The ongoing global COVID-19 pandemic triggered a series of events that resulted in the disruption of the delivery of various certifying examinations including that which was given by the Philippine Board of Ophthalmology (PBO). This paper shares the experience of the PBO using digital technology in administering its first ever online delivery of its certifying examinations. Online platform requirements used for delivering the examination are enumerated, online proctoring described, as well as the conduct of oral panel examinations and skills evaluation via video submission. Challenges encountered, feedback reported by both examinee and examiner, lessons learned from this endeavor, and future directions are discussed.

Objective: This study was designed to assess the impact of the COVID-19 pandemic on ophthalmology training from the perspective of ophthalmology residents and fellows in the Philippines. Methods: A 55-item online survey on the COVID-19 pandemic’s impact on ophthalmology training was sent to 168 ophthalmologists-in-training from March 15, 2021 to April 19, 2021. Participants from all ophthalmology training programs in the Philippines were selected via random sampling and proportional allocation. Results: A total of 158 ophthalmologists-in-training (138 residents and 20 fellows) completed the survey. The areas of ophthalmology training that were found to be most disrupted during the COVID-19 pandemic were surgical training (95%), clinical activity (94%), and in-person interaction with consultants in the out-patient department (94%) and operating room (85%). In contrast, trainees found an increase in didactic teaching activities (75%) and research activities (39%). Overall, 78% of the trainees felt that the pandemic had a negative impact on their ophthalmology training. The aspects which were most frequently found to be negatively impacted by the pandemic were mental health (70%), followed by technical skills (69%), and clinical skills (61%). No major differences were found on the impact of COVID-19 on training when compared across year levels and across institutions compared by location (National Capital Region vs. non-National Capital Region) and funding type (government vs. private funding). Ninety-nine percent (99%) of institutions shifted most of their didactic teaching activities to online platforms. Surgical video conferences and simulator training or skills labs were thought to be helpful to surgical training by 89% and 81% of the trainees, respectively. Majority of trainees attended to patients via telemedicine averaging 40% of their clinic consults. However, only 16% reported confidence in handling their patients through telemedicine. Conclusion The COVID-19 pandemic has had an overall negative impact on ophthalmology training in the Philippines. It caused significant disruption in trainees' clinical and surgical activities, and affected their mental health. Despite this, the situation provided an opportunity to boost trainees' theoretical knowledge. Majority are receptive to new technology-based learning tools to preserve the effectiveness of their training. Efforts to re-evaluate current training programs are needed to ensure sustainability and quality of ophthalmology training in the Philippines.
COVID-19 ; ophthalmology ; survey

Objective. To determine operating room efficiency for elective ophthalmologic surgeries requiring general anesthesia in a public tertiary institution based on standard efficiency parameters. Methods. Prospective observational cross-sectional study of randomly selected elective cases requiring general anesthesia from April 2019 to June 2019 in the Department of Ophthalmology of the Philippine General Hospital. A single third-party observer recorded operating room milestones from which efficiency parameters were determined and compared with local and international guidelines and efficiency benchmarks. Results. A total of fifty cases from the Retina, Plastic, Orbit, Glaucoma, and Motility services were observed. None started on the specified start time of 6:30 a.m., with surgeries starting an average of 52 ± 11.90 minutes after. Across subspecialties, median surgical preparation time was statistically significant (χ2: 12.01, p: 0.02), with the Retina and Orbit services having the most extended duration. Across age groups, pediatric cases had lower mean anesthesia preparation times (t: 2.15, df: 48, p: 0.04) and median trans-out lag times (χ2: 4.56, p: 0.03) than adults. Overall, more than 60% of cases reached targets for induction and surgical lag time. Turnaround for adult and pediatric patients was 75 ± 22.77 minutes and 71 ± 14.91 minutes, respectively. Benchmarking analysis showed that the first case on time, entry lag, and exit lag were below the 50th percentile while the room turnover time was above the 95th percentile. Conclusion. Ensuring efficiency requires a multidisciplinary team approach. This research can guide administrators in determining interventions to increase operating room efficiency.
operating room ; efficiency ; ophthalmology

Background: Andragogy, the theory of adult learning is relevant to medical education especially in the clinical internship learning context. It focuses on the students, faculty, and patients interacting together while developing competencies as future practitioners. Medical interns are active adult learners, enhancing their development of knowledge, skills, and positive attitudes, and pursuing professionalism as they participate in case-based discussions (CBD). Objectives: The study sought to identify the basic principles of andragogy while medical interns participate in case-based discussions including the end-of-course satisfaction. It also determined the selected demographic factors associated with the andragogic principles. Methodology: Respondents included 80 interns by convenience sampling who rotated at the Department of Ophthalmology and Visual Sciences in a tertiary referral hospital. The study used a combination of descriptive quantitative and qualitative research design. A valid instrument using the Adult Learning Principles Design Elements Questionnaire (ALPDEQ) was used to measure the medical intern's andragogic orientation as well as end-of-course satisfaction. A direct, non-participant observation of case-based discussions conducted at the department was done by the researcher and research associate. Results and Conclusion The occurrence of andragogic principles specifically motivation, experience, need to know, readiness, and self-directedness was observed during the conduct of case-based discussion. There was no association between principles of andragogy and demographic factors such as age, gender, civil status, medical school, preparatory medical course, and place of origin. CBD is an effective learning strategy, which provides medical interns adequate venues to be self-directed and apply the principles of andragogy in a workplace-based setting.
Internship and Residency

OBJECTIVE: To describe the visual and clinical outcomes of 3 patients with sympathetic ophthalmia treated with a combination of systemic steroids and methotrexate. METHODS: This was a small, descriptive case series. RESULTS: We reported 3 cases of post-traumatic sympathetic ophthalmia treated with steroids and methotrexate. Two patients had inciting eyes with no light perception on presentation, while one had a best-corrected visual acuity (BCVA) of counting fingers. The initial BCVA of the sympathizing eyes ranged from 20/20 to 20/50. Control of ocular inflammation was achieved using methotrexate (12.5 to 15 mg weekly) in addition to oral steroids and topical therapy. The final BCVA of the sympathizing eyes ranged from 20/20 to 20/30, indicating that good visual outcomes were attainable with steroids and methotrexate as part of the maintenance regimen. None of the patients developed adverse side-effects from methotrexate. CONCLUSION: This small case series demonstrated the effectiveness and safety of methotrexate for control of intraocular inflammation in sympathetic ophthalmia.
Ophthalmia, Sympathetic ; Methotrexate ; Panuveitis ; Steroids

OBJECTIVES: This study assessed the existing Public Health Promotion and Education 210 module (PHPE 210) as basis for the revision of the learning resource material. Specifically, this study determined the stakeholders' perceptions on the module in terms of: (1) its presentation, organization, topics covered, clarity/user-friendliness and its relevance to practice; (2) its strengths and weaknesses; and (3) the topics that need to be integrated in the resource material.

METHODS: A qualitative approach was used for this study. Through purposive sampling, 4 focus group discussions and 11 key informant interviews were done. Topic Guide was used as the main data collection instrument. Informed consent was obtained prior to data collection. Data was described verbatim, emerging themes and actual quotations from the participants and informants were extracted in the succeeding analysis.

RESULTS: The results of the focus group discussions and key informant interviews, in general, were similar and actually complemented each other. The module was perceived to be relevant, comprehensive and logically organized. The historical foundation needs to be presented in a more concise and updated manner, and examples and practical applications of the PRECEDE-PROCEED model must be used. To update the module and make it more relevant to the present issues, innovative health promotion strategies such as social media, healthy settings, health in all policies, and multi-sectoral approach must be included in the revised version. Practical applications of the theories and health promotion and education strategies also need to be considered in the revision of the module. The module has to be presented in a more reader-friendly manner, easy-to-use and visually appealing to its readers.

CONCLUSION: This study demonstrated the importance of incorporating the perceptions of educators, module developers, practitioners, experts, and the learners or students in assessing and redesigning a more relevant learning resource material. With the current trends and emerging issues in health promotion and education, an evidence-based development and improvement of learning resource modules to make them relevant to changes have to be continuously undertaken.

Human ; Male ; Female ; Health Promotion ; Health Education ; Education, Public Health Professional

This article describes the partnership between the College of Public Health, University of the Philippines Manila and the province of Laguna in the context of implementation of the field practice course. This partnership paved the way for the development and implementation of projects in seven field practice sites. Projects concentrated mainly on improving quality of data and health information system, development of educational materials, and addressing health problems such as tuberculosis, hypertension and rabies. After the implementation of the various activities, there is a need for both parties (the College of Public Health and the Provincial Health Office of Laguna) to monitor and evaluate if projects have been sustained. Moreover, successful projects must also be fully documented which can serve as models for other areas in the province of Laguna.

Human ; Rabies ; Health Information Systems ; Public Health ; Tuberculosis ; Quality Improvement ; Universities ; Teaching Materials ; Hypertension

OBJECTIVES: 

1. To describe the performance of medical students in comprehensive examinations given after each learning unit or year level. 

2. To correlate the scores of the students in the comprehensive examinations to the general weighted average grade (GWAG) for the same learning unit.

3. To correlate the scores in the subject-based part of the comprehensive examinations to the scores in the Physicians Licensure Examination (PLE)

 

METHODS: The scores of graduates of the University of the Philippines Manila College of Medicine (UPCM) for the years 2009-2011 in the comprehensive examinations, their general weighted average grade per learning unit, and scores in the PLE were retrieved and analyzed. Correlation coefficients of comprehensive examination score and GWAG, and comprehensive examination score and PLE score were computed.

RESULTS: A total of 434 out of 463 graduates from UPCM were included in this study. There was no trend observed in the performance of students in the comprehensive examinations as they progressed from one learning unit to the next. Performance in both portions of the comprehensive examinations was observed to have significant correlation to students' LU GWAG for most of the learning units, with the exception of LU 6 and LU 7 for Class B. Performance in the subject-based portion of the comprehensive examinations was observed to have significant correlation to students' PLE scores.

CONCLUSIONS: The students' scores in the comprehensive examinations had moderate to strong correlation with the GWAG for the corresponding learning unit. Similarly, scores in the subject-based portion of the comprehensive examination had moderate to strong correlation with PLE scores.

Human ; Male ; Female ; Students, Medical ; Philippines ; Learning ; Licensure ; Physicians ; Physical Examination

Objective. To compare the performance of graduates in a traditional curriculum and graduates in an organ system integrated curriculum from the same school on the national medical licensure examination. Methods. The scores of graduates of the University of the Philippines Manila College of Medicine in 2008, taught in the traditional medical curriculum were compared with those of the scores of graduates in 2009, taught under the organ system integrated curriculum, on the Physicians Licensure Examination (PLE) conducted by the Professional Regulation Commission (PRC). Average scores, and scores per subject were compared using t-test. Results. The graduates of the organ system integrated curriculum (2009) had higher average scores than the graduates of the traditional curriculum (2008). The former also had higher scores in Physiology, Legal Medicine, Pathology, Surgery, Obstetrics and Gynecology, and Pediatrics. The scores of the 2 groups were not significantly different in Biochemistry, Anatomy, Pharmacology and Medicine. The graduates of the traditional curriculum had higher scores in Microbiology and Preventive Medicine. Conclusion. The graduates of the organ system integrated curriculum (2009) had better over all performance in the physician licensure examinations than the graduates of the traditional curriculum (2008).
Human ; Male ; Female ; LICENSURE, MEDICAL ; LICENSURE

OBJECTIVES: This study was conducted to examine the validity of the National Medical Admissions Test (NMAT) score, Pre-Medicine general weighted average grade (Pre-Med GWAG) in predicting the academic performance in medical school, as measured by the medical school general weighted average grade (Med GWAG) and Physician Licensure Examination (PLE). It also aimed to study which among the NMAT, pre-medicine GWAG and MedGWAG best correlates with PLE.

METHODS: Records of graduates of th UPCM from 2004 to 2009 were retrieved and data regardin the following entry characteristics were collected: National Medical Admissions Test (NMAT) scores, pre-Medicine general weighted average grade (MedGWAG). Average and individual subject scores in the PLE were retrieved for this study. Statistical analysis using the Pearson correlation analysis was performed using STATA.

RESULTS: The NMAT, MedGWAG and PLE scores of the direct and lateral entrants were not significantly different from each other. There was weak correlation between NMAT and Pre-Med GWAG and weak to moderate correlation between NMAT and Med GWAG. Except for the 2009 graduates where no correlation between NMAT and PLE scores was noted for 2004-2008 graduates. There was moderate to strong correlation between Pre-Med GWAG and Med GWAG and weak correlation between Pre-Med GWAG and PLE scores. There was strong correlation between Med GWAG and PLE scores.

CONCLUSIONS: Pre-Med GWAG had higher correlations to Med GWAG than NMAT scores. In Terms of PLE scores, the Medicine GWAG showed the highest correlation followed by Pre-Med GWAG, then NMAT scores.

Schools, Medical ; Licensure ; Medicine ; Physicians ; Academic Performance