Bangladesh Journal of Medical Education

Aptitude and Academic Performance Among Medical Students of Bangladesh

Heera lal Roy — 2023-07-26

Background: aptitude is one of the major determinants of effectiveness of students’ learning’.

Aims and Objectives: To find out the relationship between aptitude and academic performance among medical students of Bangladesh.

Materials and Methods: This cross-sectional study was conducted to assess the relationship between aptitude tests’ scores and academic performances of the medical students of Bangladesh. A total of 436 student respondents participated in this study from eight purposively selected of Bangladesh those are located at Dhaka. As well as outside Dhaka from January to December 2022 using a pretested semi-structured self-administered questionnaire.

Results: This study Finding showed that very few medical students scored ≥60% in verbal reasoning (17.4%), abstract reasoning (21.8%), situational judgement tests (6.2%) and total aptitude tests (12.4%); but the numerical reasoning was good (60.1%). no significant association was found between deferent aptitude tests’ scores and academic performances of the medical students.

Conclusion: It can be recommended that we can consider to introduce aptitude tests in our medical student selection process so that students with good aptitude tests scores can enrolled in the course.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 3-7

Medical Students’ Views Concerning Social Security System at their Institute

Md Iqbal Hasan — 2023-07-26

Introduction: Academic performance of learners is challenging as MBBS students' performance is a result of socio-economic, psychological and environmental factors. Socially secured education systems are growing as a profitable industry with prime goal to produce high quality education which delivers well-educated and skillful students, because institutions are valueless without quality of students.

Objective: This study was carried out to find out students’ views on social security system for them in conveniently selected medical colleges of Bangladesh.

Methods: This descriptive type of cross-sectional study was carried out at four medical colleges over a period of one year from January 2021 to December 2021. Convenience sampling technique was adopted to select the medical colleges. A self administered pretested questionnaire was used to collect data from 200 purposively selected students who were present in the lecture or online classes on the day of data collection. The security factors were divided into: External Security Factors (Extracurricular activities, family & academic life problems, work and financial, social and environmental other problems, problem-solving skills) and Internal Security Factors (Students’ competence & aptitude, academic life, environmental security measurement, physical or mental expectation, learning barriers and modern technology threats).

Results: Among the total 200 students 116 (58%) were male and 84 (42%) were female. Maximum (i.e. 95%) of students expect better social security both internal and external factor. Moreover the maximum students expressed their views regarding solving any internal and external problems and direction from their administration as highly expected when they were in social security problem and stress.

Conclusion: Study recommended that the gap between the internal, external social security systems of students and the reality should be assessed meticulously and to be addressed to achieve quality of medical education outcome.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 10-17

Status of Outpatient Department based Teaching-learning in Undergraduate Medical Education of Bangladesh

Neelima Akhter — 2023-07-26

Background: Disease burden of the society is reflected in Outpatient Departments (OPDs). The doctor-patient interaction mostly occurs in OPD and it offers many unique learning opportunities to the undergraduate medical students. Most of the knowledge, skill and attitude require for professional practice can be learnt in an OPD setting.

Objectives: This study was driven to explore the current status of OPD based teaching-learning in undergraduate medical education of Bangladesh.

Materials and Methods: This was a descriptive type of cross sectional study conducted in selected eight medial colleges of Bangladesh from January to December 2022.Total sample size was 430; out of which 207 were students, 205 were teachers and Key Informants were 18. The data were collected by two sets of pre-tested questionnaires, interview schedule and checklist.

Result: out of 205 teachers 84(41%) were from govt. medical colleges and 121(59%) were from non-govt medical colleges and 125(61%) teachers had more than 10 year of teaching experience. Out of 207 students,162 (78.3%) were female and 45(21.7%) were male. The study revealed 178(89%) of teachers and 183(88.4%) of students faced challenges during OPD class. Administrative problems were identified by 110(53.7%) teachers and 115(55.56%) students and rest of the participants stated academic problems. Special OPD setup was suggested by 156(76.1%) teachers and 189(91.3%) students. The study also revealed that 15(83.3%) key informants suggested in favour of reviewing undergraduate medical curriculum regarding similar class duration with in-patient department and OPD placement.

Conclusion: The study concluded that undergraduate medical curriculum is to be reviewed with special emphasis on OPD based teaching-learning regarding duration, phases of placement and special OPD set up for maximum utilization of precious OPD time.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 18-22

Perceptions of Blended Learning in Undergraduate Medical Education in Bangladesh: Medical teachers’ Views

Julfikkar Alam — 2023-07-26

Background: Medical education exposes students to authentic learning situations and need epistemological access to tacit knowledge, skills and practice in order to interpret patient problems. Adopting a new teaching-learning approach is daunting task. Blended learning offers opportunities for the complexity of learning by integrating face-to-face and online interaction. However, this growing demand for blended learning possesses problems and challenges that are noteworthy to investigate, specifically in medical education.

Method: This descriptive type of cross-sectional study was conducted to reflect different lenses of experiences by the medical teachers on views of blended leaning in undergraduate medical education in Bangladesh. Data collected from eight medical colleges of Bangladesh. Convenient sampling technique adopted for selection of medical college and the respondents were selected from the medical college purposively. Self-administered semi-structured questionnaire was administered to collect data from 70 medical teachers to gain more details insight related with this research issue.

Results: This study revealed out that most teachers owned digital equipments, from smartphones (100%) to laptops (91.4% of teachers), had optimum knowledge and skill in ICT (88.6% of teachers), were using social networking (91.4% of teachers). All (100%) respondents stated that they did not have established e-library facilities and no established Information Technology (IT) laboratory facilities as opined by 43% of teachers in their medical colleges. The data analysis ascertained that the teachers were in affirmative consensus on the components of teaching learning process. By mean scores of 5-point likret scale, satisfying prominent components were listed as organizing teaching process by the teachers (4.3 for teachers) and well design curriculum (4.3 for teachers). In this study, maximum 55.1% of teachers respondents preferred 20-40% of overall online class.

Conclusion: The study recommended that a proper framework that integrate policies, curriculum contents alone with technological and electronic innovation matching with blended learning format to stimulate teaching and learning process in the path for successful introduction of blended learning in undergraduate medical education in Bangladesh.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 23-32

Educational Environment in Operating Theatres of Bangladesh: Views of Surgical Trainees and Trainers

Masud Ahmed — 2023-07-26

The quality of the educational environment in the operating theatre is one of the key determinants for the effective training of surgical trainees. This descriptive cross-sectional study was aimed to evaluate the views of postgraduate surgical trainees and their trainers to identify the strength and weaknesses of the educational environment of the operating theatres of Bangladesh. Data were collected by physical means from 349 surgical allied trainees of 14 different disciplines who are having a minimum of three months of working experience in operating theatre as postgraduate trainees. To evaluate the perception of trainees’ internationally validated questionnaire STEEM consisting 40 items was used. To highlight the perspective of Bangladesh, an additional self-made questionnaire consisting ten items was also used. Both questionnaires have five answering options (1-5) for each item as per Likert scale. A score of 60% was considered as satisfactory. To have more vivid ideas six sessions of focus group discussion with trainees and12 in-depth interviews of trainers with minimum five years of teaching experience in his/her specialty from most of the surgical disciplines were also carried out. In this study, the reliability score of STEEM and the self-made questionnaires were 0.757 and 0.730 respectively as determined by Cronbach’s alpha. In general, the perception of trainees regarding the educational environment in OT of Bangladesh was grossly satisfactory with a mean score of STEEM 134.32±14.05 (67%) and 36.80±5.25 (73%) for self-made questionnaire. But group D subscale of STEEM (workload, support and supervision) failed to reach satisfaction level with a mean score of 20.89±5.36 (52%) and the difference between the four subgroups of STEEM was statistically significant. The satisfaction level of juniors in group B subscale of STEEM (perception of learning opportunities) was significantly higher than seniors. The perception between trainees of different disciplines was also statistically significant. From focus group discussions of trainees and in-depth interviews of trainers, this study revealed that trainees’ felt deprived of ‘hands on’ training and perioperative briefing either due to the huge workload or long learning curves of the junior faculties. Quality of training is somehow neglected due to physical absence of faculty members after routine office hour and also because of deficient simulation or skill lab. Trainees also claimed that their financial hardship making them bound for extracurricular activities compromising their full-time residential training.

The overall educational environment in operating theatres of Bangladesh as perceived by trainees and trainers is satisfactory. To ensure the full engagement of the trainees under the direct supervision of faculties curriculum should be upgraded with the provision of a modern skill lab, workload should be managed and their financial issues need to be addressed sympathetically by the appropriate authority.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 33-44

Study Habits of Undergraduate Medical Students in Bangladesh

Yasmin Akter — 2023-07-26

The study habits of students are the most important factors that influence the performance of students. Poor study habits are considered one of the main causes of students’ academic failure and can have an important impact on their education and their occupational prospect. Currently, no time bound and elaborative research is found to identify the study habits of undergraduate medical students in Bangladesh. This descriptive-type of cross-sectional study was conducted in different medical colleges with the objective to find out the study habits of undergraduate medical students of Bangladesh. It also aimed to find out if there is any difference in study habits between the students with high, average and below-average grade achievers in professional examinations. Data were collected from 586 conveniently selected students from 10 government and 9 private medical colleges of Bangladesh within the period of one year. A pretested semi-structured, self-administered questionnaire was used for data collection. Study habits were assessed in seven domains namely textbook reading, note-taking, memorizing lessons, paying concentration, exam /test preparation, time management, and classroom-related activities. With regards to study habits, it was revealed that undergraduate medical students have an average study habit score in textbook reading (3.54±1.14), note taking (3.33±1.17), memorizing lessons (3.35±1.17), preparation for the test (3.53±1.18), time management (3.40±1.18) and classroom related activities (3.22±1.2) domains. There is a significant difference in study habit score of high grades and below-average grade achievers in professional examinations. This average score of study habits was below our expectations. This study recommended that teachers should make an effort to develop or improve the study habits of medical students by acquainting them with good and poor/ bad study habits. So that students can identify their poor study habits and can take the appropriate remedial measure. Teachers can guide weak students to develop effective study habits so that students’ learning can be enhanced.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 45-55

Applicability of Workplace-Based Assessment tools (Mini-CEX) for the trainee doctors of Obstetrics and Gynecology in Bangladesh

Hasna Hossain Akhee — 2023-07-26

This cross-sectional study was conducted to assess the applicability of workplace-based assessment tools (Mini-CEX) for the trainee doctors of Obstetrics and Gynecology in Bangladesh. The study was conducted from January 2022 to December 2022. The Study population were trainee of selected medical college hospital and Supervisors/Teachers of selected medical college hospital. Medical colleges were selected conveniently. Respondents were selected purposively. Research instruments were Mini-CEX, questionnaire of American Board of Internal Medicine. Scores were given to each scale as: unsatisfactory=1 2 3, satisfactory =4 5 6, superior=7 8 9.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 56-59

Role of Clinical Skill Centers in Undergraduate Dental Education: Stakeholders View

Md Liakat Ali Hyder — 2023-07-26

Background: The clinical skill center (CSC) offers an opportunity for students and working clinicians to learn and acquire clinical skills by using artificially simulated process, which will subsequently improve patient care and safety. To promote skill-based dental education, a CSC might be considered to incorporate in undergraduate dental education.

Objectives: To explore the views of the stakeholders about the role of clinical skill centers in undergraduate dental education. This study also identified the effect of clinical skill training in promoting and maintaining clinical teaching.

Method: A cross sectional study was carried out among 637 dental persons in 11 dental colleges and units of medical colleges of Bangladesh; of which 5 were government and 6 were non-government. Study period was from January 2022 to December 2022. Data was collected by structured self-administered questionnaire, about the views of the stake holders (Dental teachers, interns and students of 3^rd and 4^th phases of BDS course).

Results: With regard to advantages of CSC, 545 (80.4%) respondents agreed that CSC facilitate skill training before performing on real patient. More so, 544 (90.3%) respondents agreed that CSC increases scope of repeated practice, 360 (64.7%) respondents felt that CSC training helped in overcoming the resistance by the patients who were not interested to intervene them by the trainees and 531(88.5%) agreed that skill training in CSC will reduce medical error. Regarding limitations of CSC, 419 (69.6%) respondents opined that establishing and maintaining CSC are very costly. Total 548 (90.9%) respondents agreed that CSC requires formally trained trainer, 550 (91.6%) respondents felt that CSC needs formally trained supporting staffs, and 533 (89%) agreed that CSC requires well defined infrastructure.

Conclusion: The study strongly suggests stakeholder’s positive perspective towards learning clinical skills in CSC. Medical educators, policy makers and curriculum designers can use the results of this study to incorporate clinical skill center based learning in undergraduate curriculum and establish CSC to train and enhance students’ clinical skills and maintain patients’ safety.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 60-71

Occupational stress of primary level health workers in COVID-19 pandemic in Bangladesh: a cross-sectional study

Md Nuruzzaman — 2023-07-26

The study aimed to explore the level of stress of the primary-level health workers who are staying close-to-the community at Upazila-level in Bangladesh. This was a cross-sectional descriptive study with applications of both – qualitative and quantitative methods. Two upazilas were purposively selected and then stratified sampling technique was used to determine the sample size. A total of 172 health workers were selected covering a total of 11 occupational categories (doctors, nurses, midwives, pharmacists, medical assistants (SACMOs), medical technologists, health assistants, assistant health inspectors, family welfare assistants, family welfare visitor (FWV), and CHCPs. Regarding serving the COVID-19 probable cases, 57% said yes and regarding treatment to COVID-19 infected cases, 30% said yes. Regarding time spent on washing hand, about 52% said that they spent less than 30 seconds. During serving the patients, about 22% reported that they do not use PPE and 50% said that there is no arrangement of wearing PPE in their workplaces and 38% said that they do not follow standard procedures to wear. Regarding receiving COVID-19 related training, about 70% said ‘No’ and 73% said that they did not receive training on wearing PPE. Midwives and CHCPs were found to experience the highest level of stress at their workplaces. The most common stressors mentioned by the health workers were such as – dealing with difficult situation, sensitive to criticism, hunch for accuracy at work and inadequate resources. This study indicates that there is high prevalence (%) of stress among the primary level health workers in Bangladesh. Finally, the study recommends adopting an appropriate occupational stress management strategy at national level specific to the health workers working at the primary level as their nature of work is different to the secondary and tertiary level of care.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 72-83

Blood Stream Infection: Identification & Antibiotic Sensitivity Pattern of Microorganisms in a Tertiary Care Hospital in Dhaka City

Taslima Begum — 2023-07-26

Background: Blood stream infections are an important cause of mortality & morbidity in all age group worldwide.

Aim & Objective: The aim of this study was to perform bacteriological analysis and assess antibiotic sensitivity patterns of isolates from bloodstream infections in a tertiary care hospital in Dhaka city.

Material & methods: The study is a retrospective observational analysis of blood culture isolates received in the Department of Microbiology, Holy Family Red Crescent Medical College & Hospital from January to December, 2021. A total sample size was 2371, out of them positive aerobic bacterial growth was observed in 85 (3.58%) isolates. Sampling technique was used to collect data from the laboratory records and written consent was taken from concerned authority collected data were compiled and analyzed with the help of SPSS version 20. All samples were collected in BacT/ ALERT 3D 60 aerobic bottles irrespective to antibiotics administration. One to five (1-5) ml blood for children and 5-10 ml blood for adult were collected respectively. Samples were incubated in the automated BacT/ ALERT 3D. Subculture was done on blood agar, chocolate agar media & MacConkey’s agar media. Identification of organisms by Gram stain & biochemical tests were done as per the standard methods. Negative signal blood culture bottles were kept in machine for up to 5 days. No mixed cultures (the association of two microorganisms) were identified. All the isolates were tested for their antimicrobial susceptibility pattern by Kirby-Bauer’s disk diffusion technique according to the Clinical and Laboratory standards institute guideline.

Results: Overall, 45/874 (5.14%) positive blood cultures were isolated from adult followed by neonate 31/709(4.37%), children 6/390(1.54%) & infant 3/398(0.75%). Bacteremia was more or less equal in both sexes, female 44 (51.77%) & male 41(48.23%). Trend of pathogens recover in highest in November 13(15.29%). The most common organism isolated was Staph. aureus 26(30.58%) followed by Klebsiella species 15(17.64%), Acinetobacter species 13(15.29%), Pseudomonas species 11(12.94%), Salmonella Typhi 10(11.76%) and E. coli 10(11.76%). In Staph. aureus, linezolid and vancomycin were 100% sensitive. In Klebsiella spp. meropenem was 87% & in E. coli 80% sensitive. In Acinetobacter spp. amoxicillin/ clavanic acid 85% & colistin 70% sensitive. In Pseudomonas spp., meropenem and piperacillin tazobactum 100% sensitive followed by ciprofloxacin 82%, ceftazidime 82% & amikacin 81.8% sensitive. In Salmonella Typhi, ceftriaxone was 100% sensitive.

Conclusion: Drug resistant bacteria are increasing over the years, so, antibiotic policy which formulates according to local sensitivity pattern will be implemented effectively.

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 84-91

Editorial Vol. 14(2)

Md Humayun Kabir Talukder — 2023-07-26

Abstract not available

Bangladesh Journal of Medical Education Vol.14(2) July 2023: 1-3