Background: Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. Methods: The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. Results: All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. Conclusion: The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed.
Health Personnel ; Injections

No abstract available.
Caribbean Region* ; Learning* ; Schools, Medical* ; Netherlands

No abstract available.
Caribbean Region* ; Curriculum* ; Schools, Medical* ; Netherlands

No abstract available.
Humanities* ; Humans ; Netherlands

No abstract available.
Humans ; Students, Medical* ; Netherlands

PURPOSE: Xavier University School of Medicine adopted an integrated, organ system-based curriculum in January 2013. The present study was aimed at determining students' perceptions of the integrated curriculum and related assessment methods. METHODS: The study was conducted on first- to fourth-semester undergraduate medical students during March 2014. The students were informed of the study and subsequently invited to participate. Focus group discussions were conducted. The curriculum's level of integration, different courses offered, teaching-learning methods employed, and the advantages and concerns relating to the curriculum were noted. The respondents also provided feedback about the assessment methods used. Deductive content analysis was used to analyze the data. RESULTS: Twenty-two of the 68 students (32.2%) participated in the study. The respondents expressed generally positive opinions. They felt that the curriculum prepared them well for licensing examinations and future practice. Problem-based learning sessions encouraged active learning and group work among students, thus, improving their understanding of the course material. The respondents felt that certain subjects were allocated a larger proportion of time during the sessions, as well as more questions during the integrated assessment. They also expressed an appreciation for medical humanities, and felt that sessions on the appraisal of literature needed modification. Their opinions about assessment of behavior, attitudes, and professionalism varied. CONCLUSION: Student opinion was positive, overall. Our findings would be of interest to other medical schools that have recently adopted an integrated curriculum or are in the process of doing so.
Caribbean Region* ; Curriculum* ; Surveys and Questionnaires ; Focus Groups ; Humanities ; Humans ; Licensure ; Problem-Based Learning ; Schools, Medical* ; Students, Medical ; Netherlands

Xavier University School of Medicine admits students mainly from the United States and Canada to the undergraduate medical program. A previous study conducted in June 2013 used the Dundee Ready Educational Environment Measure to measure the educational environment and impact of different teaching and learning methods in the program. The present study aims to obtain information about students' perceptions of changes in the educational environment, which underwent modifications in teaching and learning, in January 2014. Information was collected about the participants' semester of study, gender, nationality, and age. Students' perceptions of the educational environment were documented by noting their degree of agreement with a set of 50 statements grouped into five categories. Average scores were compared among different groups. The mean total and category scores were compared to those of the 2013 study. Sixty of the sixty-nine students (86.9%) who enrolled in the undergraduate medical program participated in the survey. The majority were male, aged 20-25 years, and of American nationality. The mean+/-SD total score was 151.32+/-18.3. The mean scores for students' perception in the survey categories were perception of teaching/learning (38.45), perception of teachers (33.90), academic self-perceptions (22.95), perception of atmosphere (36.32), and social self-perception (19.70). There were no significant differences in these scores among the different groups. All scores except those for academic self-perception were significantly higher in the present study compared to the previous one (P<0.05). The above results will be of particular interest to schools that plan to transition to an integrated curriculum.
Atmosphere ; Canada ; Curriculum ; Education, Medical ; Educational Measurement ; Ethnic Groups ; Follow-Up Studies* ; Humans ; Learning* ; Male ; Self Concept ; Students, Medical ; United States ; Netherlands*

PURPOSE: The Tutorial Group Effectiveness Instrument was developed to provide objective information on the effectiveness of small groups. Student perception of small group effectiveness during the problem base learning (PBL) process has not been previously studied in Xavier University School of Medicine (Aruba, Kingdom of the Netherlands); hence, the present study was carried out. METHODS: The study was conducted among second and third semester undergraduate medical students during the last week of September 2013, at Xavier University School of Medicine of the Netherlands. Students were informed about the objectives of the study and invited to participate after obtaining written, informed consent. Demographic information like gender, age, nationality, and whether the respondent had been exposed to PBL before joining the institution was noted. Student perception about small group effectiveness was studied by noting their degree of agreement with a set of 19 statements using a Likert-type scale. RESULTS: Thirty-four of the 37 (91.9%) second and third semester medical students participated in the study. The mean cognitive score was 3.76 while the mean motivational and de-motivational scores were 3.65 and 2.51, respectively. The median cognitive category score was 27 (maximum score 35) while the motivation score was 26 (maximum score 35) and the de-motivational score was 12 (maximum score25). There was no significant difference in scores according to respondents' demographic characteristics. CONCLUSION: Student perception about small group effectiveness was positive. Since most medical schools worldwide already have or are introducing PBL as a learning modality, the Tutorial Group Effectiveness Instrument can provide valuable information about small group functioning during PBL sessions.
Caribbean Region* ; Surveys and Questionnaires ; Education, Medical ; Educational Measurement ; Ethnic Groups ; Humans ; Informed Consent ; Learning ; Motivation ; Netherlands ; Problem-Based Learning* ; Program Evaluation ; Schools, Medical ; Students, Medical

PURPOSE: The effectiveness of physical examination skills (PES) training is very rarely assessed using the "post-then-pre" approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students. METHODS: KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS. RESULTS: Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46x4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test. CONCLUSION: The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners' self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.
Curriculum ; Humans ; Methods ; Nepal ; Obstetrics ; Ophthalmology ; Physical Examination* ; Self-Assessment ; Students, Medical

PURPOSE: The learning environment at Xavier University School of Medicine (XUSOM), Aruba has not been previously studied. Hence, the present study was carried out using the Dundee Ready Education Environment Measure (DREEM) to obtain student perceptions about the learning environment and compare the same among different subgroups of respondents. METHODS: The questionnaire was administered to undergraduate medical students in their first to fifth semester during the first two weeks of June 2013. The students' perceptions were evaluated by noting their degree of agreement with a set of 50 statements using a Likert-type scale. The mean overall score and the scores of subcategory were calculated and compared among different respondents (P<0.05). RESULTS: Seventy-three of the 86 students (84.9%) completed the questionnaire. The overall mean+/-SD score was 131.79+/-22.86 (maximum score 200). The mean+/-SD score for students' perception of teaching/learning was 31.99+/-6.23 (maximum score, 48), while the score for students' perceptions of teachers was 30.05+/-5.54 (maximum score, 44). The mean+/-SD scores for students' academic self-perception, students' perception of the atmosphere, and students' social self-perception were 21.88+/-5.11 (maximum score, 32), 30.92+/-8.59 (maximum score, 48), and 16.96+/-4.71 (maximum score, 28), respectively. There were no differences in scores according to the respondents' personal characteristics. CONCLUSION: The student responses about the learning environment at the institution were positive. We plan to obtain regular student feedback as the curriculum becomes progressively more student-centered and integrated.
Atmosphere ; Curriculum ; Surveys and Questionnaires ; Education ; Humans ; Learning* ; Schools, Medical ; Self Concept ; Students, Medical ; Netherlands*