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Background: Ward rounds (WR) have been integral to the process of teaching and learning medicine and also provides a vital opportunity to communicate with the patient, their relatives, and other healthcare professionals. Yet in recent years trainees’ perception of the educational value of WRs seems to have declined. Objectives: The aim of this study to assess trainees’ perception of the educational value of WRs at King Abdulaziz Medical City(KAMC), Riyadh, a 1500 bed academic hospital in Saudi Arabia.Methods: A self-administered, paper-based survey was distributed to physicians in training at KAMC between October and December 2019. All residents who attended WRs were invited to participate. The questionnaire was adapted from a survey used in a previous study. The demographic section requested details of the respondent's age, gender, specialty, and seniority. The second and third sections asked about the logistics of current ward round practices. It included several questions on the structure as well as the duration and frequency of ward rounds. The fourth and fifth sections asked for participant’s perception of the opportunities for, and the obstacles to, learning on ward rounds. The subsequent sections asked several questions onward round structure and the clinical teacher. Responses were requested on a 5-point Likert-type scale (strongly disagree, disagree, neutral, agree, strongly agree). The last section asked the participant for general comments and feedbackResult: The study targeted 250 residents in specialties that routinely performed WRs. Only 166 residents returned the questionnaire (response rate of 66.4%). Male 89 (53.6%), medical 108 (65.1%), surgical 58 (34.9%), resident in first year 81 (48.8%). The overall average time spent on WR was 13 (± 11 SD) hours per week. The WR was perceived as a good opportunity to learn about diagnostic investigation 138 (83%) and patient management 133(80.1%), history taking114 (68.7%) physical examination 103 (62.0%), and time management skills 86 (51.8%). The majority of our trainees felt that the WR was educationally very useful to 86 (52%) and attribute to at least a third of the education they receive during their training. They also reported that about the quarter of the time spent on WRs is devoted to teaching. The good teacher described as enthusiastic to teach 137 (82.5%), provide feedback to trainees 135 (81%), do not rush 139(83.7), communicate to trainee 144 (86.7), and consultant level,101 (60.8). Trainees also identify a few factors that hinder their training such as lack of time 130 (79%), and the number of patients 129 (78.3). Conclusion: This study identifies the strengths and weaknesses of WR in our institution. Finding will help training supervisors in addressing and rectifying these shortcoming and factors hinder training.

Background: This study aims to assess stress level and its drivers among medical students using a PBL teaching system Method: Higher Education Stress Inventory (HESI,) was used to assess stress among medical students. All students in the College of Medicine were enrolled. Results: The response rate was 99%.The prevalence of stress was 54.7%. The overall mean stress score was higher in the 4th year students (2.64) than 1st year students (2.52) (p = 0.01). Junior students were more likely to be stressed by lack of clarity of the aims of the study (p = 0.014) and lack of feedback from the teachers (p = 0.003). Senior students were more likely to be stressed by lack of time for other activities (p = 0.036), financial worries (p = 0.027) and about preparedness for future profession (p = 0.007) Despite the high stress scores, only 8.3% regretted their choice of career and 9.3% felt that they are not prepared well for their future profession Conclusions: High level of stress was noted especially among senior students. Stress in junior students was more likely to be medical training-related and to be personal problems-related in senior students. The vast majority of students were happy with their choice of profession and optimistic about their future.

Byline: Mohammed. Khan, Nahed. Sherbini, Sami. Alyami, Abdullah. Al-Harbi, Majed. Al-Ghamdi, Suliman. Alrajhi, Rajkumar. Rajendram, Hamdan. Al-Jahdali BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic progressive age-related lung disease causing [...]

Objective: The aim of this study is to investigate the reasons for and the factors associated with deciding to enter a medical school in our graduate and undergraduate medical students and whether differ between the two groups. Method: This is a cross-sectional study. The survey we developed to investigate demographic and socioeconomic data and possible reasons for deciding to enter a medical school. The responses were scored using Likert scale 4-options. Results: A total of 244 of 275 male students responded (a response rate of 89%). Of the responders, 26% were graduate students and 74% were undergraduates. Thirty-nine percent of the students attended private schools. Compared to graduate students, undergraduate students were younger (p = 0.0001), more likely to have gone to a private high school (p = 0.001) to have a father who is a doctor (p = 0.001) or a university graduate (p = 0.001), to belong a household with a monthly income exceeding $5,333 (p = 0.001). Significantly more undergraduates than graduates reported that they were influenced to enter medical school by family (p = 0.036), having had high academic achievement at high school (p = 0.001), prestige of the profession (p=0.007), guaranteed employment (p = 0.013) and desire to help others (p = 0.003). Conclusions: The graduate medical students had significantly different demographic factors which were more reflective of in the general population as well as different motivating when compared to the undergraduate medical students.

Byline: Khan. Ayaz, Rajendram. Rajkumar, Al-Ghamdi. Basma, Al-Jahdaly. Emad, AL-Harbi. Abdullah, Hayyan. Hajar, Obaidi. Mohammad, Hamdan. AL-Jahdali BACKGROUND: The curfews and lockdowns imposed during the COVID-19 pandemic may decreased the [...]

Background: The utility of QuantiFERON-TB Gold In-Tube (QFT-G) test in the diagnosis of tuberculosis disease has been validated in high and low tuberculosis-prevalent (TB) countries. Aim: The aim of this study is to assess the performance of the QFT-G test in the diagnosis of tuberculosis disease among tuberculosis patients in an intermediate prevalent country. Setting and Design: A retrospective study at the King Abdulaziz Medical City-Riyadh (KAMC-R) Materials and Methods: We retrospectively reviewed all the patients with a diagnosis of pneumonia, including tuberculosis, admitted to KAMC-R between 1 January 2009 and 31 December 2013. We included only patients with an available result of the QFT-G test. A total of 142 tuberculosis cases and 226 pneumonia cases were studied, to assess the utility of the QFT-G test in diagnosing tuberculosis cases. Results: Among the tuberculosis (n = 142) cases, the QFT-G tested positive in 68.3%, negative in 23.2%, and indeterminate in 12 cases (8.5%). Of the 226 pneumonia cases, the QFT-G tested positive in only 20.4%, while a majority of 66.4% tested negative, with 30 cases (13.3%) being indeterminate. When we excluded 42 patients with indeterminate results, the QFT-G test achieved a sensitivity of 74.6% [95% CI: 66.09 to 81.65%] and specificity of 76.53 % [95% CI: 69.85 to 82.15%] in the diagnosis of tuberculosis cases. Conclusions: This study concludes that the QFT-G test is a useful tool for detecting tuberculosis disease when used as an adjunct tool for the diagnosis of active TB cases. It certainly cannot be used solely and indiscriminately, separate from other clinical and radiological information, in the diagnosis of active tuberculosis cases.

BACKGROUND: The prognosis of idiopathic pulmonary fibrosis (IPF) can be predicted by the gender, age, and physiology (GAP) index. However, antifibrotic therapy (i.e., nintedanib and pirfenidone) may improve survival. AIMS: This study aimed to compare the outcomes of antifibrotic-treated IPF with the survival predicted by the GAP index. METHODS: A retrospective cohort study was conducted from March 2014 to January 2020. The electronic health-care records of all IPF patients treated with nintedanib or pirfenidone were reviewed. Besides standard demographic and mortality data, the variables required to calculate the GAP index were also extracted. RESULTS: Eighty-one patients (male 55, 68%; age 71.4 ± 10.2 years) with IPF received antifibrotic therapy (nintedanib 44.4%; pirfenidone 55.6%; mean follow-up 35 ± 16.5 months). Cumulative mortality (whole cohort 3 years 12%; 4 years 26%; 5 years 33%) was significantly less than predicted by the GAP index. CONCLUSIONS: The survival of antifibrotic-treated IPF is better than predicted by the GAP index. Novel systems for prognostication are required. The survival benefit from pirfenidone and nintedanib seem similar overall. [ABSTRACT FROM AUTHOR]