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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study(Springer, 2024) Kodikara, K.; Seneviratne, T.; Premaratna, R.;Simulation is accepted as an effective method of learning procedural skills. However, the translational outcomes of skills acquired through simulation still warrants investigation. We designed this study to assess if skills laboratory training in addition to bedside learning (intervention group [IG]) would provide better learning results than bedside learning alone (control group [CG]) in the context of venipuncture training. This prospective, cluster-randomized, single-blind study took place at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Seventeen clusters of second-year medical students were randomly assigned to either IG or CG. The IG trained on venipuncture in the skills laboratory, receiving instruction after modified Payton’s Four Step Method. Following the training, students of both IG and CG underwent bedside learning for one month. Afterward, students of both groups performed venipuncture on actual patients in a clinical setting. An independent, blinded assessor scored students’ performance using the Integrated Procedural Protocol Instrument (IPPI) and a checklist. Patients assessed students’ performance with the Communication Assessment Tool (CAT). Eight and nine clusters were randomized to the intervention and control groups, respectively. IG completed significantly more single steps of the procedure correctly (IG: 19.36 ± 3.87 for checklist items; CG: 15.57 ± 4.95; p < 0.001). IG also scored significantly better on IPPI ratings (median: IG: 27 (12) vs. CG: 21 (8); p < 0.001). Rated by patients, students’ communication skills did not significantly differ between the two groups. Simulation-based venipuncture training enabled students to perform the procedure on actual patients with a higher technical accuracy than students who learned venipuncture at the bedside. Students were able to transfer the skills acquired through venipuncture training at the skill laboratory to the bedside.Item Exploring the impact of student-led peer assisted learning (‘kuppi classes’) on examination performance and mental, social and emotional development of medical students of a Sri Lankan medical school(Sri Lanka Medical Association, 2017) Chandrasekara, S.; Bandara, H.; Chandrasiri, N.; Choden, T.; Chandratilake, M.INTRODUCTION & OBJECTIVES: Peer-assisted-learning (PAL) is the acquisition of knowledge and skills through active helping and supporting among status equals or matched companions. In ‘kuppi classes’, a local term for an informal form of PAL, students of a junior batch learn from students of a senior batch in a didactic manner. The aims of this study were: to explore the educational environment and the reasons for attending kuppi classes; to determine the correlation between attendance of kuppi classes and student performance at examinations. METHODS: The study focused on kuppi classes for preclinical subjects, the student experience of the first two years, and their performance at the second-year summative examination. Two focus group discussions were carried out with 14 medical students to identify the breadth of the issues related to each objective. The transcriptions were thematically analysed and a selfadministered questionnaire was developed based on these themes. It was administered to 178 third-year medical students. RESULTS: The qualitative component revealed that the learning environment in kuppi classes were much more relaxed and acceptable compared to formal teaching sessions. According to the questionnaire, the main reason for attendance is as a backup for formal lectures. For the tutoring student it is a revision. The attendees expect kuppi classes to be more examination oriented. However, the association between kuppi attendance and subsequent examination performance was not statistically significant. CONCLUSION: Didactic and informal near-peer-learning sessions may provide students with the conducive social and emotional environment to learn. However, it may not have an impact on examination performance.Item Perceptions of Sri Lankan medical students on selecting and pursuing medicine as a career(Sri Lanka Medical Association, 2017) Karunaratne, D.R.INTRODUCTION & OBJECTIVES: Although the choice of pursuing medicine as a career has long been a topic of interest, the rapidly changing socioeconomic environment warrants a revisit. This study explored the current factors which influence this choice among medical students. METHODS: A mixed-method study was conducted among first and fourth year students in the Faculties of Medicine of universities of Kelaniya, Colombo and Sri Jayewardenepura. The perceptions of 30 medical students were explored using focus group discussions. The contents were thematically analysed to develop a valid self-administered questionnaire, which was given to 364 medical students. The responses were analysed both descriptively and inferentially. RESULTS: A total of 63.5% respondents were females and 44% were first-year students. The foremost reason for selecting medicine was to help people (mean= 2.28). The least important reason was parental pressure (mean=1.5). A/L marks (mean=2.19), social status of being a doctor (mean=1.74), job guarantee (mean=1.83) and self-interest (mean=1.98) were ranked in between. The regret of choosing medicine as a career was higher among females (p=0.035) and fourth-year students than their counterparts. The reasons appeared to be the stressfully high workload and external political issues in medical education. The interest on postgraduate studies was higher among 1st A/L attempt entrants than 3rd A/L attempt entrants (p=0.011); the interest appeared to grow along the course. CONCLUSION: Choosing medicine still has an altruistic preponderance. However, a regret of selecting medicine appears to grow along the course. The desire to pursue postgraduate studies is more if entered to medical school in the 1st attempt.Item Burden of mental illness and the need for better undergraduate education in psychiatry(Sri Lanka Medical Association, 2014) Kuruppuarachchi, K.A.L.A.; de Silva, N.R.No Abstract AvailableItem Identifying poor concordance between the 'planned' and the 'hidden' curricula at a time of curriculum change in a Sri Lankan medical school using the Dundee Ready Education Environment Measure(South-East Asian Association for Medical Education, 2009) Chandratilake, M.; de Silva, N.R.INTRODUCTION: Often there is a ‘hidden’ curriculum running alongside the planned curriculum as published in official statements of a medical school. The two aspects of the curriculum may not be in concordance, especially in a phase of change. In this study Dundee Ready Education Environment Measure (DREEM) was used as the tool to determine the level of concordance between two curricula. METHOD: The DREEM questionnaires were administered face-to-face to two batches of undergraduate medical students of Faculty of Medicine, University of Kelaniya, Sri Lanka. One batch was the first group to follow the integrated curriculum and the other was the last group to follow the discipline-based curriculum. RESULTS: The total scores of both batches indicated a reasonably positive overall perception of the education environment, but still with considerable room for improvement. The scores of third year male students for the domains of student perception of learning and teaching were significantly lower than their female colleagues and the seniors, thus indicating where interventions should be prioritised. By analysing the responses to individual items, a collection of items which were perceived negatively by both batches of students were identified. The items represented all domains with variable degree. DISCUSSION: In addition to its multiple utilities, a careful and deep interpretation of the DREEM results can be used to identify a group affected specifically by the educational environment, possibly caused by a lack of concordance between the planned and the hidden curricula of the same institution.Item 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.Item Effectiveness of teaching clinical skills in improving simple wound suturing among medical undergraduates(The Kandy Society of Medicine, 2005) Abeysuriya, V.; de Silva, P.; Pathirana, A.Item Geneder differences in undergraduate medical examination results in Sri Lanka(Sri Lanka Medical Association, 2000) de Silva, N.R.; Thabrew, M.I.; Saparamadu, P.A.M.; Jayawardena, D.R.K.C.; Arachchige, A.A.; Weerawardhane, M.; Gunawardene, Y.I.N.S.OBJECTIVE: To identify possible gender related differences in performance at undergraduate medical examinations in Sri Lanka. STUDY DESIGN AND METHODS: Results of examinations conducted by the faculty of medicine, University of Kelaniya in 1997 and 1998, and data published by the University Grants Commission (UGC) on final examinations conducted by 4 other Sri Lankan medical faculties (in the Universities of Colombo, Peradeniya, Ruhuna and Jaffna) in 1996 and 1997, were analysed for sex related differences.RESULTS: The proportion of women in each batch of students who sat for 8 examinations conducted at the faculty of medicine, University of Kelaniya in 1997 and 1998, ranged from 40.7 to 48.4% (average 44.3%). Among students sitting for the final MBBS examinations in other medical faculties in 1996 and 1997, the proportion of women ranged from 37.3% in Peradeniya to 53.7% in Jaffna. The proportions of women who obtained "classes" were higher than that of men in 12/15 examinations, with statistically significant differences in four. Higher proportions of men were referred or failed in all 8 examinations analysed; the differences were statistically significant in two. CONCLUSIONS: Women appear to do marginally better than men in undergraduate medical examinations in Sri Lanka.Item 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.Item 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.