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Although there is a high support among doctors for the promotion of EBM, there is a deficit in knowledge and skills of EBM. Hence, the time appears ripe for planning and implementing an effective EBM educational programme for both undergraduate and postgraduate doctors.

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In spite of the positive attitude towards EBM, this study demonstrated numerous personal, interpersonal and institutional barriers towards implementing EBM which necessitate prompt action to formulate a national plan to overcome such barriers.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The prevalence of COPD among cigarette smokers in the Middle East is not well studied. A prospective descriptive study was performed in the north of Jordan. Male cigarette smokers (≥10 pack-year) aged 35 years and older were recruited from the community. They completed a questionnaire and a postbronchodilator spirometry. Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria (postbronchodilator forced expiratory volume in 1 second <70%) was used to define COPD. A total of 512 subjects completed the study protocol. According to the GOLD criteria, 42 subjects (8.2%) had COPD. Of those, 27 subjects (64.3%) had symptomatic COPD. Using the GOLD criteria, eight subjects (19%) with COPD had mild disease, 24 (57.1%) had moderate disease, eight (19%) had severe disease, and two (4.8%) had very severe disease. Only 10.6% were aware of COPD as a smoking-related respiratory illness, and 6.4% had received counseling about risk for COPD by a physician. Chronic bronchitis (cough for 3 months in 2 consecutive years) was reported by 15% of the subjects, wheezes by 44.1%, and dyspnea by 65.2%. Subjects with COPD reported having more chronic bronchitis 18/42 (42.9%) and wheezing 28/42 (66.7%) than subjects without COPD. The prevalence of COPD increased with increased number of pack-years smoked. In conclusion, COPD prevalence among cigarette-smoking men in Jordan is lower than in the developed world. COPD was largely underdiagnosed, despite the majority of participants being symptomatic and having moderate to severe disease.

BACKGROUND: The use of e-learning has become mandatory during the COVID-19 pandemic. However, there are many barriers to applying e-learning in medical education. OBJECTIVE: This study aimed to explore medical students’ perspectives on the application of e-learning in medical education during the COVID-19 pandemic. METHODS: This Q-methodology explorative study was conducted in Kurdistan Region of Iraq. A sample of 37 medical students was purposively selected to represent different characteristics. The students distributed 37 statements representing different aspects of e-learning in medical education into a nine-point scoring grid from “least agree” to “most agree.” RESULTS: Data analysis revealed three distinct viewpoints. The first viewpoint, complete dependence on e-learning, emphasized a preference for e-learning to continue medical education and complete the study year with a minimal return to study halls or practical/clinical sessions. The second viewpoint, opponents of applying e-learning in medical education, included a generally negative view about e-learning and its role in medical education during the COVID-19 pandemic. The third viewpoint, e-learning as a supplement to medical education, emphasized a generally positive view about e-learning and considered it a supplement to the theoretical parts of medical education during the pandemic. CONCLUSION: The three diverse viewpoints are primarily distinguished by the availability of e-learning experience and skills, availability of technology, risk perception of COVID-19, and the need for in-hospital clinical teaching. Provision of necessary facilities and training is required to strengthen the role of e-learning in medical education. A safe environment is needed for on-campus or hospital clinical teaching.

Objectives: To assess the smoking cessation counselling practices of family physicians in Jordan and assess their perception about the availability of smoking cessation resources and about the barriers to effective smoking cessation practices. Methods: A pre-structured questionnaire was distributed to 124 family physicians practicing in teaching and Ministry of Health medical centres in Jordan. All participants were asked about their smoking cessation practices and about the barriers to effective smoking cessation practices. Results: Only 39.8% reported that they assess the willingness of the patients to quit smoking and 28.2% reported that they discuss counselling options with smokers. Considerably fewer percentages of physicians reported that they prepare their patients for withdrawal symptoms (11.6%), discuss pharmacotherapies (4.9%), describe a nicotine patch (5.0%), and provide patients with self-help materials (6.7%). The two factors cited most often by physicians as significant barriers to smoking cessation counselling were lack or too few available cessation programmes (90.3%) and limited training for physicians on tobacco and cessation interventions (90.3%). Conclusion: While a high proportion of Jordanian family physicians reported that they usually ask patients about smoking status and advise them to stop smoking, they do not regularly provide extensive assistance to help their patients to quit smoking. Lack or too few available cessation programmes and limited training for physicians on smoking cessation interventions were identified as the two major barriers to effective smoking cessation counselling.