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Article ; Online: The influence of intraoperative rectal washout on local recurrence of colorectal cancer following curative resection: a systematic review and meta-analysis.

Solomon, Josh / Majeed, Talal / Magee, Conor / Wilson, Jeremy

International journal of colorectal disease

2022 Volume 37, Issue 2, Page(s) 403–409

Abstract: Purpose: To determine the effectiveness of rectal washout in preventing local recurrence of distal colorectal cancer following curative resection.: Methods: A systematic review and meta-analysis was performed after a literature search was conducted ... ...

Abstract	Purpose: To determine the effectiveness of rectal washout in preventing local recurrence of distal colorectal cancer following curative resection. Methods: A systematic review and meta-analysis was performed after a literature search was conducted on MEDLINE, EMBASE, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, and the ISRCTN registry. The study was reported using PRISMA guidelines. The primary endpoint was incidence of local recurrence of cancer after distal colonic and rectal cancer surgery. Results: After screening, 8 studies with a total sample size of 6739 patients were identified. At 5-year follow-up, local recurrence in the washout group (WO) was 6.08% compared to 9.48% in the no-washout group (NWO) group (OR 0.63, 95% CI = 0.51-0.78, Chi Conclusion: It is safe to recommend the use of rectal washout for left sided and rectal tumour resections. It is a simple and safe step during colorectal surgery that appears to improve long-term oncological outcomes and was not reported to be associated with any complications.
MeSH term(s)	Digestive System Surgical Procedures ; Humans ; Neoplasm Recurrence, Local/prevention & control ; Randomized Controlled Trials as Topic ; Rectal Neoplasms/surgery ; Rectum/surgery ; Therapeutic Irrigation
Language	English
Publishing date	2022-01-11
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-021-04071-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A quantitative study of test anxiety and its influencing factors among medical and dental students.

Nazir, Muhammad A / Izhar, Faisal / Talal, Ahmad / Sohail, Zaid B / Majeed, Abdul / Almas, Khalid

Journal of Taibah University Medical Sciences

2021 Volume 16, Issue 2, Page(s) 253–259

Abstract: Objective: The study was conducted to assess test anxiety and its influencing factors on medical and dental students.: Methods: A cross-sectional study was conducted among students from three private and public medical and dental colleges in the ... ...

Abstract	Objective: The study was conducted to assess test anxiety and its influencing factors on medical and dental students. Methods: A cross-sectional study was conducted among students from three private and public medical and dental colleges in the Punjab province of Pakistan. The survey included statements about the demographic profile of the study participants and used the Test Anxiety Inventory (TAI) by Spielberger. Results: The study included 680 students with a mean age of 20.93 ± 1.76 years. About half the sample (51.8%) scored high on test anxiety (TAI score > 45), and the mean TAI score was slightly higher for the dental (47.75 ± 11.45) than medical students (46.42 ± 12.79). Female students had a significantly higher mean TAI score (48.45 ± 12.79) than male students (41.85 ± 8.91; Conclusion: In our study cohort, test anxiety was common among medical and dental students. A female gender, being a student from a private college, and having a mother with a high education were significantly associated with high test anxiety. The study findings may guide the development of programs that can reduce students' test anxiety and potentially improve their education.
Language	English
Publishing date	2021-01-18
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	2817396-X
ISSN	1658-3612 ; 1658-3612
ISSN (online)	1658-3612
ISSN	1658-3612
DOI	10.1016/j.jtumed.2020.12.014
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Non-anaemic iron deficiency should be investigated with the same priority as iron deficiency anaemia in fast track colorectal clinics-retrospective cohort study.

Majeed, Talal / Solomon, Joshua / Ali, Romassa Siddiq / Chitsabesan, Praminthra

Journal of gastrointestinal oncology

2020 Volume 11, Issue 4, Page(s) 609–615

Abstract: Background: Since year 2000 the diagnostic criterion for fast track (FT) referrals for patients with suspected colorectal cancer (CRC) is used in the UK. Iron deficiency anaemia (IDA) is one of the diagnostic criteria. There is a strong evidence in the ... ...

Abstract	Background: Since year 2000 the diagnostic criterion for fast track (FT) referrals for patients with suspected colorectal cancer (CRC) is used in the UK. Iron deficiency anaemia (IDA) is one of the diagnostic criteria. There is a strong evidence in the literature which suggests that Iron deficiency (ID) alone has a strong relationship with CRC. Non-anaemic Iron deficiency (NAID) and all other types of anaemia are investigated outside the scope of FT clinics. We postulated that patients with ID regardless of degree of anaemia have an increased risk of CRC. By confirming this hypothesis, we can broaden the scope of the diagnostic criterion for referral that can help to increase diagnostic yield of FT CRC services. Methods: A retrospective observational cohort study was conducted from a dedicated data for FT clinics from 2016-2018. Association between CRC and different forms of anaemia, Iron deficiency alone and bowel symptoms was determined. Results: Patients with iron deficiency (low MCV, MCH and ferritin) regardless of degree of anaemia were found more likely to have CRC. Factors like age, gender, family history and bowel symptoms (except abdominal mass) showed a very weak association with CRC in patients with ID. Conclusions: ID without anaemia has a strong relationship with CRC and should be investigated with the same priority as IDA is investigated.
Language	English
Publishing date	2020-09-09
Publishing country	China
Document type	Journal Article
ZDB-ID	2594644-4
ISSN	2219-679X ; 2078-6891
ISSN (online)	2219-679X
ISSN	2078-6891
DOI	10.21037/jgo-19-451
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Elective list cancellations and its financial ramifications.

Arshad, Mohammed Shoaib / Majeed, Talal / Shah, Numan / Hassan, Sami / Shah, Sanat

Journal of perioperative practice

2018 Volume 29, Issue 1-2, Page(s) 24–26

MeSH term(s)	Budgets ; Elective Surgical Procedures/economics ; Humans ; Retrospective Studies ; State Medicine/economics ; United Kingdom
Language	English
Publishing date	2018-06-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2226186-2
ISSN	1750-4589
ISSN	1750-4589
DOI	10.1177/1750458918780114
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Article: A case of isolated sinus bradycardia as an unusual presentation of adrenal insufficiency.

Reyes, Jonathan Vincent M / Majeed, Hafsa / Song, David / Ahmad, Saad / Bray, Ashley / Almas, Talal / Alshamlan, Abdulaziz / Lieber, Joseph J

Annals of medicine and surgery (2012)

2021 Volume 69, Page(s) 102727

Abstract: Introduction: Sinus bradycardia is a common entity encountered in clinical practice. The differential diagnosis is quite broad; it can be an incidental finding in otherwise healthy adults or the first clue to a lethal pathology.: Case presentation: ... ...

Abstract	Introduction: Sinus bradycardia is a common entity encountered in clinical practice. The differential diagnosis is quite broad; it can be an incidental finding in otherwise healthy adults or the first clue to a lethal pathology. Case presentation: This case highlights a patient who presented with symptomatic sinus bradycardia, which resulted in syncope requiring admission for permanent pacemaker implantation and later found to have an underlying adrenal insufficiency (AI). Patient's underlying hyponatremia was corrected but bradycardia persisted and after the initiation of steroids, bradycardia resolved. Therefore, the likely culprit for bradycardia was AI. Discussion: Multiple disease processes that manifest with sinus bradycardia are commonly due to the increased vagal tone or the presence of intrinsic conduction disorders. Sinus bradycardia is a common clinical finding with a broad differential including intrinsic and extrinsic causes of sinus node dysfunction or AV block. Conclusion: It is imperative for clinicians to be aware of rare etiologies for underlying symptomatic bradycardia. While extremely effective at preventing symptomatic bradycardia, avoiding a pacemaker by correcting the underlying etiology of symptomatic bradycardia may improve quality of life and avoid an unnecessary procedure.
Language	English
Publishing date	2021-08-16
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2021.102727
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Article ; Online: A quantitative study of test anxiety and its influencing factors among medical and dental students

Muhammad A. Nazir, MPH / Faisal Izhar, MPhil / Ahmad Talal, PhD / Zaid B. Sohail, BDS / Abdul Majeed, PhD / Khalid Almas, FDSRCS

Journal of Taibah University Medical Sciences, Vol 16, Iss 2, Pp 253-

2021 Volume 259

Abstract: الملخص: أهداف البحث: أجريت هذه الدراسة لتقييم قلق الإختبار وعوامله المؤثرة على طلاب الطب وطب الأسنان. طرق البحث: أجريت هذه الدراسة المقطعية المستعرضة بين الطلاب من ثلاث كليات للطب وطب الأسنان خاصة وعامة في إقليم البنجاب في الباكستان. شمل الاستطلاع بيانات ...

Abstract	الملخص: أهداف البحث: أجريت هذه الدراسة لتقييم قلق الإختبار وعوامله المؤثرة على طلاب الطب وطب الأسنان. طرق البحث: أجريت هذه الدراسة المقطعية المستعرضة بين الطلاب من ثلاث كليات للطب وطب الأسنان خاصة وعامة في إقليم البنجاب في الباكستان. شمل الاستطلاع بيانات عن الملف الديموغرافي للمشاركين في الدراسة باستخدام مخزون قلق الاختبار بواسطة سبيلبرجر. النتائج: شملت الدراسة ٦٨٠ طالبا مع متوسط ٢٠.٩٣±١.٧٦عاما. سجل تقريبا نصف العينة (٥١.٨٪) درجة عالية في قلق الاختبار (مخزون قلق الاختبار <٤٥)، وكان متوسط درجة مخزون قلق الاختبار أعلى قليلا عند طلاب الأسنان (٤٧.٧٥±١١.٤٥) عن طلاب الطب (٤٦.٤٢±١٢.٧٩). حصلت الطالبات درجة أعلى بكثير في متوسط درجة مخزون قلق الاختبار (٤٨.٤٥±١٢.٧٩) من الطلاب (٤١.٨٥±٨.٩١). أظهر الطلاب من الكليات الخاصة أعلى درجة من قلق الاختبار (٥٠.١٥±١٣.٢٣) عن الطلاب في الكليات العامة (٤٢.٨٨±٩.٧). وأظهر الطلاب الذين تخرج والديهم من كلية أو جامعة زيادة قلق الاختبار بشكل ملحوظ عن الطلاب الذين لم يحصل والديهم على تعليم. الجنس الأنثوي (النسبة الفردية المعدلة ٢.١٠، ٩٥٪ فاصل الثقة: ١.٣٧، ٣.٢٢)، طالب الكلية الخاصة (النسبة الفردية المعدلة ٢.٨٨، ٩٥٪ فاصل الثقة: ١.٩٠، ٤.٣٨) وكان حصول الأم على تعليم في الكلية أو جامعي مرتبطا بأعلى قلق الاختبار (النسبة الفردية المعدلة ٢.٠٥، ٩٥٪ فاصل الثقة: ١.٢٥، ٣.٣٥). الاستنتاجات: في مجموعة دراستنا، كان قلق الاختبار شائعا بين طلاب الطب وطب الأسنان. وكان الجنس الأنثوي، الطلاب من الكلية الخاصة، والتعليم العالي للأمهات مرتبط بشكل كبير بقلق شديد من الاختبار. يمكن لنتائج هذه الدراسة أن ترشد تطوير برنامج يمكن أن يقلل من قلق الاختبار لدى الطلاب ويحتمل أن يحسن تعليمهم. Abstract: Objective: The study was conducted to assess test anxiety and its influencing factors on medical and dental students. Methods: A cross-sectional study was conducted among students from three private and public medical and dental colleges in the Punjab province of Pakistan. The survey included statements about the demographic profile of the study participants and used the Test Anxiety Inventory (TAI) by Spielberger. Results: The study included 680 students with a mean age of 20.93 ± 1.76 years. About half the sample (51.8%) scored ...
Keywords	Academic score ; Exam anxiety ; Gender ; Parental education ; Students ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The Role of the Computed Tomography (CT) Thorax in the Diagnosis of COVID-19 for Patients Presenting with Acute Surgical Emergencies. A Single Institute Experience.

Majeed, Talal / Ali, Romassa Siddiq / Solomon, Joshua / Mesri, Mina / Sharma, Shiv / Shamim, Sarah / Aiynattu, Sony / Ishak, Rafik / Wilson, Jeremy / Magee, Conor

The Indian journal of surgery

2020 Volume 82, Issue 6, Page(s) 1005–1010

Abstract: The current Coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on emergency surgical services in the UK. The Royal College of Surgeons (RCS) published guidelines about COVID-19 pandemic in March, 2020 to aid decision making for the ... ...

Abstract	The current Coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on emergency surgical services in the UK. The Royal College of Surgeons (RCS) published guidelines about COVID-19 pandemic in March, 2020 to aid decision making for the surgeons. These guidelines recommended that all patients requiring urgent surgery should have reverse transcriptase polymerase chain reaction (RT-PCR) and/or computed tomography (CT) thorax pre-operatively. However, it is currently unclear whether the use of CT thorax is a sensitive and specific diagnostic test. The objective of this study was to find out whether CT thorax is a reliable and accurate test in the diagnosis of COVID-19 compared to RT-PCR. This is particularly important in surgical patients where there is no time to wait for RT-PCR results. A prospective cohort study of patients presented with acute surgical emergencies at a University Teaching Hospital was conducted. Data was collected from March 23, to May 15, 2020, during the peak of the crisis in the UK. All adult patients presented with operable general surgical emergencies were considered eligible. Another group of patients, admitted with acute medical emergencies but with suspected COVID-19 infection, was used for comparison. Data was manually collected, and sensitivity, specificity and predictive value were calculated using the MedCalc statistical software version 19.2.6. Standard reporting for COVID-19 infection for CT chest based on guidelines from British Society of Thoracic Imaging (BSTI) and Radiological Society of North America (RSNA) was used. Patients who had their CT thorax reported as typical or classic of COVID 19 (high probability) were treated as infected cases with extra precautions in the wards and surgical theatres as suggested by health and safety executive (HSE). These patients had serial RT-PCR during their admissions or in the post-operative phase, if the first swab was negative. For the study, 259 patients were considered eligible for inclusion from both groups. Patients admitted for acute surgical emergencies were treated according to RCS guidelines and subjected to RT-PCR test and/or CT scan of the thorax. There were 207 patients with high clinical suspicion of COVID-19. Of those 207 patients, 77 patients had CT thorax with radiographic features consistent with COVID-19 pneumonia. However, only 40 patients had a positive RT-PCR result. CT thorax was normal in 130 patients, out of which 29 patients were found to have COVID-19 diagnosis after swab test. Sensitivity of CT scan to diagnose COVID-19 infection was found to be 58% (95% CI; 45.48% to 69.76%) whilst specificity was 73% (95% CI; 64.99% to 80.37%) with a negative predictive value of 77.69% (95% CI; 72.17% to 82.39%). CT scan was found to be a reliable tool in the diagnosis of COVID-19. With a negative predictive value of up to 82.4%, CT thorax can play an important role to help surgeons in their decision making for asymptomatic suspected cases of COVID-19. However, over-reliance on CT scan which also has a high false positive rate for diagnosis of COVID-19 infections can lead to overtreatment, overuse of resources and delays in decision-making process. Hence, results should be interpreted with caution and correlated with clinical presentation and swab test results.
Keywords	covid19
Language	English
Publishing date	2020-10-20
Publishing country	India
Document type	Journal Article
ZDB-ID	138063-1
ISSN	0972-2068 ; 0019-5650
ISSN	0972-2068 ; 0019-5650
DOI	10.1007/s12262-020-02626-9
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Article ; Online: Hand hygiene perception and handshaking practices among pediatric inpatient caregivers

Mohamad-Hani Temsah / Fahad M Alsohaime / Ayman Al-Eyadhy / Gamal Hasan / Abdulrahman Alarfaj / Hazim Bajri / Talal Al-Judi / Gosay Al-Mazyad / Abdulrahman Al-Shammari / Majeed Jawad / Mark S Sklansky / Sarah Al-Subaie / Ali Mohammed Somily

Journal of Nature and Science of Medicine, Vol 4, Iss 2, Pp 130-

A cross-sectional study at a teaching hospital in Saudi Arabia

2021 Volume 134

Abstract: Background: Direct or indirect hand contact plays a significant role in health-care-associated infections. Family members of pediatric patients may have various hand hygiene practices. We aimed to evaluate the perceptions of hand hygiene and handshaking ... ...

Abstract	Background: Direct or indirect hand contact plays a significant role in health-care-associated infections. Family members of pediatric patients may have various hand hygiene practices. We aimed to evaluate the perceptions of hand hygiene and handshaking practices among family caregivers of hospitalized children in a tertiary care hospital. Methods: A cross-sectional study was conducted using a pretested two-part questionnaire for a randomly selected caregiver of hospitalized children at King Khalid University Hospital, Riyadh, Saudi Arabia, between January 21 and March 8, 2018. The survey data were analyzed using SPSS version 21. Results: One hundred and eighty caregivers voluntarily participated in the study. The mean age was 35.1 years, and female parents comprised 85.6% of the sample. The majority of participants (82.8%) did not receive any previous formal education on hand hygiene. Most of the participants (relative importance index of 84.6%) had correct answers on a modified version of the World Health Organization “Perception Survey for Health-Care Workers.” However, handshaking avoidance was low in general, with caregivers reporting their handshaking practices did not change even when dealing with people who have flu-like symptoms. There was no significant correlation between the participants' characteristics and handshaking avoidance practice, except for those who were working in the medical field, who showed a significantly higher handshaking avoidance. Conclusion: Formal education for hospitalized children's caregivers on hand hygiene and handshaking practice is lacking. Information on appropriate hand hygiene and potential risks of infection spread is required, especially for those parents without a previous medical background.
Keywords	hand hygiene ; handshaking ; parents ; pediatric inpatient ; Medicine ; R ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The Role of the Computed Tomography (CT) Thorax in the Diagnosis of COVID-19 for Patients Presenting with Acute Surgical Emergencies. A Single Institute Experience

Majeed, Talal / Ali, Romassa Siddiq / Solomon, Joshua / Mesri, Mina / Sharma, Shiv / Shamim, Sarah / Aiynattu, Sony / Ishak, Rafik / Wilson, Jeremy / Magee, Conor

Indian J Surg

Abstract	The current Coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on emergency surgical services in the UK. The Royal College of Surgeons (RCS) published guidelines about COVID-19 pandemic in March, 2020 to aid decision making for the surgeons. These guidelines recommended that all patients requiring urgent surgery should have reverse transcriptase polymerase chain reaction (RT-PCR) and/or computed tomography (CT) thorax pre-operatively. However, it is currently unclear whether the use of CT thorax is a sensitive and specific diagnostic test. The objective of this study was to find out whether CT thorax is a reliable and accurate test in the diagnosis of COVID-19 compared to RT-PCR. This is particularly important in surgical patients where there is no time to wait for RT-PCR results. A prospective cohort study of patients presented with acute surgical emergencies at a University Teaching Hospital was conducted. Data was collected from March 23, to May 15, 2020, during the peak of the crisis in the UK. All adult patients presented with operable general surgical emergencies were considered eligible. Another group of patients, admitted with acute medical emergencies but with suspected COVID-19 infection, was used for comparison. Data was manually collected, and sensitivity, specificity and predictive value were calculated using the MedCalc statistical software version 19.2.6. Standard reporting for COVID-19 infection for CT chest based on guidelines from British Society of Thoracic Imaging (BSTI) and Radiological Society of North America (RSNA) was used. Patients who had their CT thorax reported as typical or classic of COVID 19 (high probability) were treated as infected cases with extra precautions in the wards and surgical theatres as suggested by health and safety executive (HSE). These patients had serial RT-PCR during their admissions or in the post-operative phase, if the first swab was negative. For the study, 259 patients were considered eligible for inclusion from both groups. Patients admitted for acute surgical emergencies were treated according to RCS guidelines and subjected to RT-PCR test and/or CT scan of the thorax. There were 207 patients with high clinical suspicion of COVID-19. Of those 207 patients, 77 patients had CT thorax with radiographic features consistent with COVID-19 pneumonia. However, only 40 patients had a positive RT-PCR result. CT thorax was normal in 130 patients, out of which 29 patients were found to have COVID-19 diagnosis after swab test. Sensitivity of CT scan to diagnose COVID-19 infection was found to be 58% (95% CI; 45.48% to 69.76%) whilst specificity was 73% (95% CI; 64.99% to 80.37%) with a negative predictive value of 77.69% (95% CI; 72.17% to 82.39%). CT scan was found to be a reliable tool in the diagnosis of COVID-19. With a negative predictive value of up to 82.4%, CT thorax can play an important role to help surgeons in their decision making for asymptomatic suspected cases of COVID-19. However, over-reliance on CT scan which also has a high false positive rate for diagnosis of COVID-19 infections can lead to overtreatment, overuse of resources and delays in decision-making process. Hence, results should be interpreted with caution and correlated with clinical presentation and swab test results.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #888301
Database	COVID19

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Article ; Online: Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

McManus, I C / Harborne, Andrew Christopher / Horsfall, Hugo Layard / Joseph, Tobin / Smith, Daniel T / Marshall-Andon, Tess / Samuels, Ryan / Kearsley, Joshua William / Abbas, Nadine / Baig, Hassan / Beecham, Joseph / Benons, Natasha / Caird, Charlie / Clark, Ryan / Cope, Thomas / Coultas, James / Debenham, Luke / Douglas, Sarah / Eldridge, Jack /

Hughes-Gooding, Thomas / Jakubowska, Agnieszka / Jones, Oliver / Lancaster, Eve / MacMillan, Calum / McAllister, Ross / Merzougui, Wassim / Phillips, Ben / Phillips, Simon / Risk, Omar / Sage, Adam / Sooltangos, Aisha / Spencer, Robert / Tajbakhsh, Roxanne / Adesalu, Oluseyi / Aganin, Ivan / Ahmed, Ammar / Aiken, Katherine / Akeredolu, Alimatu-Sadia / Alam, Ibrahim / Ali, Aamna / Anderson, Richard / Ang, Jia Jun / Anis, Fady Sameh / Aojula, Sonam / Arthur, Catherine / Ashby, Alena / Ashraf, Ahmed / Aspinall, Emma / Awad, Mark / Yahaya, Abdul-Muiz Azri / Badhrinarayanan, Shreya / Bandyopadhyay, Soham / Barnes, Sam / Bassey-Duke, Daisy / Boreham, Charlotte / Braine, Rebecca / Brandreth, Joseph / Carrington, Zoe / Cashin, Zoe / Chatterjee, Shaunak / Chawla, Mehar / Chean, Chung Shen / Clements, Chris / Clough, Richard / Coulthurst, Jessica / Curry, Liam / Daniels, Vinnie Christine / Davies, Simon / Davis, Rebecca / De Waal, Hanelie / Desai, Nasreen / Douglas, Hannah / Druce, James / Ejamike, Lady-Namera / Esere, Meron / Eyre, Alex / Fazmin, Ibrahim Talal / Fitzgerald-Smith, Sophia / Ford, Verity / Freeston, Sarah / Garnett, Katherine / General, Whitney / Gilbert, Helen / Gowie, Zein / Grafton-Clarke, Ciaran / Gudka, Keshni / Gumber, Leher / Gupta, Rishi / Harlow, Chris / Harrington, Amy / Heaney, Adele / Ho, Wing Hang Serene / Holloway, Lucy / Hood, Christina / Houghton, Eleanor / Houshangi, Saba / Howard, Emma / Human, Benjamin / Hunter, Harriet / Hussain, Ifrah / Hussain, Sami / Jackson-Taylor, Richard Thomas / Jacob-Ramsdale, Bronwen / Janjuha, Ryan / Jawad, Saleh / Jelani, Muzzamil / Johnston, David / Jones, Mike / Kalidindi, Sadhana / Kalsi, Savraj / Kalyanasundaram, Asanish / Kane, Anna / Kaur, Sahaj / Al-Othman, Othman Khaled / Khan, Qaisar / Khullar, Sajan / Kirkland, Priscilla / Lawrence-Smith, Hannah / Leeson, Charlotte / Lenaerts, Julius Elisabeth Richard / Long, Kerry / Lubbock, Simon / Burrell, Jamie Mac Donald / Maguire, Rachel / Mahendran, Praveen / Majeed, Saad / Malhotra, Prabhjot Singh / Mandagere, Vinay / Mantelakis, Angelos / McGovern, Sophie / Mosuro, Anjola / Moxley, Adam / Mustoe, Sophie / Myers, Sam / Nadeem, Kiran / Nasseri, Reza / Newman, Tom / Nzewi, Richard / Ogborne, Rosalie / Omatseye, Joyce / Paddock, Sophie / Parkin, James / Patel, Mohit / Pawar, Sohini / Pearce, Stuart / Penrice, Samuel / Purdy, Julian / Ramjan, Raisa / Randhawa, Ratan / Rasul, Usman / Raymond-Taggert, Elliot / Razey, Rebecca / Razzaghi, Carmel / Reel, Eimear / Revell, Elliot John / Rigbye, Joanna / Rotimi, Oloruntobi / Said, Abdelrahman / Sanders, Emma / Sangal, Pranoy / Grandal, Nora Sangvik / Shah, Aadam / Shah, Rahul Atul / Shotton, Oliver / Sims, Daniel / Smart, Katie / Smith, Martha Amy / Smith, Nick / Sopian, Aninditya Salma / South, Matthew / Speller, Jessica / Syer, Tom J / Ta, Ngan Hong / Tadross, Daniel / Thompson, Benjamin / Trevett, Jess / Tyler, Matthew / Ullah, Roshan / Utukuri, Mrudula / Vadera, Shree / Van Den Tooren, Harriet / Venturini, Sara / Vijayakumar, Aradhya / Vine, Melanie / Wellbelove, Zoe / Wittner, Liora / Yong, Geoffrey Hong Kiat / Ziyada, Farris / Devine, Oliver Patrick

BMC medicine

2020 Volume 18, Issue 1, Page(s) 136

Abstract: Background: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of ...

Abstract	Background: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. Method: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. Results: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. Conclusions: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.
MeSH term(s)	Female ; Humans ; Male ; Schools, Medical/standards ; Students, Medical/statistics & numerical data ; United Kingdom
Language	English
Publishing date	2020-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-020-01572-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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