Background: A year senior medical students can prove to be a useful teaching resource with added benefits for the tutors. The objective of this study was to explore the perceptions of near-peer tutors after facilitating small group discussions while delivering an integrated curriculum in preclinical years. Material and Methods: This qualitative exploratory pilot study was conducted in Rawal Institute of Health Sciences Islamabad, Pakistan from July 2017 to November 2017. Students of First year MBBS class (n=100), were divided into six small groups. Seven Second year MBBS students who had secured more than 60% marks throughout year one assessments and in Professional examination were selected as Near-Peer tutors after informed verbal consent. In the first discussion, three groups were taught by three tutors and three by junior faculty. In the second discussion, the groups were swapped and exposed to the same strategy as above, with new learning objectives, but the remaining three tutors now took batches. One tutor acted as a substitute. Qualitative data was collected after interviewing the tutors individually and responses were audio recorded. The collected data, both notes and audio recordings of the interviews, was transcribed into text to generate codes, theme and sub themes. Results: Transcription of data revealed that the tutors enjoyed teaching and were of the opinion that Near-Peer tutoring is more effective in small groups, for both tutors and the learners. The tutors felt a boost in self-confidence and improvement in communication skills, after facilitating a small group. Tutoring also helped in developing their higher order cognitive thinking, learning skills and time management. Conclusions: Near-Peer tutoring helped the tutors develop learning and communications skills while facilitating small group sessions, thus helping them in their future medical roles. Key words: Integrated curriculum, Near-Peer tutoring, Peer Assisted Learning, Small group discussions.
BACKGROUND & OBJECTIVE: Leukocyte adhesion deficiency (LAD1) is an autosomal recessive type of inherited disorder caused by total or partial deficiency of CD18 expression. LAD1 is characterized by recurrent bacterial and fungal infections, in some cases delayed umbilical cord separation, delayed wound healing due to blockade in leukocyte migration to site of inflammation and infection. The present study involves genetic analysis of two unrelated families suffering from LAD1. METHODOLOGY: In the present study, two separated and unrelated Pakistani families are included suffering from Leukocyte Adhesion Deficiency type -1 (PAD1). After detailed clinical evaluation, whole blood samples were collected from patients, parents and available healthy siblings. Genomic DNA was extracted from all the blood samples, and using a specific primer all the coding ITGB2 gene exons were PCR amplified. RESULTS: The amplified products were sanger sequenced. DNA sequencing analysis revealed a nonsense mutation c.186C > A, p.(Cys62*) in exon four and a missense mutation c.382G>T, p.(Asp128Tyr) in exon five of the gene. The mutation is segregating in autosomal recessive pattern in the family. CONCLUSION: Recurrent mutations on a specific locus (gene) changes the allele frequency from a healthy allele to a disease allele and hence play role in new genotype. This research study demonstrates the allelic heterogeneity of the ITGB2 gene in Pakistani patients diagnosed with LAD1. The research findings in the present study suggest that every population should develop national registry of patients suffering from primary immune deficiencies and a mutation database for rare genetic disorders. This will facilitate early diagnosis and genetic counseling to the patient family.
BACKGROUND & OBJECTIVE: Nonverbal communication has been overlooked in medical education. The purpose of this study was to explore student-teacher perceptions regarding impact of nonverbal behavior of medical educators on educational environment. METHODOLOGY: A qualitative exploratory study was conducted among purposively chosen final year students (n=150) and medical teachers (n=73) from three dental colleges of Islamabad. A web-based survey concerning three domains of kinesics (Facial expressions, Gestures, Head movement and postures) was developed and validated before execution. Comparison of participant’s responses to closed-ended questions was done by applying Fisher’s Exact Test and open-ended questions were thematically analyzed. RESULTS: Response rate of students and teachers was 46% and 63% respectively. Five out of nine closed-ended questions gave statistically significant difference among student’s and teacher’s responses (p≤0.05). Twenty-seven subthemes emerged from three domains of kinesics. Students revealed that happy mood of their teachers reduces boredom in the classroom and a teacher’s smile lets them freely express anything, whereas anger produces fear among them. According to the educators a happy instructor inspires students to study and makes the environment friendly and an undemanding smile helps build a rapport with students. Moreover, positive gestures used by teachers encourage students to clarify concepts and upright posture brings energy and motivation to the classroom. CONCLUSION: A teacher’s nonverbal behavior has a profound effect on educational environment. A smile on a teacher’s face creates a friendly and fearless environment whereas anger creates barriers to communication. A happy teacher can generate a pleasant and motivating learning environment.
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