Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Intermediate fidelity simulation to educate emergency management skills(Penerbit Universiti Sains Malaysia, 2020) Kodikara, K.G.; Karunaratne, W.C.D.; Chandratilake, M.N.Medical students learn clinical skills related to the management of emergencies during their clerkships, mainly via peripheral participation and observation. Simulation-based training is identified as an adjunct to clinical practice enabling students to learn clinical skills in a safe environment. Nevertheless, simulation-based training is still underutilised in many countries in the developing world. The purpose of this study was to explore the value of simulation-based learning using an intermediate fidelity simulator to train medical undergraduates on the management of medical emergencies. A pilot group of 80 fourth year medical students attended four simulation-based clinical skills sessions. The students completed a self-administered evaluation, which included both open and close-ended questions postsimulation. Descriptive statistics were employed to analyse the responses to close-ended questions, and the responses to open-ended questions were analysed for recurring themes. All participating students responded to the evaluation. Students rated the simulation-based learning experience with high positivity. The self-competency of 74 (92.5%) students had increased following the sessions. The sessions have provided a “safe” learning environment to all students, and 70 (87.5%) felt it helped apply theory into practice. Thirty-three (41.2%) noted the simulation session as an important learning tool for practising clinical skills. Thirty-one (38.5%) wished to participate in more sessions, and 39 (48.7%) felt that simulation should be introduced to the curriculum from the first-year. Students have recognised intermediate fidelity simulators as a valuable learning tool to train on the management of clinical emergencies and should be integrated into undergraduate medical curricula.Item Attitudes towards homosexuality, bisexuality and transgenderism among medical students of a Sri Lankan university(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Rajapaksha, J.S.R.L.; Rajapaksha, R.G.D.T.; Ranawaka, A.U.R.; Rangalla, R.D.M.P.; Ranwala, R.D.E.B.; Chandratilake, M.N.Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards LBGT community. Methods: A cross- sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka using a validated online questionnaire.3 The questionnaire focused on eight areas. The data was descriptively analysed and the demographic groups were compared. Results: 358 completed the survey. Their attitudes on traditional gender role and comfortability in interacting with LGBT people were moderate and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing social practices of LGBT people. Their acceptance and association of LGBT was moderately positive. A minority has encountered LGBT in close social circles and the majority of them were batch-mates. Although males’ knowledge about the origin ot LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents' political ideology. Conclusions: Although medical students' knowledge on sexuality/gender basis ot LGBT is poor they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences and political ideology may have influenced their attitudes.Item High fidelity simulation in undergraduate medical curricula: experience of fourth year medical students(South East Asia Regional Association for Medical Education -SEARAME, 2020) Kodikara, K.G.; Karunaratne, W.C.D.; Chandratilake, M.N.INTRODUCTION: Application of theoretical knowledge to management of critically ill patients is a challenging task for medical undergraduates where opportunities to learn clinical skills with regard to management of emergencies are few. High fidelity simulation (HFS) is widely used globally to learn clinical skills in a safe environment. However, research in use of HFS in developing countries such as Sri Lanka is minimal. PURPOSE: The purpose of this study was to explore the response of medical undergraduates to a high fidelity simulator in the context of management of emergencies. METHOD: A pilot group of 30 fourth year medical students underwent a high fidelity simulator session. They completed a self-administered evaluation, which included both open and close ended questions and participated in a focus group discussion post-simulation. Descriptive statistics were employed to analyze the responses to close-ended questions and the responses to open- ended questions and focus group discussion were analyzed for recurring themes. RESULT: Students rated the simulation-based learning experience with high positivity. The self-competency of 29 (96.6%) students had increased post-simulation while providing a safe learning environment to all students. Majority (63.3%; n=19) felt it helped put theory into practice. Qualitative data gathered from open-ended questions and focus group discussions further confirmed these findings. CONCLUSION: The study demonstrates that HFS can be used to provide a safe environment and a satisfying educational experience for students to learn medical emergencies, and as an educational opportunity of translating theory into practice. Although HFSs are costly they appear to be cost effective in terms of educational outcomes. KEYWORDS: Simulation, Medical students, High fidelity, CompetencyItem Professionalism in Medicine; the transition of a movable feast and its implications for clinical and educational practices(Postgraduate Institute of Medicine University of Colombo, 2016) Chandratilake, M.N.Item Availability and cost of medicines for treatment of non-communicable diseases in private sector drug outlets in Sri Lanka(Sri Lanka Medical Association, 2006) Kasturiratne, A.; Chandratilake, M.N.; Pinidipathirage, M.J.; Jayaratne, G.S.; Mahawithanage, S.T.; Subhashini, K.A.P.; Jayasekara, D.P.A.R.N.; Wickremasinghe, A.R.BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality in Sri Lanka. Availability and affordability of medicines to treat them determine patient outcomes. OBJECTIVES: To determine the availability and affordability of common medicines for the management of NCDs in private sector drug outlets in four districts in Sri Lanka. METHODS: A descriptive cross-sectional study was conducted in randomly selected private pharmacies in Anuradhapura, Colombo, Matara and Monaragala districts. A pre-tested questionnaire administered to pharmacists/dispensers and direct observations were used to obtain availability and prices of drugs for treatment of ischaemic heart diseases, hypertensive diseases, diabetes mellitus, asthma and cancer by trained data collectorsItem Availability of drugs for the treatment of non-communicable diseases in the government health care institutions in Sri Lanka(Sri Lanka Medical Association, 2006) Pinidiyapathirage, M.J.; Chandratilake, M.N.; Kasturiratne, A.; Jayaratna, G.S.; Jayasekera, D.P.A.R.N.; Subhasini, K.A.P.; Mahawithanage, S.T.; Wickremasinghe, A.R.OBJECTIVE: To assess the availability of commonly used drugs in the treatment of non-communicable diseases in government health care institutions. METHODS: Forty four government health care institutions, representing the 3 levels of health care institutions (level 1 - CD & MH, level 2 - PU, DH, RH, level 3 - BH, GH, PH, TH) were randomly selected from the districts of Colombo, Anuradhapura, Moneragala and Matara. Each of the selected institutions was visited and the availability of a selected list of drugs was ascertained on the day of the visit. Availability was considered satisfactory if the drug was available in at least 75% of institutions of a particular level. RESULTS: Of the drugs that should be available at each level the following results were obtained: Level I -Availability of thiazides, beta-blockers, aspirin and nitrates were satisfactory. Availability of benzathine benzylpenicillin, glibenclamide andprednisolone were unsatisfactory. LevelII- Furosemide, thiazides, nitrates, glibenclamide, metformin andprednisolone were available in all and the availability of methyldopa, nifedipine, beta-blockers and aspirin was satisfactory. Availability of benzathine benzylpenicillin, insulin (isophane/so ruble) and spironolactone were unsatisfactory. Level III - Furosemide, thiazides, metformin, aspirin, beta-blockers, nitrates, nifedipine and prednisolone were available in all while the availability of benzathine benzylpenicillin, captopril, spironolactone, methyldopa, glibenclamide, insulin (isophane/soluble) and timolol eye-drops were satisfactory. Availability of steptokinase, inhalation steroids and salbutamol, ipratropium bromide, losartan, and tamoxifen were unsatisfactory. CONCLUSIONS: Availability of some essential drugs for non-communicable diseases was unsatisfactory at all 3 levels of health care institutions. This may be a reason for patients bypassing smaller institutions and the back referral system not functioning properly in the country. Inadequacy of national stocks cannot by itself explain the non-availability of these drugs as the survey was carried out in July/August.Item The Common General Paper at the GCE Advanced Level examination as a predictor of performance in medical school(Sri Lanka Medical Association, 2006) de Silva, N.R.; Pathmeswaran, A.; Chandratilake, M.N.; Dias, R.BACKGROUND: Since 2000, all students seeking admission to Sri Lankan universities have to answer a Common General Paper, along with three subjects of their choice, at the GCE Advanced Level (AL) examination. The CGP aims to assess the intellectual ability of students, and their general awareness of the world they live in. OBJECTIVES: To determine the relationship between CGP scores and performance in medical school METHODS: The study sample consisted of medical students in Colombo and Kelaniya entering university in 2002 and 2003. Students were ranked according to the average mark obtained in 2nd year examinations in medical school, and dichotomized according to their presence in the top 30%. The predictive value of CGP scores in determining this outcome was examined using logistic regression in a multivariate analysis that also included AL z-scores, General English grades, sex, year of entry, district of admission and university. RESULTS: AL results and university examination results were matched for 473 students (297 in Colombo, 176 in Kelaniya). CGP marks showed significant positive correlation with AL z-scores and General English grades. All three AL scores and university examination results differed significantly according to university, year of entry, and sex of student, Multivariate analysis showed that higher AL z-scores and female sex were significant predictors of successful outcome, but none of the other variables, including CGP, were significant. All variables together explained only 12% of the variation in outcome (pseudo-R2 = 0.1224). CONCLUSIONS: CGP scores do not predict student performance in medical school.