Browsing by Author "de Silva, N*."

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Challenges in medical education to enhance quality in medical care
(College of General Practitioners of Sri Lanka, 2007) de Silva, N*.
Challenges in recruting older twins for the Sri Lankan twin registry
(Australian Academic Press, 2003) Sumathipala, A.; Sribaddana, S.H.; Abeysingha, N.M.; de Silva, N*.; Fernando, D.J.; Dayaratne, D.A.; de Silva, D.; Warnasuriya, N.D.; Hotopf, M.
The National Twin Registry of Sri Lanka was established in 1997 as a volunteer register. To extend it to a population-based register, we examined the effectiveness of tracing older twins by inspecting birth records and recruiting them by postal invitation and in-person contact. Birth records at a divisional secretariat reported from 2 maternity hospitals between the years of 1954-1970 were scrutinised to identify a random sample of twins. These hospitals had the highest twin delivery rates for the whole country. We identified 620 twins and a questionnaire was mailed to them. Research assistants visited a cohort of non-respondents (71) in the postal survey. These 620 twins were identified after perusing 20700 birth records. The twinning rate was estimated at 29.95 ([620/20700] x 1000) twins per 1000 registered births (CI 27.63-32.27). In the postal survey, 37 (12%) responded and 62 letters were returned (20%). Both twins were still alive in 20 pairs, one was still alive in 15 pairs, and both twins were dead in 2 pairs. During field visits, 42 (59.2%) addresses were located. Information was available on 16 twin pairs. Both twins were alive in 8 pairs, one each in 4 pairs, and both were dead in 4 pairs and at least one twin was traced in 10 pairs (14%). Both the postal and the field survey gave a low yield. This finding is different from tracing younger twins born between 1985-1997 by using the same methods. Migration, urbanization and development in the country might have affected tracing older twins from the birth record addresses, which were decades old.
Clinical audit on screening for cardiovascular risk factors
(College of General Practitioners of Sri Lanka, 1996) de Silva, N*.
Clinical adults is the method used to assess evaluate and improve the care of patients in a systematic way. An adult was carried out on screening for three cardiovascular risk factors, namely asymptomatic hypertension, heper cholesterolemia and diabetes mellitus among patients over the age of forty years, consulting the doctor. Results revealed that the high standard expected with regard to screening for cardiovasccular risk factors had not met in this practice population. Corrective actions have been proposed in order to achieve the standard.
The Consultation and doctor - patient communication
(College of General Practitioners of Sri Lanka, 1999) de Silva, N*.
The Consultation and doctor - patient communication
(Sri Lanka Medical Association, 1999) de Silva, N*.
Continuing professional development (CPD) - an emerging international trend for doctors in practice
(Ruhunu Clinical Society of Sri Lanka, 2000) de Silva, N*.
Continuous Medical Education (CME) and Continuous Professional Development (CPD) by which doctors maintain current knowledge and skills, acquire knowledge and skills is mostly volunteered at the present time. It is to be become an enforced requirement for doctors to continue in practice and should be taken seriously by doctors, professional colleges and medical associations
Distance education:a flexible learning approach for practising doctors
(Galle Medical Association., 2000) de Silva, N*.
Distance education is a mode of delivery of education materials such as printed matter, audio and video tapes to the doorstep of learners. It is flexible because it is learner centered, self paced, not constrained by fixed time and place commitments and is transferable to be undertaken anywhere at anytime. General practice teaching through this method was started in the U.K. in the 1950s. In Sri Lanka, a distant education programme for general practitioners to update themselves and obtain post graduate qualifications has enormous potential. These article describes the methodology applied to implement a distant education course for the Diploma in Family Medicine conducted by the Postgraduate Institute of Medicine. This method could be adapted for post graduate education or for CME programme in any other clinical specialising.
Educational audit on the counselling module of the diploma in family medicine (DFM) course
(Galle Medical Association., 1998) de Silva, N*.
The criterion for the audit was that the audit was that the trainees should progress from their existing level of confidence to a highest level of knowledge and skills. Pretest and past test assessing of knowledge of skills and evaluation of teaching and learning was carried out results are indicated.
Evaluation of the Family Medicine Programme at the Faculty of Medicine,University of Kelaniya by Students and GP Teachers
(College of General Practitioners of Sri Lanka, 1995) de Silva, N*.
This paper reports the findings of the course evaluation carried out at the termination of the family medicine programme in 1995. Evaluation was through 2 questionnaires - one students and the other to GP teachers. The significant finding was that more students and GPs agreed that family medicine should be taught as a clinical discipline. One third of the students indicated they will consider family medicine as a career choice GP teachers found teaching students a satisfying experience.
The Family in crisis, family as a unit of social change
(Peoples Bank, 1996) de Silva, N*.
Family medicine in the undergraduate curriculum
(Sri Lanka Medical Association, 1995) de Silva, N*.
Describes family medicine and its relevance. Two universities established family medicine departments.The introduction of family medicine to the curriculum is particularly opportune in Sri Lanka with medical schools turning out for more doctors than can be absorbed by the health service. Mentions that this is the only discipline in which a newly register doctors can practice unsupervised without postgraduate training. Also there is ha any training available.
Family medicine in the undergraduate curriculum : teaching and learning
(College of General Practitioners of Sri Lanka, 1997) de Silva, N*.
Recognizes the importance of family medicine in the undergraduate curriculum in UK, USA, Singapore, Malaysia and Sri Lanka. Looks at newer methods of teaching and the teaching potential of family medicine. Provides a very detailed account of the author's personal experience and educational endeavours in the teaching and learning of family medicine and the evaluations of such teaching and learning in the undergraduate curriculum.
International course on "Promoting Excellence in Teaching General Practice"
(College of General Practitioners of Sri Lanka, 1996) de Silva, N*.
Medical students experiences of learning communication skills during a family medicine clerkship in Sri Lanka
(Department of Family Medicine, Aga Khan University Pakistan, 2005) de Silva, N*.
INTRODUCTION: The teaching of communication skills to medical students was introduced for the first time in Sri Lanka in 1996, during a clinical attachment in family medicine. Setting: The University Family Medicine Clinic which provides a free primary medical care service to the community. A two week family medicine clerkship for third year students in groups of 15-18. Teaching and Learning METHODS: Small group discussions and learning of communication skills through viewing of educational videos and live consultations on a TV monitor. Students received "hands on experience" in communication skills followed by constructive feedback by the teacher and peers on a video tape replay of student-patient encounters and role plays. METHOD: Qualitative research methodology was used. Students from two groups were requested to write down their experiences of learning communication skills through video tape replay and feedback during the family medicine clerkship. RESULTS: The students` narratives of their learning experiences were analyzed. The themes that emerged were: apprehension at being observed by the teacher and peers during student-patient encounters, anxiety about not remembering to ask relevant questions from the patient, enjoyment of the feeling of real doctoring, developing confidence in consulting skills and learning by watching themselves in action on video tape replay. Excerpts of the feelings expressed by the students under these themes were selected to be presented in this paper. CONCLUSION: The learning of communication skills had been an enjoyable experience for the students who appreciated the learning achieved. They had also undergone personal and professional development in the process.
One day general practice morbidity survey in Sri Lanka
(Oxford University Press, 1998) de Silva, N*.; Mendis, K.
BACKGROUND: National morbidity surveys provide valuable data for monitoring the health needs of populations, health policy planning and design of medical curricula. In order to meet a long-standing need for such information in Sri Lanka, a nationwide general practice morbidity survey was conducted for the first time in 1996. OBJECTIVES: We aimed to identify people's needs by determining the reasons for encounter or the demand for care with GPs/family physicians, to illustrate the pattern of morbidity in general practice and to determine the average daily workload of GPs in Sri Lanka. METHOD: A random sample of 75 GPs were requested to complete a Practitioner Profile Questionnaire (PPQ) and to record on an encounter form (EF) the reason/s for encounter (RFE) and problems managed during all consultations on 4 July. Central coding of the RFEs and problems defined was done using the International Classification of Primary Care (ICPC). RESULTS: Forty GPs (53.3 percent) completed the PPQ, while the EF received a response from 34 (43.3 percent). The GP profile showed a male to female ratio of 7:1, none below 35 years and none qualified after 1984. The average daily workload was 74. It was estimated that GPs handle at least 26.5percent of the primary care morbidity. Children accounted for 32 percent of consultations. There was a significantly higher proportion of children (P 0.0001) and of the elderly (P 0.05) in the consulting population compared with the general population. In 2068 encounters, 3448 RFEs and 2087 problems had been recorded. Respiratory and General chapters included 55 percent of the RFEs. By ICPC rubrics, 27 of the top thirty RFEs were for common symptoms. In addition to acute illnesses, asthma, hypertension and diabetes as well as preventive care activities were within the top 12 problems managed. CONCLUSIONS: The fact that many common illnesses, chronic diseases and preventive treatments are dealt with in general practice shows the necessity to include family medicine in the undergraduate curriculum of all medical schools. Undergraduate and postgraduate training in family medicine should concentrate more on child care and care of the elderly. Suitable incentives may be necessary to motivate younger doctors to become GPs to meet,the medical care needs of the community.
Patient satiasfaction with consultation in ambulatory care setting in Sri Lanka
(Department of Family Medicine, Aga Khan University Pakistan, 2006) de Silva, N*.; Abayasekera, S.; Mendis, K.; Ramanayake, J.
Patients' expectations and satisfaction with consultations
(College of General Practitioners of Sri Lanka, 2007) de Silva, N*.
Psychiatric morbidity in 3 family practices
(College of General Practitioners of Sri Lanka, 1989) Ferdinando, K.; de Silva, N*.; Wijegoonewardena, A.D.P.A.
Qualitative research
(Sri Lanka Medical Association, 2003) Sumathipala, A.; Siribaddana, S.; de Silva, N*.
No Abstract Available
Qualitative research: how to do it
(Department of Family Medicine, Aga Khan University Pakistan, 2005) de Silva, N*.
Traditionally bio-medical research has been quantitative research which reduces data to quantities and numerical values. Qualitative research on the other hand is characterised by the use of non numeric textual data. By qualitative research, one tries to understand human behaviour from the subjects own frame of reference. Quantitative and qualitative research is complimentary to each other and when used together in a single study will increase the breadth, depth and scope of the research. One should follow certain guidelines while conducting qualitative research. This article discusses the following methods of data collection in qualitative research - observation, interviews, focus groups and narratives. Qualitative data analysis requires a system for coding and retrieval of chunks of text and organizing them into categories and themes. Computer programs developed specifically for qualitative research are also available. Qualitative research is often criticized as it seems to lack reliability and validity. However there are certain strategies that can be used to add rigour to a qualitative study.