Challenges and Attitude towards Research among Physicians of Bangladesh: A Cross Sectional Questionnaire Survey.

In the history of human civilization, research has played a significant role. There is no doubt that meeting the challenges of the 21st century will be tough if we are not world leaders in science and technology. The objective of this study was to assess physicians' attitude about research and the challenges they confront when doing research. From July to December 2020, a cross-sectional questionnaire survey was performed among physicians in Bangladesh. The questionnaire poll had 626 responses in total. There were 55.6 % female physicians and 44.4% male physicians among them. The majority of physicians (87.6%) felt that conducting research is critical to become a specialist. Research methodology training at the medical colleges are extremely beneficial, according to a substantial percentage of physicians (72.2%). Research methodology should be included in undergraduate curriculum, according to 89% of physicians. Research is beneficial as it aids critical thinking and policy implementation, according to almost all respondents (96.7%). The majority of respondents cited insufficient research training (92%), insufficient funding (92.2%), insufficient time (61%), insufficient familiarity with statistical analysis (88%), insufficient skill to design and conduct a research project and write a scientific paper (90%), as barriers to research. Priority on teaching and clinical practices over research and lack of interest to do research also mentioned by 93.3% and 61% responded respectively. Consequently, this study identified challenges and attitude of physicians towards research. This finding will guide for further studies to find out effective interventions to address the obstacles raised by research participants. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 10-19

The Impression of ICT in Medical Education throughout COVID-19 Pandemic: A Survey among Medical Graduates of Bangladesh

In COVID-19 pandemic, the importance of ICT in Medical education is amplified. The purpose of the study was to assess and estimate the role and impact of ICT in relation to learning on medical education and changing behavior of the students in the period of pandemic. A questionnaire survey approach was applied amid of the Bangladeshi medical undergraduates during the period of August, 2020 to November, 2020. A Google linked structured questionnaire was used and distributed to the study population via email, messenger and WhatsApp. The questionnaire was completed by 201 medical students, with 65% were female and 35% were male students. Almost all respondents (98%) owned an android smartphone and used it to access the internet. Two-thirds (69%) of respondents have medical and health related apps in their device, with Medscape being the most widely utilized app. Respondents (49%) encountered bandwidth trouble during online class. For collaborative learning with classmates, 76% respondents favored messenger and whatsApp group. ICT knowledge should be included in the curriculum, according to 57% respondents. Over one-third participants, 37.3%, were neither satisfied nor dissatisfied. 30.8% respondents were satisfied while 19.4% were dissatisfied. The long-term benefits and problems of reforming the medical education system and utilizing ICT technologies should be considered. In this pandemic circumstance, digitalization of learning can give essential foundations for future medical education, aided by ICT tools. Our study may be used as a foundation for future research into developing digital teaching models in medical education. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 58-68

Integrated Teaching: the Need of the Hour

Integration means a systemic organization of teaching matter pertaining to different disciplines coordinating delivery of the learner to give a holistic approach to medical study. The objective of this study is to compare the effectiveness of integrated with traditional teaching. Twenty integrated and ten traditional sessions were conducted over five semesters. Duration of each session was 90 minutes. Sample sizes for integrated and traditional groups were respectively 5600 and 1400 students. Pre and post- test scores for integrated, pre and post- test scores for traditional and post-test scores for integrated and traditional teaching groups were compared. Faculty and students’ feedback were analyzed. Difference in Pre and Post-Test scores for integrated teaching was statistically highly significant. Difference in Pre and Post-Test scores in traditional teaching group, though statistically significant, was less than that observed with integrated teaching .The difference in Post-Test scores obtained in integrated and traditional teaching groups was statistically highly significant. Ninety four percent Faculties agreed that integrated teaching was an effective mode of training. Ninety percent faculties rated the program on a higher scale. Ninety five percent students liked the concept of integrated teaching. .Student-centered, patient-oriented approach is the fruitful outcome of the integrated teaching model, which will definitely help us to have a much needed “Basic Doctor.” Bangladesh Journal of Medical Education Vol.13(1) January 2022: 79-86

Role Model Characteristics and Impact of Role Models on Medical Students’ Specialty Choices (difficult to catch the concept! can it be “Medical teacher’s role model characteristics and their impact on student’s carrier choice”?)

This was a descriptive type of cross-sectional study conducted to identify the Characteristics /qualities of role model/ medical teachers as perceived by medical students and to identify the influence of role models in selecting subjects for their future career. This descriptive type of cross-sectional study was conducted during July 2019 to June 2020. A semi-structured, self-administered questionnaire was used to collect data. A total of 868 medical students of phase III and phase IV were the respondents of the study. All available students who were willing to participate in the study were selected and medical colleges were selected purposively. Study revealed that out of 868 respondents 741 (85.4%) had identified role models during the course of their studies and 127 (14.6%) respondents could not identify any role models. It was observed that 91% students opted for clinical subjects while 9% opted for preclinical and para-clinical subjects. With regards to their subjects of choice for future career 21.0% of the students preferred Medicine, followed by Surgery (20.0%), Gynecology (9.2%) and Orthopedics (3.8%).Two hundred and thirty-two (26.7%) of the students did not choose any subject for their future career. Regarding the influence of role models in selecting subjects for future career it was revealed that 334 (61%) respondents felt that role models had influence. Maintaining integrity and neutrality by role models was given the highest importance and general appearance of role model was considered least important by the respondents. (Not clear! is it Role Model Characteristics?).The academic institutes should make an effort to develop the role modeling of faculty by highlighting positive attributes of role models. Teachers should be made aware of the influence of role models on their future colleagues Bangladesh Journal of Medical Education Vol.13(1) January 2022: 3-9

Knowledge of recent medical graduates and views of stakeholders and teachers regarding medical ethics and professionalism in Bangladesh

Medical education aims to produce competent medical professionals and gives emphasis on competency-based learning in Bangladesh. Medical ethics and professionalism are considered as a core competency. A competent physician can ensure patient-centered health care system. This was an effort to obtain data regarding the knowledge of recent medical graduates and the opinion of medical educational stakeholders and teachers about medical ethics and professionalism at undergraduate medical education in Bangladesh. This mixed-method study was conducted in two rounds. The Round I was conducted from January 2018 to June 2019 for assessing the knowledge of 308 recent medical graduates towards medical ethics and professionalism. In Round II, key informant interviews were conducted among 30 medical educational stakeholders and teachers from July 2020 to December 2020. Data were collected by pre-tested self administered semi-structured questionnaire and interview guidelines. The percentages of recent medical graduates who could give correct answers regarding autonomy, justice, presenting a subject to visual social media, breaching of confidentiality, organ donation and medical certificate were 19.8%, 54.9%, 73.1%, 37.3%, 91.6% and 74.4% respectively. Most of the medical educational stakeholders and teachers (80%) expressed their opinion related to curriculum. They also suggested for practicing ethics (20.0%) and training (20.0%). A gap was observed in the knowledge regarding medical ethics and professionalism of recent medical graduates. To improve practice of ethics and professionalism, enhancement of the knowledge by incorporating “medical ethics and professionalism” in curriculum might be considered. A separate compulsory module for training on medical ethics and professionalism can be added at pre-internship period for the recent medical graduates. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 40-48

Present status of portfolio based training and assessment in postgraduate residency program in Bangabandhu Sheikh Mujib Medical University (BSMMU): A quantitative approach

Since 2009, the portfolio has been a prerequisite for the evaluation of postgraduate residency programs at BSMMU. This descriptive cross-sectional study was conducted with the aim of investigating the current status of portfolio-based training and assessment in BSMMU`s postgraduate training program. Total 264 residents and 30 faculty members selected conveniently and completed the Likert scale-based questionnaire. A checklist was used for reviewing portfolios (n=33) those were preserved by residents. Study revealed that most of the respondents were male (68.6% of residents and 93.3% of faculty members). About 60% of residents have given positive views on presence of instruction and purpose about maintaining the portfolio. Several participants expressed concerns because the portfolio content is self-reported; it may include bias or inaccuracy. Regarding opinions of respondents on characteristics of portfolio, both of the respondents perceived high satisfaction on portfolio based learning, reasonable contents, and practicable and feasible use of portfolio (p<0.05) except regular updating (p<0.05) and comprehensiveness of portfolio. In line with ownership and motivation, faculty members (4.03) highly assumed that the portfolio completed by residents as requirement of the university than residents (3.22) and p<0.05). Residents did not agree that they worked on the portfolio during university deadline (2.89) whereas faculty members ((3.73) showed vary positive views in this regard. Concerning commitments to use the portfolio, both respondents have conveyed high expression (mean >3.5) on the relationship between residents and supervisors so the role of an available supervisor in direct observations of the residents and dedicated educational meetings, giving feedback and support, cannot be exaggerated. Relating to assessment of portfolio, overall views of the respondents have expressed poor to moderate views and faculty members (2.37 to 4.23) have less satisfaction than residents (2.88 to 3.73). Though there are so many constraints such as the lack of clear purposes and instructions, poor understanding regarding ownership, assessment issues, and confusion about educational impact in future, but the portfolio as a feasible and acceptable tool to train and assess clinical competence and clinical specialization. Study recommended for generic format of portfolio based training and assessment to be considered in Bangladesh context. All Stakeholders should be well oriented at the beginning for utilizing the portfolio (supervision, monitoring and assessment system). Bangladesh Journal of Medical Education Vol.13(1) January 2022: 69-78

Teachers and students opinion regarding updated MBBS curriculum 2012 in a teaching hospital.

The modern concept of a curriculum originally derived from the Latin word for a race course. Undergraduate medical education is part of a continuum of education and training.The new curriculum is structured to provide a balance among learning opportunities through integrated teaching system. This study was carried out to explore the views of teachers and students regarding the current undergraduate medical curriculum. This cross-sectional descriptive study was conducted between October 2019 to October 2020 among the teachers and students of a private medical college and hospital (MH Samorita medical collegesandhospital) in Dhaka Bangladesh. The sample size were 100 in total. Most of the participants suggested for changes in overall existing MBBS curriculum. Highest satisfaction was seen in content related to learning objectives that were 90% and highest dissatisfaction was seen in Phase distribution of subjects that were 89%.However, they were satisfied with present pattern of course content, objectives, evaluation system and carry on system. Teachers and students evaluation may prove useful if analyzed further to overcome the shortcomings of existing MBBS curriculum. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 27-32

Opportunities and Challenges of Nurses after Upgradation of Class 2 Status

Nurse’s job facilities and challenges have emerged as a burning issue in health care delivery system in Bangladesh. This descriptive cross sectional study with a mixed quantitative and qualitative design aimed to explore the opportunities and challenges of nurses after upgradation of class 2 status. The study was carried out in two specialized public hospitals for one year duration among purposively selected 144 nurses with a semi structured interview administered questionnaire In depth interview and focus group discussion (FGD) were conducted among selected personnel. The study revealed that the mean age of nurses was 42.3 (±6.3) years, majority (86.1%) were female, most of them (79.1%) were senior staff nurse with 16.8 years mean working experience. The study explored the opportunities of nurses after upgradation of class 2 status like increased responsibilities and honor in working place, promotional opportunities mentioned by majority of respondents. On the other hand, the challenges were noted as not changing the physicians attitude, not changing the working environment, limited scope for utilization of professional skill, not having job security mentioned by majority of respondents. The study also found that most of the nurses (90.3%) were satisfied after upgradation, but a large portion were not satisfied regarding fringe benefits and current salary structure. From FGD and in depth interview some suggestions come forward for nursing profession empowerment like good salary package, medical incentive, residence and training facilities etc. Few opportunities increased in upgradation of nurses in class 2 status, however nurses were depriving from many of their facilities, which indicated that 2nd class status was partially implemented in professionally, socially and culturally. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 20-26

Evaluation of Pharmacology MCQ Papers of MBBS Professional Examinations

This cross sectional descriptive study was conducted to observe the quality of Pharmacology professional MCQ papers of different Universities of Bangladesh. For this purpose, total 80 MCQ papers of five universities dated from January 2007 to July 2015 were reviewed against a checklist to find out the coverage of recall, understanding and problem solving type questions, content coverage and construction of each question. The mean of recall, understanding and problem based type questions of all the universities were 92.1, 7.8 and 0.1 respectively and all of them statistically significantly differed from curriculum standard. All of the MCQ papers contained more than 75% recall type questions and 27.5% MCQ papers had only recall questions, Only 1(1.2%) MCQ papers contained 100 % topics (all the 11 groups). Eighteen (22.5%) contained 10 groups and 26.3% contained 9 groups out of 11. Forty percent MCQ papers contained less than 80% topics. Most of the stems of the MCQ were in the form of incomplete sentence (53.5%), 28.4% were in the form of complete statement and 16.8% were in the form of single word. Only 0.4% stem were in the form of clinical scenario. Fifty (62.5%) MCQ papers had defective stems and 68.75% had defective options. Total 14 (17.5%) MCQ papers were without any flaw but the rest 88.5% MCQ papers were with flaws either defective stem or faulty options or both. Findings of this study may be used to redefine the distribution of different type of questions in SAQ papers and to improve the quality of question papers by ensuring their coverage. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 49-57

Editorial Vol.13(1)

not available Bangladesh Journal of Medical Education Vol.13(1) January 2022: 1-2