Human ; Male ; Young Adult ; Prostheses And Implants ; Attitude Of Health Personnel ; Medicine ; Physical And Rehabilitation Medicine

<p style="text-align: justify;">INTRODUCTION: Clinicians rarely screen their patients for musculoskeletal disorders during routing physical examination. Reasons vary, but inadequate teaching of musculoskeletal medicine is cited as a major factor. To address the above issue, the Section of Rheumatology, Department of Medicine, College of Medicine, and Philippine General Hospital, University of the Philippines Manila recently adopted the Gait, Arms, Legs and Spine Locomotor Screen (GALS) as the central focus of instruction for musculoskeletal conditions.
OBJECTIVES: A total of 189 medical interns participated in this descriptive study to determine whether GALS is deemed useful and can be readily applied in the outpatient clinics.
METHODS: Data was gathered using a questionnaire, key informant interviews, and chart review. The data was analyzed using measures of central tendency, percentages and qualitative evaluation.
RESULTS: Only 26% claimed to routinely perform the musculoskeletal screening examination and only 21% claimed they used the GALS technique. The medical interns emphasized that they were adequately taught to perform the GALS technique but felt that the routine of GALS was time consuming. Emphasis on musculoskeletal screening was done only during clinical rotations in specialties like rheumatology, rehabilitation medicine or orthopedics, but not in other specialties. In addition, only the Section of Rheumatology used the GALS technique.
CONCLUSION: The findings of this study suggest that while medical interns feel competent in performing the GALS technique, its application in the clinics leaves much room for emphasis and that there is a need to standardize instruction on musculoskeletal screening.p>
Human ; Male ; Female ; Ambulatory Care Facilities ; Arm ; Gait ; Hospitals, General ; Humans ; Leg ; Musculoskeletal Diseases ; Orthopedics ; Philippines ; Rheumatology ; Spine ; Surveys And Questionnaires

<p style="text-align: justify;">INTRODUCTION: Clinicians rarely screen their patients for musculoskeletal disorders during routing physical examination. Reasons vary, but inadequate teaching of musculoskeletal medicine is cited as a major factor. To address the above issue, the Section of Rheumatology, Department of Medicine, College of Medicine, and Philippine General Hospital, University of the Philippines Manila recently adopted the Gait, Arms, Legs and Spine Locomotor Screen (GALS) as the central focus of instruction for musculoskeletal conditions.
OBJECTIVES: A total of 189 medical interns participated in this descriptive study to determine whether GALS is deemed useful and can be readily applied in the outpatient clinics.
METHODS: Data was gathered using a questionnaire, key informant interviews, and chart review. The data was analyzed using measures of central tendency, percentages and qualitative evaluation.
RESULTS: Only 26% claimed to routinely perform the musculoskeletal screening examination and only 21% claimed they used the GALS technique. The medical interns emphasized that they were adequately taught to perform the GALS technique but felt that the routine of GALS was time consuming. Emphasis on musculoskeletal screening was done only during clinical rotations in specialties like rheumatology, rehabilitation medicine or orthopedics, but not in other specialties. In addition, only the Section of Rheumatology used the GALS technique.
CONCLUSION: The findings of this study suggest that while medical interns feel competent in performing the GALS technique, its application in the clinics leaves much room for emphasis and that there is a need to standardize instruction on musculoskeletal screening.p>
Human ; Male ; Female ; Arm ; Gait ; Hospitals, General ; Musculoskeletal Diseases ; Orthopedics ; Philippines ; Rheumatology ; Spine

<p style="text-align: justify;">OBJECTIVES:To (1) compare abbreviation usage practices in the Doctors' Orders and History Sheet in two tertiary hospitals in Cebu City, namely, Cebu Velez General Hospital (CVGH) and Vicente Sotto Memorial Medical Center (VSMMC); (2) determine why medical students and physicians use abbreviations and (3) determine the perceived effects on medical student training.
METHODS:This is a descriptive cross-sectional study utilizing medical chart reviews as well as group and key informant interviews. Stratified Random Sampling with Proportionate Allocation was used to select 100 charts each from CVGH and VSMMC. Purposive sampling was done for key informants.
RESULTS: All patients' clinical history, physical examination and doctors' orders in all departments of both hospitals contained abbreviations. First initialization was the most common form, e.g. BP (blood pressure). Non-universally-accepted abbreviations were common, e.g. HFD (heredofamilial disease). Potentially dangerous abbreviations were noted, e.g. d/c, D/C. Abbreviations were used to maintain patient-doctor confidentiality, save space and time, and for convenience. Perceived effects on medical training included speeding up of task performance.
CONCLUSIONS: Use of abbreviations in medical charts among medical students and physicians in both private and public tertiary hospitals in the Philippines is a prevalent practice. While such has its perceived benefits, it also poses potential danger to patients because not all abbreviations are understood and used the same way. Medical schools and their training hospitals must initiate moves to standardize the use of abbreviations in medical education and promote awareness of their potential dangers. The authors suggest that potential dangers/benefits of abbreviations be formally introduced in medical school as a separate topic.p>
Human ; Blood Pressure ; Blood Pressure Determination ; Confidentiality ; Cross-sectional Studies ; Education, Medical ; Hospitals, General ; Hospitals, Public ; Philippines ; Physicians ; Schools, Medical ; Students, Medical ; Task Performance And Analysis ; Tertiary Care Centers ; ; Medical Records

<p style="text-align: justify;">OBJECTIVES: Because of the growing concern for stroke in the young, this study was done to determine functional outcome among patients seen at the out-patient clinic of the Department of Rehabilitation Medicine, Philippine General Hospital.
METHODS: Twenty-two patients diagnosed to have stroke in the young, who were referred for comprehensive rehabilitation and satisfied the inclusion criteria participated in this prospective study. The patients were evaluated using the Institute of Rehabilitation and Restorative Care-Long Range Evaluation System. The scores were analyzed using paired t-test, repeated measures ANOVA and linear regression at 95% confidence level.
RESULTS: Significant changes across time in all variables tested: communication, motor function of the affected extremity, the unaffected extremity, proficiency in self-cafe activities, family cluster, social cluster, resources, outlook in life and work status. Significant changes were also noted between the first and second, and between the second and third evaluation periods. Family cluster, resources and the motor functional outcome of the patients.
CONCLUSION: The present study suggests that it is not the improvement in motor recovery alone but also increased psycho-social support that determine functional outcome for stroke in young patients.p>
Human ; Male ; Female ; Adult ; Analysis Of Variance ; Hospitals, General ; Linear Models ; Mental Processes ; Outpatients ; Personal Satisfaction ; Philippines ; Physical And Rehabilitation Medicine ; Prospective Studies ; Rehabilitation ; Social Support ; Stroke

<p style="text-align: justify;">OBJECTIVES: To evaluate the relevance, usefulness, applicability, responsiveness, acceptability, efciency, overall impact and sustainability of the Master of Science in Epidemiology-Clinical Epidemiology (MSE-CE) curriculum.p> <p style="text-align: justify;">METHODS: The context, input, process and product evaluation (CIPP) design was used. Of 106 alumni and students, 100 were contacted and 80 participated in a survey. Key informant interviews, direct observation and focus group discussions with faculty members, present and past administrators, selected alumni and students, and review of data were done. The results were analyzed using descriptive statistics and content analysis.p> <p style="text-align: justify;">RESULTS: Context evaluation revealed that MSE-CE responded to the need to train physicians to use research evidence in clinical decision-making. Despite some reservations among other UP colleges, the program pushed through due to support from local and international sponsors. Alumni and students appreciated the effectiveness of their teachers and complementing instructional resources. The range of work by its graduates, the networks established, and the expansion of the Department of Clinical Epidemiology (DCE, the UP department ofering the MSE-CE program) prove that the MSE-CE is a sustainable post-graduate program.p> <p style="text-align: justify;">CONCLUSION: The MSE-CE institutionalized clinical epidemiology as a distinct discipline among medical colleges in the Philippines.p>
Human ; Male ; Female ; Clinical Decision-making ; Philippines ; Program Evaluation ; Faculty ; Curriculum ; Students

Musculoskeletal conditions are among the leading causes of consultations in Rehabilitation Medicine. A fellowship program in Musculoskeletal Rehabilitation Medicine was proposed to enrich physiatrists’ knowledge and skills in evaluating and managing musculoskeletal conditions. In this paper, we shared the process of developing the curriculum of the fellowship program, which was proposed to and eventually approved by the Postgraduate Institute of Medicine, College of Medicine, University of the Philippines Manila. A core group of consultants, considered as experienced clinicians and educators in Musculoskeletal Rehabilitation Medicine in the study institution, designed the program from the scope of training to learning competencies, outcomes, and assessment methods. To our knowledge, developing the fellowship program in this constantly evolving area in Rehabilitation Medicine is the first of its kind in the Philippines and a milestone in the history of postgraduate education in the longest-running training program for aspiring physiatrists.
Physical and Rehabilitation Medicine

Objectives: Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients. Methods: This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis. Results: Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited. Conclusion Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.
Perception ; Students, Medical ; Curriculum

<p style="text-align: justify;">Background. Stroke remains a leading cause of death and disability in the Philippines, rendering its survivors unable to cope well with activities of daily living, including sexual functioning. Sexual dysfunction is an under-recognized complication post-stroke, and mobility and communication barriers among those with aphasia can further contribute to sexual dysfunction, potentially affecting their quality of life.p><p style="text-align: justify;">Objective. To determine the changes in sexual functioning among patients with aphasia and the communication methods they used to compensate for language and communication deficits.p><p style="text-align: justify;">Method. This was a descriptive cross-sectional study involving patients (?30 years old, with 1 episode of stroke, with non-fluent aphasia) and their respective sexual partners. Data were gathered using a clinician-administered questionnaire based on previous studies. Outcomes included changes in libido, coital frequency, time of resumption of sexual activity, erectile/ orgasmic ability, sexual satisfaction, and alternative methods of communication.p><p style="text-align: justify;">Results. Forty participants were included comprising of 20 patients with aphasia and their respective sexual partners. There was a decline in sexual activity among the couples, with reduced frequency of sexual intercourse. Both patients and partners reported difficulties in expressing the desire for sexual activities, hindering initiation. There was noted difficulty in ascertaining the sexual experience of patients with aphasia (i.e., whether pleasure or pain), hindering maintenance and enjoyment of the sexual act. In response to the difficulties mentioned above, sexual innuendoes as communication strategies were described by the couples.p><p style="text-align: justify;">Conclusion. The study provides baseline local data on changes in sexual functioning among stroke patients with nonfluent aphasia and their sexual partners. Sexual rehabilitation is recommended in the holistic management of patients with aphasia to train couples develop compensatory techniques to adjust to the changes in their sexual lives.p>
Stroke ; Aphasia ; Sexuality ; Communication

Objectives: Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients. Methods: This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis. Results: Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited. Conclusion Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.
Perception ; Students, Medical ; Curriculum