclinical classes but as they proceed into clinical classes the interest wanes away
mainly on account of lifestyle. The disinclination towards gynaecology and obstetrics is also on account of these
factors. Medical students are motivated to continue their professional development with moral encouragement and
facilitation on part of the healthcare system

Predictors of medication compliance in psychiatric population

Afsheen*
Senior Lecturer
University of the Punjab, Lahore. Pakistan.

Summary:
The current research investigated the determinant factors or predictors that ensured the medication compliance
among psychiatric population. Psychiatric population probably is one of such population who demonstrate maximal
non compliance and non adherence towards medication. Non-adherence to appropriately prescribed medicines is a
global health problem of major relevance to the National Health Service (NHS). Non-adherence prevents patients
from gaining access to the best treatment, and this may be particularly problematic in chronic medical conditions,
including current NHS priorities such as mental health. An explanation of the concepts of compliance, adherence
and concordance and recommendations for use of terminology is discussed. A summary of current knowledge about
the factors influencing medication-taking and how these might be influenced have been elaborated. A qualitative
research was carried in which various health professionals like doctors, nurses and psychologists were interviewed
on different dimensions of compliance and adherence. The content analysis was done and thematic inference was
drawn from the findings. The major themes and predictors that emerged as valuable and worthwhile in making the
Poster Presentations

medication compliance and adherence strong included consultant related factors, patients' related factors and
environmental factors. The patients' related factors emerged as most significant predictors for treatment compliance
and adherence.

59
 Perceptions of high school students about nursing as a career choice

Afsar Jan*, Shomail Sikander,

Instructor Medical and Surgical Nursing
Shifa College of Nursing, Islamabad. Pakistan.

Objective:
The general objective of this study is to evaluate high school students' perceptions about nursing. The specific
objectives are as follows:
1. To analyze the high school students' perception of nursing
2. To identify the students' potential interests in nursing career.

Methods:
A descriptive cross sectional study was carried out and data were collected from 570 high school students of 12
colleges from Rawalpindi and Islamabad by using self-administered questionnaires. The data were analyzed on
SPSS 16.0

Results::
In positive perception of nursing in career image, the mean score for male=17.34 while that for female=16.58 with a
significant p value=0.002. Similarly, for negative perceptions of nursing in career preference the mean score for
males =9.51 while that for female=10.4 with a significant p value=0.000. In positive perceptions of nursing career
accessibility, the mean score for male=9.51 and that for females=10.41 with p value=0.000. Despite higher scores
career image and career accessibility, only 5.5% students' responses are “definitely yes” to enter in nursing.

Conclusion:
The findings suggest that campaign sessions regarding nursing and its scope should be conducted by nursing
schools before commencing the admissions. Nurse educators and nurse manager should perform a role model.
This will help to emphasize the positive field of work and prestige level involved in nursing.

Keywords:
Career image, career preference, career accessibility, self concept, career choice, perceptions, field of work,
prestige level.

Pre-clinical operative Dentistry: Student Viewpoints

Alia Ahmed, * Maryam Hasan, Adil Shahnawaz,

Associate Professor, Department of Operative Dentistry, Islamic International Dental College. Islamabad.
Pakistan.

The aim of the study was to evaluate the pre-clinical operative dentistry course from a student's viewpoint in order to
monitor the academic environment and give recommendations for improvement. A questionnaire was completed by
second year dental students on the last lecture day of the year. The questionnaire consisted of questions evaluating
different aspects of the course. 46 out of 50 students completed the questionnaire. The course was considered by
almost all to be of benefit. Opinion was divided regarding formal assessment in the final professional examination.
Quality of teaching was reported to be good although teaching sessions were perceived to be disorganized and
prone to repetition. Exercises on plaster models were widely condemned. Improvements in pre-clinical teaching can
be brought about by a more structured course, adding more topics and assigning more faculty to supervise the
exercises.

Keywords:
Dental education, pre-clinical operative dentistry, questionnaire
Poster Presentations

60
Teaching pediatrics nursing care to second year
nursing students using case study method

Huma Rubab* Nafisa Iqbal

Instructor
Shifa College of Nursing. Islamabad. Pakistan.

Introduction:
The purpose of study is to compare two teaching strategies among the II year nursing students of Shifa College of
nursing, and to determine if there is a difference in students' performance when taught Peads nursing care in a case-
based learning format as compared to traditional lecture format.

Methods:
A randomize control trial has been done in Year II BSN students. Group A (n=14) was control group and was taught
two topics through traditional lecturing. Group B (n=14) was intervention group and was taught the same topics
using case study method. Multiple choice questions were used to assess student's academic performance. A Pre
and a Post test was given to both the groups and their results were calculated for comparative analysis. Also
evaluation of teaching strategies was taken from the students.

Results:
Independent sample T test is used to observe the difference among the group. Two tailed P value is 0.15 showing
that there is no statistical significance difference was found between groups (case based method and lecture
groups).Descriptive statistic is used to analyze the feedback of the students to see the effectiveness of two different
strategies. Student responded that use of small groups engages students to be active participants. It is a self
learning strategy. Student did not like the case based method because most of the students did not come prepare for
the tutorial and they share the information incorrectly. Student has suggested that after the tutorial, faculty should
discuss the topic briefly. Lecture group has responded that each and every thing is well explained in the lecture.
Student learns more from the lecture than Tutorial based activity. Lecture is the best strategy in comparison with
tutorial.

Conclusion:
No significant difference was observed but the student's perception indicates that, whole pediatric curriculum must
be taught through lectures.

Key words:
Case based method, didactic lecture, teaching strategies, small group strategy.

Barriers against implementation of problem based learning

in Menofia Faculty of Medicine.

Wafaa Ahmed Zahran*

Prof. Microbiology &Immunology, Director Quality Assurance Unit,
Faculty of Medicine Menofia University. Egypt.

We have planned to start new trends in learning in order to excite students to follow potentially new methods aiming
to shift towards student centered learning. We have investigated the possibility of activating the PBL through
questionnaires of Teachers,

Results revealed the following concerns:

1. PBL is more expensive than traditional methods,
3- Lack of competent trainers,
5. Difficulty in Creating relevant problems,
7. Fear of loss of prestige, power, or control:
9. Fear of extra work:
11-Some thought that there is no political will
Details will be discussed
2. The changing role of the teacher:,
4. The changing role of the student:
6- Curricular issue:
8. Ignorance about PBL:
10. Faculty lacks extrinsic rewards for PBL teaching:
Poster Presentations

Conclusion:
In order to start that new trend of learning, PBL designers and tutors should be well trained, physical facilities
(places, classrooms and library) should be enhanced to accommodate for large number of small group meetings.
We think it would be better for us to start gradually linking traditional and PBL methods as hybrid of the two systems.

61
 Students perspective on Community based medical education

Farah Rashid* Shifa Umar, Fahad Rafique, Ali Ahsan, Saad Shahid
Assistant Professor, community health sciences
Shifa College of Medicine, Islamabad. Pakistan.

Background:
Medical education most commonly occurs within universities and tertiary teaching hospitals. Evidence is emerging
that a community setting may provide students with a better medical education during the clinical years of their
training. A cornerstone of this effort has been the use of Shifa Rotary Clinic (SRC) in Noorpur Shahan (suburb of
Islamabad) which is a primary health care unit as a community-based learning centre.

Objective:
To share the students perspective on the practice of community based medical education Shifa College of Medicine
(SCM) in Islamabad.

Method:
The curriculum of the clerkship is designed by the Family medicine (FM) and community health sciences (CHS)
department of SCM. The batch of 20 students, along with the FM and CHS instructors departs from SCM for SRC,
where students have their morning group discussion, learning competencies in community health sciences and FM.
The morning session is followed by division of students into four groups, allocated to conduct the following activities:
? Vaccination following EPI
? Maternal health centre
? Family planning
? Daily OPD linked with exploring psycho-social domain of disease
? Counseling of patients
? Performing health need assessment surveys.
The students are also taken for special field visits to the Water Filtration Plant, Behbood and DPO NGO.

Result:
Focused group sessions will be conducted with the students. Themes from the focused group sessions will be
analyzed to evaluate effectiveness of community based medical education in a private institute.

Conclusion:
Community based medical education can provide an ideal avenue for experiential learning. Living in a developing

Exposing 3rd year medical students to public health practice module in the urban
slum of noor pur shahan, first time experience by Shifa College of medicine.

Noreen Waheed*
Senior Instructor
Shifa College of Medicine, Islamabad Pakistan

Background:
Public Health Practice is the strategic, organized, and interdisciplinary application of knowledge, skills, and
competencies necessary to perform essential public health services and other activities to improve the population's
health.
Public Health Practice Module was first time conducted by Department of Community Health Sciences, Shifa
College of Medicine in the urban slum of Noor Pur Shahan, Islamabad from 28th March-16th April, 2011.

Methodology:
Household Screening surveys were done for Diabetes, Hypertension, Obesity and Oral Hygiene through structured
Questionnaires. Batch of 100 students was divided into 4 subgroups. Sample size was 990.

Results:
Data was analysed by SPSS version 17.0. The prevalence of diabetes was 17.4%. About 23 suspected diabetes
Poster Presentations

cases were referred for further evaluation. Prevalence of hypertension in the study population was 12.6% with
female predominance. Out of the total 140 individual, 59 were found obese & 43 were overweight. Eight cases were
referred .Study revealed that out of 300 adults, 58.3% had poor oral health with male predominance.

Conclusion:
This module provided students with the necessary evidence-based knowledge and skills to critically assess
individual, family, community and population health needs in a public health context & to develop a critical
understanding of health problems of the community. This module also provided us the opportunity to inculcate the
62 real essence & importance of Public Health Practice among the medical students.
“Quality assurance in medical education”

Mehwish Abid*
Liaquat National Hospital and Medical College. Karachi. Pakistan.

Background:
The ultimate goal of medical education is to improve the health of the community. To ensure that medical training
achieves this objective, its quality must be assured.

Objective:
The aim of this presentation is to attempt a definition of quality assurance in the context of medical education,
explore its linkage to improved services and outline a framework for its application in Karachi.

Methods:
A review of published articles and policy documents on quality assurance in higher education and medical training
from different parts of the world, identified through an internet search, was done to distil the current ideas on the
subject.

Findings:
There is a consensus that graduates from training institutions must attain an agreed minimum standard in the
quantum of skills and knowledge, as well as the attitudinal disposition that they are expected to acquire in the course
of their medical education. Quality assurance should be seen as a first step towards quality improvement. Sustained
improvement requires that stakeholders demand quality in service delivery and a credible process of clinical audit,
with widespread dissemination of evaluation results, to ensure accountability and maintenance of quality.
However, this can only happen if the medical professionals are properly trained in all accredited institutions, a
situation that can best be attained by agreement on a common core curriculum and the systematic use of
improvement tools, especially the continuing professional development (CPD) of trainers. The Pakistan Medical and
Dental Council (PMDC) is the body that has the legal mandate for the accreditation of medical and dental schools. It
has published separate policy documents on minimum standards of training. There is however no system of audit or
formalized CPD in place yet.

Conclusions:
For proper quality assurance and service improvement, PMDC need to achieve a consensus on the implementation
of minimum standards for trainees and trainers, leading the issue of curriculum and quality training, the credentialing
of trainers and their continuing medical education and self development.

Keywords: medical education, quality assurance, Karachi.

Detecting the prevalence of Hypertension in adult population

by conducting a Screening in Noor pur shahan in Pakistan

Ibraheem
Student
Shifa College of Medicine, Islamabad, Pakistan

Background:
Hypertension is a chronic medical condition. Morbidity of HTN is very high since it leads to many complications like
arteriosclerosis, retinopathy, stroke, renal failure, and cardiac myopathys. Dietary and lifestyle modification can
significantly reduce the risk of associated

Methods:
It was a Cross sectional survey at Noor Pur Shahan Islamabad using self-administered questionnaire, age group 35
and above, males and females. Sample size was 300. Different questions regarding the symptoms, correlations and
relevance to hypertension were asked, the questions were structured close ended, and a quantitative data was
collected. The questions were developed according to WHO criteria for HTN.

Results:
Households screened: 200 (approx) Total number of individuals screened: 317 Suspected number of hypertensive
Poster Presentations

individuals: 40 Hypertensive males: 14 Hypertensive females: 26

Conclusion:
There was 12.61% prevalence of hypertension in the study population, with 65% female predominance as
hypertensive Sedentary life style also had a significant effect on blood pressure with a mean blood pressure of
126/81mmHg compared to a mean BP of 121/77mmHg in individuals who were physically active Individuals with
gained weight in the past 3 years the mean blood pressure was 125/78mmHg as compared to 122/78mmHg for
those who had not gained any weight. There was increased mean blood pressure with other factors such as a
positive family history, occurrence of headache, and the use of fatty substances and salt. 63
 Attrition in surgical residency- The real face of a hidden problem

Mehwash Nadeem*, M Shahrukh Effendi, M Hammad Ather

Aga Khan University. Islamabad. Pakistan.

Background:
Attrition in surgical residency is of continued concern for surgical educators globally. It results in loss of morale and
resources and often leaves the program scrambling to find replacement residents.

Rationale of Study:
There is increase in residents' attrition over the years but due to paucity of data, the actual magnitude and factors
associated with it are unclear.

Objective:
i) To determine the rate and trend of attrition at our institute,
ii) To identify the reason/s for attrition,
iii) To correlate perspective of residents and program directors (PD).

Design, setting and participants:

A questionnaire based survey conducted at university hospital. Separate questionnaires were designed for
residents and PD. The residents who left voluntarily from one of the five surgical residency program i.e., General
surgery, Orthopedics, neurosurgery, ENT or Urology during academic year 2005 to 2011 were identified from
department database. The residents who did not respond after three attempts or those who refuse to participate
were excluded.

Results:
During last six years total of 106 residents were recruited. 84 (78%) were male, of them 34.5% left the program
voluntarily. Of 22% females, 54% left the program voluntarily but this gender related attrition was not statistically
significant (p=0.07). The overall 6 years attrition rate is 39%. The reasons identified for attrition in descending order
are personal, attitude of senior residents or faculty and change of specialty. None of the resident left due to work
load. Approximately 40% rejoined same specialty after leaving while 35% chose different specialty (80% surgical
subspecialty and 20% medicine). There is significant discrepancy in residents and PDs perspective.

Conclusion:
Although attrition in surgical residency is not unique to our program but the recent rise in attrition is a major concern.
As the leaders of surgical education, it is the responsibility of institute to analyze the important issue, to optimize the
career paths of the residents, and to assure the continued maturation of trainees.

AEIRC; Empowering the intellect wellbeing.

Shamoon Noushad & Sadaf Ahmed

Advance Educational Institute & Research Center (AEIRC)

Dimension is compulsory but not satisfactory for excellence development in Health care for a common man in our
Country. For the reason that Advance Educational Institute & Research Center (AEIRC) is trying to develop
excellence, exchange of ideas of the association between dimension and development that is vital for ensuring any
suitable system design and efficiency. We are interested in improving the degree of Internet use for health care and
research intellect among Pakistani population, to positively influence the research culture by promoting the
frequency of internet based study and relevant information sharing and spread of awareness about health care
matters and to educate the population even from non-science backgrounds about the working and significance of
the health care system with relevant latest researches. The specific target population includes individuals or
organization from age group 16-50 yrs of both sexes and all socio-economic sets. Several people use the Internet for
health information; use is not as common as is sometimes reported. We observe that effects on actual health care
utilization are also less significant than some have claimed. Discussions of the role of the Internet in health care and
the development of policies that might influence this role should not presume that use of the Internet for health
information is universal or that the Internet strongly influences health care utilization. We suggest that as this group
Poster Presentations

of young researchers and science graduates are sharing relevant information but also collaborating with the
expertise of the relevant field with the aim of improve the standards of proper health issues and research in our side
of the world. Organizations must try to target this set of population as they assemble future of our Country with
potential expectations of much aware and healthier generation and their custodians.

64
Assessment of undergraduate medical professionalism in integrated curriculum
A Faculty point of view

Usman Mahboob* Phillip Evans Philip Cotton, Nicki Hedge

Khyber Medical University of Glasgow
Medical Education Scholar, Scotland UK.

Context:
The assessment of professionalism is complex due to subjective nature of the topic. The faculty members have an
important role in assessment of professionalism as they have to map the learning outcomes with suitable
assessment instruments. The mapping is done according to GMC document guidelines of 'Tomorrow's Doctors'
which is followed by all medical schools in UK.

Objectives:
The objective was to identify the role of faculty members in managing assessment of professionalism in School of
Medicine, University of Glasgow.

Methods:
A grounded theory approach was used in the study for data collection; analysis of the data and for the new themes
which came out of the data. The purposive and snowball sampling techniques were used to interview only those
members of faculty who deal with assessment of undergraduate medical professionalism.

Results:
The learning outcomes are assessed in both formative and summative exams but focus is mainly on formative
assessments. Both objective and subjective assessment instruments are used although qualitative assessment
instruments can assess the topic in much better way. Some of the assessment instruments are used both
formatively as well as summatively. The study also identified some new issues which need to be addressed and
assessed by valid and reliable instruments.

Conclusion:
The assessment of professionalism is a multidimensional topic. Both formative and summative assessments can be
used to assess professionalism. The role of formative assessment in this case is more important as it is a continuous
process and the frequency of the assessment & feedback will make a deep impression on the student.

Impact of movie-based simulation training along with conventional verbal demonstration on

observed ospe scores in male & female medical undergraduates: A double control Study

Samina Malik*, Gulfreen Waheed, Muhammad Bilal

Associate Professor and Head, Dept. of Physiology,
Avicenna Medical College, University of Health Sciences (UHS), Lahore

Background:
Movie-based simulation training may be useful in the preclinical OSPE curriculum along with conventional verbal
demonstration; however, the optimal timing and duration of training have not been defined. Likewise, gender-based
response & student feedback have yet to be assessed.

Objective:
To compare the scores of only half an hour of a combination of movie-based simulation training along with verbal
instructions at a single time point with instructor-based training alone as well as with movie-based simulation training
alone as double controls, to receive feedback from students about the best mode of teaching with proper reasoning,
and to study their scores in male Vs female students.

Subjects & Method:

Second-year medical undergraduates (n=90) were randomized to movie-based simulation training “group B”
(n=30), traditional verbal training alone “group C” (n=30) & a combination “group A” (n=30). The scores were marked
by observers using a standardized key & were compared for performance at 2 observed OSPE stations.

Results:
Group “B” & “A” performed significantly better than group “C” on station 1 and 2. Gender factor did not seem to
influence the score. A total of 99% students reported that combination of the 2 teaching modes is the best option due
to more clear understanding with interest (61%), long term memory (21%), use of both senses (10%) & better focus
Poster Presentations

of attention (3%).

Conclusion:
These results suggest that even half an hour of movie-based simulation training along with traditional-instructor-
based training may improve student performance significantly without any gender influence.

Key words:
Movie-based simulation training, Conventional Verbal Demonstration, Observed OSPE score, preclinical medical
education, visual-learning, Male Vs Female. 65
 Misconception between headache and migraine:
a cohort study among Pakistani population.

Shamoon N*, Sadaf A, Tahir S, Faiza A & Zainab Q.

Advance Educational Institute & Research Center
Department Of Physiology. University Of Karachi. Pakistan

Purpose of study:
There are many miscellany factors thought to be related to Headache and its characterization. The major dispute is
to find out the basic causes as well as to be acquainted with & long-suffering weak points of the contemporary status
of our information in migraine and headache diagnosis.

Introduction:
There are many aggravating factors for migraine, such as hormonal changes, stress, specific foods but to exactly
suggest the migraine is difficult and debatable and not all the patients in this series would fall within the narrow
category of associated headache and vomiting.

Methodology:
In this study 400 boys of 18-22 yrs of age were selected, who were diagnosed as migraine patients. They were
investigated for causes, family history, BMI, fat distribution, diet & calories and their socioeconomic status.

Results:
Our results showed that 52.94% of boys reported headache in front of head 17.64% reported entire head area while
only 6.10% reported unilateral headache and main causes reported were sleeplessness 23.4% and high attitude
12.76%. Fewer boys related it with their addictions as smoking. 37.50% of boys show aggressive attitude and 25.2%
annoying behavior during their episodes while almost 52% of the population reported recurrence of episodes as
monthly and 47.05% reported that their episode lasts in an hour.

Conclusion:
In Pakistan our main highlighting issue is on the diagnostic criteria as well as to find out the exact exaggerating
factors of headache or migraine. The targeted population for this study was reported to be suffering from migraine
while our results suggested that there are variations from the reported symptoms of migraine & observed analysis. It
is recommended that in majority of our population there is a disparity found with wide-range of related pathologies
such as headache may need a great deal of expertise in different fields from diagnosis to treatment.

AEIRC; Empowering the intellect wellbeing.

Thematic OSCE assessment of final year students in SCM

Lubna Meraj
Senior Registrar
Shifa College of Medicine, Islamabad Pakistan

Background:
Traditional performance assessment in undergraduate medical students revolves around long case, short case and
OSCE in Pakistan. OSCE was developed as a performance evaluation tool. Fragmented tasks limit its holistic
application.

Objective:
To incorporate Long and short case assessment in a thematic OSCE assessment for final year students

Methodology:
We developed 12 station performance based OSCE for final year students. OSCE stations were divided in clusters
of 3 stations. Each cluster started with a history from a real patient (non-standardized), followed by relevant physical
examination on another real patient and finally an interactive discussion on the two stations about diagnosis and
management addressing clinical reasoning. Competency-based blueprint was established after several
discussions within the section of Medicine ensuring validity. Multiple trained examiners were used for grading
purposes. Each station was given seven minutes. Feedback from both students and faculty was obtained.
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Results:
Structured questionnaire was completed by 91 students (out of 100). Involved faculty members also filled the
feedback forms. Eleven out of fifteen faculty members responded to the feedback questionnaire. More than 80% of
students gave favorable feedback on various aspect of thematic OSCE. Faculty members also liked the new format
for its efficiency, competency – based approach and real patients' participation.

Conclusion:
66
We found that thematic OSCE can serve as a practical alternate for traditional undergraduate assessment, in
Pakistan.
A faculty development survey: Analyzing the appropriate approach and needs.

Nazish Fatima*
MHPE (Student)
Lecturer, Bahria Medical and Dental College Karachi. Pakistan.

Introduction
Faculty development has become an increasingly important component for maintaining the academic vitality in
medical education. It is important to derive not only the needs but the format too with the consideration of the
resources provided by the institution. The author carried out a survey in order to plan the future activities of faculty
development at Bahria University Medical and Dental College (BUMDC)

Objectives
To determine the specific needs and formats of the faculty development program at BUMDC

Methods
The target population comprised of 71 faculty members of BUMDC. A questionnaire was developed and
administered to all faculty members after formal consent. The respondents rated the perceived interest (great,
moderate, low) on 26 competencies described in the literature. They also rated the formats of the program in order of
preference that meet the resources of the institution. The ratings were summed up to determine the priority ranking
of competencies and strategies of faculty development program. The respondents' ratings of time and days were
also determined

Results
The response rate was 81.7% (N=58/71). The competencies rated highly by the faculty were case based learning
(96.6%), writing instructional objectives (93.1%), communication skills (89.7%), teaching strategies (87.9%),
integrated curriculum design (86.2%), evaluation (84.5%) assessment (82.8%), medical ethics (82.8%) and MCQ
development (81%). Workshops, faculty based presentations and structured discussions were the most popular
learning format. They showed least interest in PBL, feedback and developing portfolio. 39.7% were willing to attend
training sessions on Monday and 65.5% suggested time slot of 9-11 am to be the most feasible for them.

Conclusion
Faculty development has high pay off potential thus it is crucial for every educationist to design and implement
effective programs only after needs assessment

Key words:
Faculty development, needs assessment, learning format

Enigmatic expression behavior of Interferon Lambda receptor (IL-?Ra)

in different cell lines and its dependency on signal peptide

Hashaam Akhtar*, Ole Jensen Hamming, Muhammad Yamin, Ishtiaq Qadri, Rune Hartmann
National University of Technology Islamabad Pakistan

Abstract
Interferons (IFNs) are important components of the immune system and their stimulation results in recruitment of
cytokines for clearing viruses from infected region. IFNs produced exogenously are potent antiviral agents that can
reduce viral titer in many patients. Tumor regression has also been associated with IFN treatment in some cases.
IFNs are divided into three types and Type III IFN (IFN-?) is also one of the promising candidates in the list of antiviral
drugs with fewer side effects and is hoped to clear clinical trials soon. This study tries to explore the unknown reason
behind these elective expression of the IFN-?R, which makes IFN-?protein to target specifically to certain organs
and tissues, thus making it undisruptive for other normal body functions. IFNaR2 and IFN?Ra signal peptides were
interchanged and expressed in HEK93 cell line in order to study post transcriptional modifications and regulations.
Interestingly IL-28Ra(attached with the signal peptide of IFN-a) expression was still observed on the cell surface
indicating independent post transcriptional regulation of this region. Results show that there was no difference in the
expression of these altered receptors, as HEK93 cell line supports the expression of both these receptors. We
Poster Presentations

conclude that the specificity of IFN-? Rexpression can be due to its signal peptide, which would later be confirmed
with the expression IFN-aR altered with IFN-?R signal peptide in a specific cell line, which does not express IFN-?R
but do express IFN-aR naturally.

67
 Correlation between attendance of teaching sessions
and examination performance in clinical subjects.

Azra Naseem*
Associate Professor Obstetrics and Gynecology
Pakistan Ordinance Factory Hospital & Wah Medical College
Wah Cantt, Islamabad Pakistan

Introduction:
Lectures and clinical classes contribute not only to the knowledge and experience of medical students but also help
them score better in assessments.
Research question: Is there a correlation between class attendance and examination performance in clinical
subjects?
The objective of the study was to determine if a relationship exists between the total number of Surgery, Gynecology
and Obstetrics classes( both lectures and clinical sessions) attended by the medical students during their academic
year and the final marks/scores obtained by them in the final subject papers.

Methods:
The study was conducted for the academic year2011 at Wah Medical College, Pakistan. It was an observational
correlation study and the sample comprised of 93 students. The total batch comprised of 96 students and almost all
were included in the study. Pearson's correlation test was applied at 1% level of significance.

Results:
Pearson's correlation coefficient (r) of 0.538 was obtained for obstetrics classes attended and their total scores in
final Obstetrics paper with a p-value of 0.00.For gynecology, r was 0.45 and p-value was 0.00.For Surgery= 0.60 and
p-value was 0.00.
Even though the mean attendance and mean scores in examinations in all three disciplines of medical education
were higher amongst the 56 female students compared to 37 male students, the positive correlations were
comparatively stronger amongst the male students.

Discussion and Conclusion:

A strong positive and highly statistically significant correlation exists between the number of classes attended by
medical students in Surgery, gynecology & obstetrics disciplines and the final scores secured by them in their final
subject papers, which is consistent with previous studies conducted in medical students.
Our study showed stronger positive correlations of attendance with performance in male students.

Role play An effective learning strategy

Sadaf Mumtaz*, Riffat Shafi

Assistant Professor
Shifa College of Medicine, Islamabad Pakistan

Role play:
Conceptual learning is helpful in the process of learning. Teaching complex concepts has always been a major
challenge. Role play is a way of learning concepts through examples. Role play has been used widely as an effective
way of developing skills in communication, problem solving, demonstrating empathy, team work and acquiring
knowledge. We introduced learning concepts through role play in EMR module of 2nd year MBBS class. 96 students
participated in role play. Students were divided into seven equal groups and a single theme was assigned to each
group. Two weeks before the end of the module, students were given time slots to prepare for role play. Clear
guidelines were provided to the students for their assessment. A total of eight faculty members which included
instructors, assistant and associate professors assessed student learning on the following parameters; accuracy of
the documented information, creativity, ethics, group participation and communication skills. An analysis of student
assessment by the faculty showed that role playing was very effective tool for student learning in terms of
documenting information (76%), enhancing creativity (76%) and communication skills (74%). Ethics were poorly
addressed (63%) in role plays. Some students encountered problems in group participation. We conclude that role
play can be used effectively as a learning strategy in undergraduate medical curriculum.
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68
Online Research Course: An Innovative Elearning Activity
By 'the Medical Writers' - A Course Evaluation

Masood Jawaid*
Assistant Professor Surgery
Dow University of Health Sciences, Karachi Pakistan

Introduction:
The introduction of new learning technologies, the fast growth of the internet and theadvent of the World Wide Web
have made significant changes in education.Active learning can motivate learners to become more engaged with
the content and a well-designed e-course can enhance learner-content interaction and experience.

What is Online Research Course?

This is one of the first online research courses in which participants are directly supervised throughout the course for
understanding and during the practical work in writing of their research proposal. Every participant is free to choose a
topic of his choice (whether cross sectional study or RCT). Each participant was helped to make the proposal final so
that the final research paper would be ready to be published in middle to high ranked journals.

Duration and Methodology:

This 4 week course methodology includes webinars, Flash based presentations, videos, interactive whiteboard and
MOODLE (LMS) utilizing forum, chat room, quiz, assignments.

Participants:
Total 60 participants from Pakistan, UK, USA, Saudi Arabia and Libya take part in two courses.

Evaluation:
The data were collected using four processes: webinar feedback, Moodle statistics, post course feedback
questionnaires and participants interviews.

Conclusion:
Total 50 participants completed the feedback form. Only 20% have any prior eLearning experience, 10% attended
any webinar before and only one has prior experience of MOODLE. However course evaluation showed that
majority highly rated the course and its methodology despite their first experience and 88% think that the e-learning
package met the overall objectives.

In this presentation methodology and detailed evaluation of the course will be discussed.

Towards Behavioural Sciences in undergraduate training: A core curriculum

Asma Humayun* Michael Herbert

Associate Professor of Psychiatry
Rawalpindi Medical College
Rawalpindi, Pakistan

All over the world, the medical profession faces ever growing concerns about improving the quality of healthcare.
There is strong evidence to link biological, behavioral, psychological, and social variables to health, illness and
disease. But this knowledge has not been successfully incorporated into standard medical practice. There is a
general accord that a simple disease-based model of clinical practice is inadequate and that there is need to change
the approach of doctors to include a better understanding of behavioral issues. The need to integrate Behavioral
Sciences (BS) as an integral component of medical training is well recognized. PMDC initiated these efforts in 2005
but since then little progress has been made towards developing a core curriculum. This aim of discussing this
proposal is to initiate a concerted effort towards this direction in Pakistan. We have outlined specific objectives
keeping the recommended domains for BS in mind. Relevant areas from behavioral sciences have been identified to
discuss the core content. We have attempted to clearly demonstrate their application to our healthcare system. In
addition, knowledge and skills-based learning outcomes for each topic/area have also been defined.
Poster Presentations

69
 Social accountability: Where we are?

Hussain, RP*
Assistant Professor
Section of Nuclear Medicine, Dept. of Radiology, Aga Khan University Hospital, Stadium Rd. Karachi, Pakistan.

Introduction:-
Social accountability (SA) has been defined as the obligation of the medical schools to direct education, research
and service activities towards addressing the priority health concerns of the community, region, and/or nation they
have a mandate to serve.
The idea of SA is not new, having been first introduced by Abraham Flexner over 100 years ago and has been coined
as “Birth of Modern Medical Education”. The importance of this idea cannot be denied to this date as it seeks to
advance health by recommending instructional and institutional innovations to develop a new generation of health
professionals better equipped to address emerging health challenges that will be future requirements of any
community/nation.

Objectives:-
The objectives of this presentation are to explain the concept of SA, its evolution and history and current standing
and endorsements. Also dealt are the present international calls on the issue of accreditation standards for SA and
their applications in relation to the medical schools. In the end, an effort is made to give a look at where and how, all
of this fits into the medical school system in Pakistan; what and where are the strengths and weaknesses and where
we should be directing ourselves to attain our accountability mission.

Discussion:-
The idea of SA has long been under discussion over the international arena, especially US and Canada, ever since
its inception over 100 years ago. It has been debated, deliberated, modified and reformed over the years by
accreditation standards. The idea of SA, though not new to the Medical Schools in Pakistan, however its total
integration can be questioned. Many reasons for the lack of its total induction can be given, however no two
arguments exist towards the acceptance of its presence in the framework of the national policy of medical schools.
The promotion of SA and social responsiveness of medical schools will be one of steady improvement especially
against a background of political instability in certain areas of the country, however an understanding and
persistence to the cause will eventually, hopefully bear fruit.

Key Words:-
Social Accountability, Global Consensus, Accreditation, medical schools, ethics, equity, parity

A Work Place Based Assessment in Foundation Year: FUMC experience

Shahid Rauf* , Naushaba Sadiq, Seyyeda Abbas

Foundation University Medical College, Foundation University Islamabad, Pakistan

Background:
Structured Foundation year program was introduced at Foundation University Medical College in year 2011. A study
on workplace based assessment (WPBA) of foundation year doctors working in the surgical department was
conducted at teaching hospital of Foundation University Medical College to assess their clinical competencies.
Before the actual implementation of program a comprehensive workshop for faculty on work place based
assessment was conducted by the department of medical education, FUMC.

Material and Methods:

In this descriptive studies cross sectional study, we administered a questionnaire to trainee and faculty separately
for assessing the effectiveness of the method.

Results and conclusions:

are being tabulated and will be displayed on the poster later on in poster presentation.

Key words:
Poster Presentations

WPBA, FUMC, Mini-Cex, DOPPS, CBD

70
Workplace Based Assessment (WPBA) -reasons for
implementation and factors affecting it

Sobia Ali*
Lecturer, Bahria Medical and Dental College Karachi Pakistan.

Introduction:
Workplace based assessment (WPBA)has gained increasing importance as an in-training assessment system for
resident's training globally, particularly inThe United Kingdom, Canada, Australia and The United States of America.
It promotes resident's learning by understanding of self-assessment, refining of professional skills, identifying the
level of performance and weak areas, and thus helps in achieving a more holistic competence.

Objectives:
To review the literature in order to summarize the reasons for the implementation of WPBA in institutions outside
Pakistan. This paper also goes on to discuss how WPBA may be implemented in our training hospitals and lists
factors that would support or hinder its implementation.

Method:
The author searched Google Scholar database of 2002-2011 and the references of the captured papers. Studies
were excluded if the sample population was nonmedical. However, commentaries and the postgraduate training
program documents were counted as evidence.

Result:
The main findings are: 1. WPBA is vital for the evaluation of residents' progress, in their performance, over time by
repeatedly observing, assessing, and then giving feedback. 2. Daily ward rounds and log documentation are the
factors that could support its convenient implementation in our scenario. 3. The factors that could hinder its
implementation are the lack of motivation on part from some of the clinicians, the political instability of the country,
and the unawareness of the trainees and assessors regarding the process and feedback.

Discussion and conclusion:

Although, structured residents training program is currently being practiced in Pakistan, its validity can be enhanced
by incorporation of WPBA. Recommendations for its implementation are: motivating the clinicians, mapping for each
individual method, appropriate ratio of all levels of case complexities, proper training of assessors, as well as
trainees, and giving this in-training assessment some weightage in summative examination.

A call for mentoring of undergraduate medical students

in the backdrop of integrated modular teaching program

Naushaba Sadiq, Shahid Rauf, .

Foundation university medical college, Foundation University Islamabad, Pakistan

Abstract

Background:
Integrated Modular Teaching program was introduced at Foundation university medical college in year 2009. The
concept of integrated modular teaching was new to the faculty and students. Studies conducted regarding this new
system at various centers indicate faculty and students' resistance. A need is felt by medical education department
for establishing a mentoring system in order to have the better understanding of students' problem, to provide them
continuous support and to make them sail smoothly through this new system1. This study was conducted for need
assessment and to gain students' perspectives regarding establishing a mentoring system.

Material and Methods;

It is a Cross sectional Descriptive and analytical study. A questionnaire was administered to third year medical
students of academic year 2010-14, who underwent the new integrated curriculum. The questionnaire is focused on
the students' view regarding the need of mentoring platform in the institution as part of formal education. Data
collected through questionnaire was analyzed using SPSS.
Poster Presentations

Results and Conclusion:

of the study will be discussed in paper presentation.

71
 Areca nut chewing and systemic inflammation: evidence of a
common pathway for systemic diseases

Moin Islam Arain*, Kashif Shafique, Saira Saeed Mirza, Priya Vart, Abdul Rauf Memon, Muhammad Farooq
Tareen, Zia-ul-Haq

Background
Areca nut, the seed of fruit of an oriental palm, known as Areca catechu, is commonly
chewed in many countries. Diabetes, hypertension, cardiovascular diseases, oropharyngeal and oesophageal
cancers have been associated with areca nut chewing and the mechanism by which areca nut chewing increases
the risk of systemic diseases remains elusive. We hypothesize that systemic inflammation may be elevated among
areca nut users, which is linked with many systemic diseases. Therefore, this present study was conducted to
examine the systemic inflammation among areca nut chewers and healthy controls.

Methods
This was an observational cross sectional study carried out on areca nut chewers and healthy individuals in Karachi,
Pakistan. Participants were selected from a region of the city by invitation request sent from door to door. Information
was collected regarding the sociodemographic profile and the pattern of use, and a blood sample was obtained to
measure the level of C-reactive protein (CRP). We carried out multiple logistic regressions to investigate the
association between socio-demographic profile, areca nut chewing and CRP levels.

Results
We carried out final analysis on 1112 individuals of which 556 were areca nut chewers and 556 were the age, gender
and area matched controls. Areca nut chewers had a significantly higher proportion of men (15.1%, n=84) who had
an elevated CRP (>10 mg/dl) as compared to controls (5.2%, n=29). Multivariate analyses showed that areca nut
chewers had significantly higher odds of an elevated CRP (OR=3.23, 95% CI 2.08-5.02, p value <0.001) as
compared to controls. Further analysis revealed that areca nut chewers with tobacco additives were two times more
likely to have an elevated CRP as compared to raw areca nut users. These associations remained unchanged after
adjustments for age, BMI and years of full time education.

Conclusions
Areca nut chewing has a significant association with systemic inflammation. Further work is required to confirm that
systemic inflammation is the main pathway by which areca nut use increases the risk of systemic diseases.

Keywords: systemic inflammation, Areca nut, cancers, cardiovascular diseases.

Problem based or problem oriented learning

Javaid Usman*
Professor of pathology
Army Medical college Rawalpindi, Pakistan

It is well over a decade that we in Pakistan introduced the newer education modalities in an attempt like else where to
shift from the passive transfer of knowledge to its active acquisition in our medical education. Problem based
learning was one of them. We were able to comprehend and apply the concept but have not been able to implement
it as warranted. The system has met with many problems ranging from the reluctance from the senior faculty to the
lack of trained manpower, resulting in large groups to handle. Many years down the road what we are practicing
currently can at best be called a problem oriented learning rather than problem based learning. a major handicap has
been obtaining the optimal audience response. An experience at the Army medical college along with results of the
faculty and student opinion will be presented.
Poster Presentations

72
Perceptions of borderline students regarding integrated practical
examination of basic medical sciences: a qualitative study.

Muhammad Saeed* Ashraf Hussain, Arshad Javaid, Shazia Moazzam, Mamoona Mansoor,Shazia Imran,
Faiza Kiran Noor, Samreena Mansoor, m.Zafar Rabbani,Muhammad Amir,
Department of Anatomy
AJ&K Medical College, Muzaffarabad AJK.

Background:
To contextualize the training & assessment of Basic Health Sciences (BHS) and make BHS practical's relevant to
the clinical practice; we introduced innovative assessment-IPE (Integrated Practical Examination) in 2009. The IPE
blueprint consists of 15-stations, each based on a clinical theme and 2-3 integrated tasks involving application of
Basic Health Science(BHS) knowledge with clinical & generic skills. Each station is directly observed/assessed by
trained faculty OR simulated patient through check-lists. During past 2-year, IPE failure % is on the rise which
compelled us to explore perceptions of the borderline students.

Study Design:
An exploratory case study, using mixed method approach (with a dominant qualitative focus) was conducted at Shifa
in Feb 2011. 21-student of 1st year MBBS failed in 2010-summative assessment. During their resit exam held in
Feb-2011, all voluntary participants were given a semi-structured questionnaire. After exam, a focus group
discussion was conducted with nine randomly selected participants, recorded digitally, transcribed, coded and
categorized into themes. Questionnaire data was analyzed for descriptive statistics. Triangulation of data was
done.

Results:
Students validated the IPE with positive perceptions. “It relieved anxiety of viva. IPE depicts integration of
disciplines. It renders us clinically more competent as compared to students in other medical colleges”.

Conclusion: IPE is acceptable to even borderline students.

Take Home Message:

Psychometrics do matter; however, acceptability of assessment to all stakeholders must be explored by qualitative
research.

Students' Perceptions of Educational Environment of Problem Based

Learning Sessions at Rawalpindi Medical College

Afifa Kulsoom* Farhan Hassan, Saira Mansoor, Zarmina Saga, Muhammad Mussadiq Khan
Department of Community Medicine, RMC, Rawalpindi. Pakistan.

Background:
The need for learning in a problem based, student centered environment is well identified in our country, but its
implementation is almost nonexistent especially in the public sector medical colleges. The reluctance generally is
due to lack of resources and substantial manpower needed for its implementation. In order to keep pace with current
trends in medical education, Rawalpindi Medical College (RMC) affiliated with University of Health Sciences stood in
the front line among the rest of the public sector medical colleges of Punjab by introducing Problem Based Learning
to the session inducted in 2007/2008.

Objective(s):
To identify the strengths & weaknesses of the educational environment after introduction of PBL in the curriculum

Study Design: Cross-sectional study

Methods:
The data was collected using a questionnaire. The questionnaire was constructed using DREEM inventory. The
whole DREEM questionnaire could not be administered because of time constraint. The three domains included
were “Students' Perception of Learning”, “Students' Academic Self Perception” & “Students' Perception of
Atmosphere”. The extract from DREEM questionnaire was administered in paper form to undergraduate medical
students in the year 1 & 2. The students answered the questionnaire anonymously.
Poster Presentations

Results
The subscale with the highest mean score was “Perception of Atmosphere” which indicates students' perception of
their academic environment. Mean score of this subscale was 6.02 + 1.23 corresponding to 75.5% of the maximum
score. The lowest mean score was for Students' Perception of Learning: 16.57 + 2.55 (69%). The overall mean score
for the ten items was 28.32 + 4.48 (70.5% of maximum).

Conclusions:
The educational environment of Rawalpindi Medical College after introduction of PBL was generally perceived
positively by students. 73
 Doctor in the witness box An academic drill

Zubaida zain* Waseem Ullah Khan Syed Shoaib Shah

Assistant professor
Shifa College of medicine Islamabad Pakistan

Objective:
To introduce legal medicine education as a vehicle for changing health professionals' attitudes towards law and legal
systems instead of many hours of passive absorption of information from lectures provided by a parade of
specialists.

Background:
There is a rising tide of malpractice and increasing criticism by the society, citing the failure of medicine to contribute
properly to the administration of justice. This demands modification in the traditional educational methods. Forensic
Medicine faculty at Shifa College of Medicine introduced an innovative method of familiarizing their students to the
court proceedings and the important legislations of our country. Summary of work A full day was assigned.100
students were assigned 10 different cases. Role plays were performed by 10 different groups demonstrating the
steps of evidence recording. Overview of the fundamental tenets of the legal system was provided.

Results
Student feed back was taken. Results were based on the agreement or disagreement using five point Likert scale.
Most agreed that the activity was very useful to build a basic framework for the substantiative learning to follow.
MCQ's and SAQ's were used as tools of assessment having cronbach's alpha 0.62 with mean of 56.7 ± 8 .

Conclusion:
Such activities help them learn how to work in interdisciplinary team, employ evidence-based practice and foster self
directed learning skills. Take home message: This approach shifts the emphasis toward the final learning outcomes
at the end of the course rather than the traditional focus on the educational process itself.

Objective:
To introduce legal medicine education as a vehicle for changing health professionals' attitudes towards law and legal
systems instead of many hours of passive absorption of information from lectures provided by a parade of
specialists. Such activities help them learn how to work in interdisciplinary team, employ evidence-based practice
and foster self directed learning skills.

Take home message:

This approach shifts the emphasis toward the final learning outcomes at the end of the course rather than the
traditional focus on the educational process itself.

Illustrated account of the medical care available to the people of

Middle East and Europe over the last few millenniums

Anum Illahi
Associate Professor
AL Nafees Medical College. Isra University. Islamabad. Pakistan.

The progress of medical science has been haphazard in the last few millenniums. It has progressed in fits and starts
and has had experienced long relapses. The areas of progress have also been varied.
Most of the progress has been Concentrated in Middle East and Europe followed later on by North America. This
Illustrated presentation examines the quality of medical care available to the people of Middle East and Europe over
the last few millenniums.
Poster Presentations

74
 Conference Secretariate
Isra University Islamabad Campus
Farash Town, Lethrar Road, Islamabad-Pakistan
Tel: 92 51 843 9901 - 10 Ext 3025 Fax: 92 51 843 9920
con12@ae-me.org
www.ae.me.org