Health Sciences Education

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    Exploring the Pattern of Social Media Usage by Medical Students in School of Medicine, College of Health Sciences, Addis Ababa University
    (Addis Ababa University, 2019-05) Lako Wajana; Prof.Mekasha Amha; Kulasegaram Kulamakan(Dr)
    Even though millions of the younger generations are using social media (SM) for various purposes in Ethiopia, there is no clear study showing how the trends and patterns of SM usage look like in this group of people, particularly in medical schools. Therefore, the global objective of the current study was to explore the pattern of usage of SM by medical students in school of medicine, College of Health Sciences, AddisAbaba University. A descriptive cross-sectional quantitative study was conducted on four cohorts (Year II, Year III, Year IV and Year V)of study subjects. Simple random sampling technique was applied to determine the proposed sample size. Totally, 132 students were recruited from each cohort; thus a total of 528 students were included in the study. Using pre-tested anonymous questionnaire, information was collected on sociode mographics, the extent of using the SM, the type of SM used, average time spent on them, the purpose why the students use SM, the influence of these media onsocial interaction of students and students opinions regarding the effect of SM on their grades and academic performance. The questionnaire was tabulated and data was analyzed by using descriptive, inferential and quantitative analytical techniques with estimations from the Statistical Package for Social Sciences (SPSS). A correlation of the variables was determined and X2 was used to compare the relationship of the variables. p<0.05 was considered statistically significant. There were 38.1% (N=201) females and 61.9% (N=327) males included in this study. Almost all students, irrespective of background were active users of SM (99.6%,N=526). Facebook was the dominant SM used by students before joining medical school (82%, N=433), followed by You Tube and Whatsapp. The number of Facebook users has been declined significantly from 82% to 47% after joining medical school. The dominancy of Facebook was over taken by Telegram after joining medical school. The use of Telegram has significantly increased from 18% (N=495) to (82%, N=433) after joining medical school. The proportions of You Tube users has increased significantly from 31% (N=165) to 52% (N=275) after joining medical school. We show for the first time that majority (70%, N=379) of medical students were distracted by SM while preparing for exam and doing their assignments. The distraction of medical students by SM while studying for examination and preparing assignments is significantly higher in males than females. The implications of this finding is triplicate: 1) The need for orientation for medical students at the beginning of the first year, 2) Continuous and intimate follow up is needed by family, Deans and advisers, 3) Special policy is also needed concerning the use of SM by medical students. Continuous personal development trainings might be important to clear out the confusion of medical students about the impact of SM.
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    The Learning and Practice of Surgical Residents on Whole Person Care: The Issue of Counseling.
    (Addis Ababa University, 2016) Deneke Andualem; Kuper Ayelet
    Studies have shown that the perceived cleanliness of hospitals, the perceived empathy, experience and ability of health care workers, consultation duration, as well as educational status and occupation of patients are unique determinants of patient satisfaction in health institutions in Ethiopia1,2However, a study at Tikur Anbessa Specialized hospital identified a significant deficiency of communication skills among all categories of physicians in the hospital.
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    Inter-Professional Education: a Qualitative Descriptive Study Exploring Inter-Professional Learning Experience of Clinical Psychology and Psychiatry Residence Students in their Training AAU, Department of Health Education.
    (Addis Ababa University, 2020-06) Tibebu Getahun; Mekasha Amha (Prof); Brydges Ryan(PhD); Kalocsai Csilla(PhD)
    Objective: To explore the inter-professional learning experience of clinical psychology and psychiatry residency students. Design: Qualitative study Setting: This study was conducted in Addis Ababa University, at the School of Medicine, in the College of Health Science, Department of Psychiatry where both clinical psychology and Psychiatry Residence programs are provided. The study was conducted from Sept -April, 2020. Participants: Purposefully sampled 9 participants; 5 clinical psychology and 4 psychiatry residents’ inter professional learning experiences were explored. Methods: A descriptive qualitative study using thematic analysis was conducted. Data was obtained with semi-structured interviews and analyzed thematically. Data collection and analysis was concurrent. Result: Three themes and five sub-themes emerged from the data describing the experiences of clinical psychology and psychiatry students. The themes were: (a) IPE experience, (b) Factors affecting active participation (c)Professional identity and IPE experience. Conclusion: IPE experiences were various and resulted from an interaction of many factors. Despite the limitations, IPE experience provides many opportunities compared to Uni-professional learning experience. Inequality in professional status between participants negatively affects IPE experience. Learning experience require a balanced two-way interactive learning between participants. In the initial phase of IPE participants need a clear role assignment with a formal objective to avoid confusion and frustration. Participating in IPE is not an easy performance - the experience opens many opportunities as well as has many challenges.Finally, if implemented with a clear role assignment, significant supervision, and for an optimal duration of time IPE experience can help participants to develop their own profession and guide them in their future work with other professionals.
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    The Lived Experience of Mistreatment Among Medical Students the Case of St.Pauls’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2020-07) Yeshitila Tsedey; Bahretibeb Yonas(Dr); Soklaridis Sophie(Dr); Islam Faisal(Dr)
    Mistreatment of medical students has long been a challenge in medical schools of various countries. However, studies assessing the prevalence and its effects on students' perceptions of their professional development are scant in Ethiopia. Thus, this study is an attempt to contribute empirical evidence to fill this gap. Specifically, the paper probes the prevalence of exposure to mistreatment among intern medical students at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia. Both quantitative and qualitative data were collected from primary and secondary source. The data collected were analyzed and discussed using several descriptive statistics. The survey result revealed the presence of different types of mistreatment, which fairly varies between male and female students. The most important ones were yelling or shouting that is offensive, harsh, or insulting speech on both male and female students and some sort of sexual harassment in only female students. Threat to unfair grade and giving some kind of negative or disparaging remarks are also types of mistreatments (closer to often) perceived and reported by students. The paper also find evidence that nurses and residents were most important source of mistreatment in the learning environment. However, the reasons for such unprofessional conducts were not very clear to most of them. The perceived effect of one or more types of mistreatments were also analyzed and the result shows that medical students who experience mistreatment are found to have hurtful outcomes on their emotional security and professional attitudes. Specifically, many students indicated to sometimes feel a sense of regret in choice of career or lack of satisfaction their educational experience, hating the health environment and depression and low self-confidence. Such feelings of distress during intern status of studies could exacerbate the compromising quality of potential physicians and health care system. Qualitative analysis of data was also highly consistent with the above findings and used for triangulation purpose. The study concludes by highlighting some short- and long-term recommendations that can help the school develop policies and eradicate the widespread and complex mistreatment phenomenon.
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    Nursing Specialty Students and Educators Perception and Experience of Simulation Based Learning at SPHMMC :a Qualitative study.
    (Addis Ababa University, 2020-07) Adem Seada; Awoke Damte(MSc); Braydge Ryan(Prof); Chapman Leigh(PHD)
    Background: using simulation-based learning for nursing is a safe environment for students to have good skills and knowledge translation from theoretical to practical. Objective: to explore the perceptions and experiences of nursing specialty students and educators of simulation-based learning. Methodology: Because of the goal of this study need detail information about their perceptions and experience, qualitative approach was applied by using tow focus group discussions with the students and three interviews with educators. Result: Almost all participants have positive perception about SBL as it helps the students to have skill for different procedure and manipulating some medical equipment‟s and machine, build confidence and to become competent before they go to real clinical area. But they don‟t have a chance to use this method properly because of less attention given by the administration, (organizational and department), poor time management from the department as well as educators. Less use of the strategy (SBL) because of shortage of materials.
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    Medical Teachers’ and Undergraduate Medical Students’ Perceptions of Role Models in Medical Education
    (Addis Ababa University, 2020-07) Engida Fasikawit; Mekasha Amha(Prof); Dempster Laura(Dr); Paul Robert(Dr)
    This paper focuses on role model and role modeling impact on undergraduate medical students and medical teachers encountered in the School of Medicine, College of Health Sciences at Addis Ababa University. To become successful in their education path and future endeavors, academic members have to proceed with extensive phases with several potential role models. Students and teachers agreed on the lack of a positive influence in terms of integrity, respect, and motivation. The paper analyzes a highly unpopular topic that silently affected the academic member morale and efficiency. It incorporated different hypotheses toward role-modeling assessed from the formal and informal study. The study identified two-perception phases: teachers, and students; with a precise analogy of positive modeling, negative modeling, and role modeling. Based on the causes and effects emphasized in the paper, the appointed problems were not adequately addressed earlier. The difficulties might continue and harm the audacity of the students and teachers to join the medical school when the country's demand rises.
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    Undergraduate Medical Radiologic Technology Students’ Perceptions of the Factors Influencing their Academic Performance
    (Addis Ababa University, 2020-07) Beyene Ali; Leslie Karen(Dr); Bahretibeb Yonas(Dr); Soklaridis Sophie(Dr)
    Background: Higher education institutions, including medical schools, still grapple with the challenge of poor academic performance of students. However, limited detailed insights and understanding of the factors contributing to academic performance of medical students who experience challenges that are more complex are available. Objective: The study aims to identify the factors that students perceive to affect their academic performance in undergraduate studies.Identification of the factors associated with poor academic performance and their root causes can help in improvement of students learning by suggesting remediation, appraisal and support mechanism to the concerning stakeholders within the educational institution. Methods: This study was conducted at college of health sciences, Addis Ababa University,Ethiopia to determine Undergraduate Medical Radiologic Technology students’ perceptions of the factors influencing their academic performance. Semi-structured interview was conducted with undergraduate final year MRT students. The Interviews were recorded and transcribed verbatim. Results were categorized and analyzed by thematic content analysis methods. Results: Different factors affecting academic performance of the students were identified: factors related to unsuitable college environment, factors related to inadequate campus facilities, factors related to poor school management systems, factors related to teachers and individual students. The root causes contributing to the students’ academic performance were lack of interest on the department,fear of future career development and lack of strict follow up of the students. Inadequate facilities such as lack of transportations, library, demonstration and skill lab., and classrooms were directly related to academic performance of the students. Lack of student’s supervision is the most common factor affecting performance at clinical learning areas. Conclusion: collection of factors related to the college environment and facilities, factors related to poor management of the students by the school, factors related to teacher and the students themselves were the determinant factors influencing academic performance of the students. Identification of these factors is crucial in devising a proper approach for better teaching- learning activities and creating a suitable learning environment to the students.
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    Challenges of Undergraduate Pharmacy Students During their Hospital Clerkship (Attachment): Case of Selected Private Health Colleges in AA
    (Addis Ababa University, 2020-06) Bezabih, Abera; Kellar Jamie(Dr); Shimelis Damite(Dr)
    Clerkship is a clinical experience in the education of a student of the health professions in whichhe or she is introduced to the practical care of patients with particular illnesses orcharacteristics. This study aimed to assess the challenges experienced by pharmacy students as they start their clinical training in the context of private colleges in Addis Ababa. The study focused on final year undergraduate pharmacy students during their hospital clerkship(attachment) in AA. Using descriptive research method, this study identified lack of supervision,inopportune feedback and dispiriting current environment were the key challenges of final year undergraduate pharmacy students during their hospital clerkship (attachment) in private health colleges in AA. This study helps students gain familiarity with clerkship expectations and settings and it generally focus on orienting students to workplace logistics and roles and helps to enhance their clinical skills. It recommends that the necessity of careful preparation for clinical clerkship, uncertainty when starting clerkship lasted only a few days transition from pre-clinical to clinical training went smoothly and a need time to adjust to the new environment.
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    Exploring Medical Radiological Technology Students Perceptions and Preferences for Feedback at CHS, AAU.
    (Addis Ababa University, 2019-06) Shumi Natnael; Brydges Ryan; Baheretibeb Yonas(Dr)
    Background: Feedback is seen as essential component of the learning environment .It enables students to be aware of their strength and weakness and provide them with the base line for future improvements. It is considered central to the development of student learning guides them to remain on course by giving them clear picture of the goal to be reached. Despite this its implementation has the least satisfactory aspect of student experience in higher education. Purpose: To identify the students’ perceptions of valuable feedback in the medical radiologic technology department and their preferred process for receiving feedback. Method: This study has used semi-structured focus group discussions. Research participants were fourth year medical radiologic students at Addis Ababa University. The sampling method was purposeful sampling. Result: Five major themes were apparent during the discussion regarding the perceptions and preference of MRT students for feedback. Student saw feedback as suggestion for improvement. Though they have little exposure to constructive individual feedback, the student highly regard continuous constructive feedback in higher education. The students also stressed that culture and societal challenges are the major barriers of feedback being followed by academic and pedagogic background of instructors. Feedback which is dialogic, verbal, continuous, on the things which can be improved and from role model instructors is preferred by the students. Conclusion: This study has showed that medical radiologic technology students are aware of the meaning and value of feedback. But the students are concerned with the amount of feedback they are getting from their instructors. The students need continuous and constructive feedback. They preferred feedback to be given individually and orally. This study also showed that culture is the biggest barrier of constructive feedback in this context. Recommendation: to improve the feedback culture the society needs to educate. Training for both the students and faculty members is recommended.
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    Exploring the Effects of Lack of Pocket Money on Undergraduate Clinical Year Health Science Students’ Learning Activities
    (Addis Ababa University, 2019-06) Jebessa Marema; Martimianakis Tina(PhD); Paul Robert(PhD); Deneke Andualem(Prof)
    Background The expenses of the university lead to various challenges and affects students’ daily learning activities. In developing countries, higher education students face acute financial problem, which affects their daily educational activities. In Ethiopian higher educational system, students obtained the cost sharing benefits, which do not entitle them to get cash money. Health sciences students need additional costs other than common expenses in the university during clinical Therefore; lack of pocket money primarily affects students’ daily learning activities. Objectives The main objective of this research is to explore the challenges that undergraduate health science students faced due to lack of pocket money and the perceived effects of financial hardships on their learning activities during clinical years. Methods Year three and four MRT students have been selected for the study. Purposeful sampling method and snowball sampling method in getting those who are potentially in similar conditions with those who interviewed but missed during the selection of participants using the purposeful method. Accordingly, ten participants were identified and the semi-structured used to collect data. The interview took place from January 28, 2019, to February 1, 2019. Result The challenges due to acute financial hardships include difficulty in affording basic needs, unable to get into friendship, and struggling with small pocket money management. These challenges are rooted in poverty, poor parental awareness of university expenses, bad cost-sharing policy and poor management in the university. The interrelationship among these challenges and learning activities were also discussed. Lack of pocket money enforced students to stay hungry and quit studying, from coming late to the class to absent from the class, loss of attention in class, and missing clinical placement learning. Thus, there is a poor learning process and the clinical skills are not learned as expected, which directly affects students’ competencies.
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    Challenges of Clinical Learning Environment of Dental Students at Addis Ababa University, Ethiopia, 2018/19
    (Addis Ababa University, 2019-05) Assefa Lakew; Shimelis Damte(Dr); Lawrence(Dr); Rangel Cristian(Dr)
    Background: Clinical learning is one of the main teaching methods in health professions, including dental education, and it has many strengths. It is focused on real problems in the context of professional practice. Learners/students are motivated because they are involved directly and participate actively,but clinical learning can be challenging, unpredictable, stressful, and constantly changing environment. Objective: To identify the challenges, of the clinical learning environment of dental students at Addis Ababa University Dental Department, Ethiopia. Material &Methods: An institution based qualitative study was conducted from Dec.2018 to Jan. 2019. The sample was obtained by purposive sampling of 4th, 5thyear and final year dental students. Data were collected by focus group (FG). Three FG discussions were conducted. (Groups contained 4 students from each year) using a semi-structured questionnaire. One data collector was selected. The information was recorded separately and transcribed for thematic analysis. Ideas were grouped and analyzed depending on themes. Results: Six themes were derived from the data analysis, which represented the students’ clinical learning challenges. These six themes included shortage of resources and maintenance problem, non-approachable & uncooperative instructors, poor teacher student relationship, evaluation and feedback, and non-organized administrative system Conclusion: The results of this study clearly indicated presence of challenges and the most common challenges are shortages of resources (e g. dental materials and equipment’s),non-approachable and uncooperative clinical teachers and unsupportive clinical learning environment are the main challenges of clinical learning
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    Evaluation of the Clinical learning Environment of Tikur Anbessa Specialized Teaching Hospital of Addis Ababa University using the Post Graduate Hospital Health Education’s Environment Measure
    (Addis Ababa University, 2020-02) Shimelis Damte; Martimianakis Tina(Dr)
    Background The public health system in Ethiopia is the main deliverer of health services and the largest employer of physicians. The public universities are the only available training institutions for post graduate medical education and also have full authority over residents’ training. In their training years, residents have dual responsibility as students and responsible physicians. A conflict arises between these two roles as students and workers leading to dissatisfaction among the residents that could affect the quality of the services they deliver during the training or then after and the training outcomes; thus negatively affecting resident learning. Determining the work place conditions that can exacerbate tensions in navigating student and worker roles, can inform reform to improve the resident experience. Assessing the post graduate hospital education environment using the Post Graduate Hospital Education Environment survey tool identifies the weaknesses and strengths of the hospital education environment for rectifying the weaknesses and maintaining the strengths Objective: To assess the post graduate clinical education/work environment of Tikur Anbessa Specialized Teaching Hospital of Addis Ababa university using the PHEEM survey tool as seen by residents from the 4 major clinical departments (Internal medicine, Pediatrics, Surgery, Obstetrics and Gynecology) in the three domains of the Post graduate Hospital Educational Environment Measures (PHEEM); perception of role Autonomy, perception of teaching and perception of social support. Methods: This is a cross sectional study that was conducted from April 1-30, 2016. In this study we used the English version of the PHEEM tool to assess the perception of residents on the health educations learning environment. Results: Out of 363 residents 218 residents (60.06%) completed the questionnaire. There were 152 males (71.7%), and 60 females (28.3%) . Their age ranges between 20-38 years with a mean age of 26.1.There were 89 residents in year one (42%), 64 residents in year 2 (30.2%), 38 year 3 (17.9%) and 20 were in year 4 (20%) one resident didn’t mention year of residency. Twenty-two items were rated as poor with a score of less than 2. The overall score on the three domains of PHEEM was 76.8/160. This indicates plenty of problems of the clinical learning environment. There is statistically significant difference among genders, year of residency and department of residency in the perception of the learning environment (p < 0.05, p =0.002, p < 0.001) respectively. Male residents and junior residents rated the environment as more positive than females and senior residents respectively. The load of work is heavy in the order Obstetrics and Gynecology, Pediatrics, Internal Medicine and Surgery. Conclusion and recommendations: For our training program to succeed the program should be designed according to the best standards to ensure satisfaction of residents as well as clients. Improving the quality of duty rooms, more supervision during working hours, reducing the work load, providing junior doctors’ handbook etc. will improve the learning environment and facilitate learning. After remedial measures are taken we recommend a regular assessment of the clinical learning environment to determine whether the measures taken are effective.
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    Assessment of Morning Report Sessions: Experience from Department of Surgery, Addis Ababa University
    (Addis Ababa University, 2019-02) Tadesse Amezene; Mekasha Amha (MSc); Whitehead Cynthia(Dr); Paradis Elise(Dr)
    Background: The term ‘‘morning report’’ is used to describe case-based conferences where residents, attending physicians, and others meet to present and discuss clinical cases. Morning report (MR) session is one way of delivering clinical teaching. It is case based approach, designed to teach residents and medical students from the actual patients managed in a hospital. The primary goal of the morning session is improving and monitoring the patient care given by the faculty. The objective of the study is to assess the perception of general surgery residents, faculty and the medical director about morning report sessions and look for their suggestion on areas of improvement in TASH, the main teaching hospital of Ethiopia. Methodology: This study was conducted using qualitative research methodologies and thematic analysis. Focus group discussion was conducted with the residents. Semi-structured Interviews were done with selected instructors and the medical director of the hospital. Purposeful sampling of third and fourth year general surgery residents was used to recruit study participants. Selected faculty members were interviewed using a convenience sampling technique. The Medical Director of Tikur Anbessa Specialized Hospital (TASH) was also interviewed. Results: The FGD and interviews were transcribed and translated by the principal investigator.Three major themes emerged from the study. These are: 1) Importance of MR; 2) Challenges encountered and 3) Areas for improvement. Its role in teaching and learning and impact in quality of patient care were mentioned as an importance of MR. The main challenges were poor attendance, unfavorable environment, inadequate scientific discussion, failure to address logistical and administrative issues and time inconsistency. Participants also suggested three major areas for improvement. These included using resident as a moderator, digitalizing presentations, and restructuring the sessions, subspecialty unit level MR, sharing responsibility amongst the different levels of trainees, and enforcing stricter timing and duration of MR. Conclusion: MR is a vital teaching and service activity of the department. It has a role in the development of varied components of teaching and learning in the residency program including learning from cases, assessment of resident’s performance, acquiring leadership skills and enriching the communication and presentation skills of a resident. Despite all the mentioned advantages, MR is not without challenges. Poor attendance especially by faculty, inappropriate feedback, and time inconsistency are major drawbacks. The majority of the participants have suggested valuable areas of improvement to benefit maximum from MR.
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    Identifying Challenges for Faculty & non-Faculty Clinical Supervisors in Providing Effective Practical Supervision of Radiology Technology Students at CHS, AAU
    (Addis Ababa University, 2019-06) Nigussie Alemayehu; Rowland Paula (PhD); Bahire tibeb Yonas(MSc); Whitehead Cynthia(PhD)
    This study, conducted in Addis Ababa University, College of Health Sciences, Department of Medical Radiology Technology was designed to identify challenges faced by faculty and nonfaculty clinical supervisors in providing effective practical supervision of Radiology Technology students at CHS, AAU. The study aims to contribute possible recommendations and ideas for improvement of the quality of teaching at practicum sites. Qualitative research approaches were used. In this study a total 16 participants (9 Faculty supervisors and 7 Non-faculty supervisors) were selected through purposive sampling techniques and participated in the in-depth interviews. Data analysis was conducted using thematic analysis. The analysis of interview responses identified four main themes which form the focus of discussion: presence of supervisory guidelines and training, support from administrative bodies, appropriateness of clinical practical site, and commitment of clinical supervisors. The findings indicate that clinical supervision was given less attention than the theoretical academic curriculum. The outcomes of the study also draw attention to the concerned bodies on fulfillment of the necessary requirements for the faculty and non-faculty supervisors in order to obtain the benefits of clinical supervision.