P Ravi Shankar | International Medical University (original) (raw)
Papers by P Ravi Shankar
Medical Journal of Australia, 2020
Journal of Educational Evaluation for Health Professions, 2011
Concern has been raised about inadequate pharmacology teaching in medical schools and the high in... more Concern has been raised about inadequate pharmacology teaching in medical schools and the high incidence of prescribing errors by doctors in training. Modifications in pharmacology teaching have been carried out in many countries. The present study was carried out using a semi-structured questionnaire to obtain students??perceptions of their knowledge, attitudes, and skills with regard to different subject areas related to rational prescribing at the end of two-year activity-based pharmacology practical learning sessions in a private medical school in Nepal. The effectiveness of the sessions and strengths and suggestions to further improve the sessions were also obtained. The median total knowledge, attitude, skills and overall scores were calculated and compared among different subgroups of respondents. The median effectiveness score was also calculated. Eighty of the 100 students participated; 37 were male and 43 female. The median knowledge, attitude, and skills scores were 24, 3...
Academia Medicine, Jun 11, 2024
The distribution of publications in selected health professions education (HPE) journals accordin... more The distribution of publications in selected health professions education (HPE) journals according to the income status of the country where the first author was located during the period from January 2020 to December 2022 was studied. The Scopus quartile one (Q1) journals Academic Medicine, BMC Medical Education, Medical Education, Medical Education Online, Medical Teacher, and Teaching and Learning in Medicine were examined. The year of publication, the type of article, and the income status of the country of the first author were noted. Instances where the first and the corresponding author were the same and different were noted. There were 5,714 unique articles published. There were 26 instances where the first author had multiple affiliations in countries of differing income levels, and the articles were duplicated/triplicated providing a total of 5,740 articles. Most articles (87%) were published by authors from high-income countries and only 0.8% were from low-income countries, with the remainder from middle-income countries. BMC Medical Education had the maximum percentage of authors from low- and middle-income countries. Nations having most of the world’s population and medical schools are significantly underrepresented in publications in the assessed journals impacting diversity and inclusivity in HPE publishing. This is a matter of concern requiring further studies.
■ Self directed learning (SDL) which is associated with the management of lifelong learning, is c... more ■ Self directed learning (SDL) which is associated with the management of lifelong learning, is considered as a central theme of adult learning. ■ Readiness for SDL can be improved among students. ■ Measuring the SDL readiness of the students and using the results to develop teaching and learning methods for them is a new concept in Nepal. ■ Studies which have been done to find the relationship between the SDL readiness score and the academic performance of the students are lacking.
Indian Journal of Pharmacy Practice, 2010
International Journal of User-Driven Healthcare, 2012
Medical students and the number of medical schools are increasing in Nepal and South Asia. The st... more Medical students and the number of medical schools are increasing in Nepal and South Asia. The student perspective does not receive sufficient attention in most schools. In this paper, the author shares initiatives in creating a user-driven student perspective in a private medical school in Lalitpur, Nepal. Communication was a key component and the author used the internet extensively to communicate with students in addition to printed written materials.
IGI Global eBooks, Nov 10, 2015
Medical Teacher, Mar 1, 2006
Introduction: In Nepal, there are no mandatory clinical trials for new products. Drugs are approv... more Introduction: In Nepal, there are no mandatory clinical trials for new products. Drugs are approved based on the data from developed countries. Manipal Teaching Hospital is one of the pioneers in establishing the Pharmacovigilance program in Nepal. For the past three years, the students of Pokhara University visit the Pharmacovigilance center, Drug information center and the Hospital Pharmacy of MTH for a 15 days training program. In the year 2007, the students were also trained in pharmacovigilance. Objectives: To study the demographical details of the students who participated in the pharmacovigilance training and to obtain student feedback regarding the sessions. Methodology: The session module was activity based and emphasized the following four areas: sketching out the current National Pharmacovigilance programme, designing an adverse drug reaction reporting form, carrying out the causality assessment and severity assessment. The feedback of the students on the training module was evaluated using the specially designed feedback form. Results: Altogether, thirty students [males 18 (60%) and females 12 (40%)] were present and all of them participated in the study. The Mean ± SD overall feedback score was 81.5 ± 4.4 (maximum possible score was 100). In general, male students had a higher score (82.29 ± 4.88) than females (80.33 ± 3.75). Conclusion: Overall, the students liked the session and were interested in having similar sessions in the future. This module can be taken as a model for other researchers who would like to carry out educational sessions in pharmacovigilance for pharmacy students.
Learning: Research and Practice
Journal of BP Koirala Institute of Health Sciences
Background: Medical humanities (MH) uses subjects like literature, music, drama, and painting for... more Background: Medical humanities (MH) uses subjects like literature, music, drama, and painting for specific purposes in medical education. We aimed to assess its medium-term impact on medical alumni whose curriculum incorporated a module on MH which was named as Sparshanam. Methods: After approval from the Institutional Review Committee of KIST Medical College, this cross-sectional online survey was performed from December 2020 to January 2021on the 2008 batch medical alumni who had experienced Sparshanam in their medical education curriculum 10 years before. A mixed modal design (both qualitative and quantitative) was applied. The participants’ perception of the module, like its strengths, weaknesses, and its contribution to personal and professional development were assessed. Results: Out of the 75 first batch alumni, 39 (52%) participated. Most of them were working in the Kathmandu valley. The perceived strengths were teamwork, interactive group sessions, and imparting a holistic ...
Rural and Remote Health, 2010
Education in Medicine Journal, 2018
The article examines various initiatives undertaken by the curriculum committee at an offshore Ca... more The article examines various initiatives undertaken by the curriculum committee at an offshore Caribbean medical school to strengthen teaching-learning. The authors examined various initiatives undertaken by the committee since September 2017. They also searched the scientific literature for brief descriptions of similar initiatives at other medical schools in the Caribbean and other regions. A number of initiatives have been introduced to strengthen the curriculum and teaching-learning. Among the new initiatives were creating a structured outline for course syllabi, initiating online modules on nutrition in medicine and patient safety, introducing a health humanities module, starting a module on integrative medicine, system-wise sequencing of the fourth semester, conducting sessions on critical appraisal of scientific literature, and introducing a day long orientation programme. The impact of these initiatives can be assessed in the future.
BMC pediatrics, Feb 5, 2018
Earthquakes impact child health in many ways. Diseases occurring immediately following an earthqu... more Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7.8 magnitude Nepal earthquake on 25th April 2015. The admitted children were grouped based on direct effect of earthquake on their family (house damaged or family member injured or dead) and on whether their place of residence was located in an earthquake affected district. Most common diagnoses were identified and their distribution between the aforementioned groups analyzed to examine differences, if any, in disease occurrence or presentation. The fifteen weeks study duration was divided into three parts of five weeks each, to study tre...
Asian Journal of Medical Sciences, 2016
SPs have been used for teaching-learning and assessment of basic science medical students since J... more SPs have been used for teaching-learning and assessment of basic science medical students since January 2013. The opinion of SPs about their involvement in teaching-learning and assessment of students has been recently studied. The present study had the objective of studying student perception about various aspects of the program. Materials and Methods: The study was conducted towards end of March and beginning of April 2016. Student perception regarding the program was studied by noting their degree of agreement with a set of 25 statements. Free text comments were also obtained. Gender, nationality and semester of study of the respondents was noted. The total score was compared among different subgroups of respondents. Results: Ninety-eight of the 107 students (91.6%) participated. The mean ± SD total score was 92.33 ± 13.68 (maximum possible score being 125). The scores were significantly higher among first semester students compared to other semesters. Students agreed that interacting with SPs will prepare them for interacting with patients, for their licensing exams and improve their clinical skills. Students learn how to interact with persons from a different cultural background. Suggestions for further improvement were also obtained. Conclusions: The response rate was high and students' perception of the SP program was positive. Our experiences would be of special interest to educators in other medical schools with small and/or new SP programs. Similar feedback could be obtained from other Caribbean schools with SP programs.
The Internet Journal of Orthopedic Surgery, 2012
Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial... more Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial treatment of Low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a reliable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of ongoing study of the use of epidural steroid injection the management of low back pain cases coming to the orthopaedic department of Government Medical College Jammu. Methods: 150 Patients reporting with low back pain and sciatica not responding to other modes of conservative treatment were prospectively followed over a two year period. The caudal epidural steroid injections were performed, as many as three injections two week apart .The patients were assessed before and after the procedure clinically and the Level of pain, improvement in physical signs and ability to do activities of daily living were noted. Results:150 patients were observed for the duration of 2 years. Average duration of symptoms was for six months. After first epidural steroid injection 80% [120] of patients reported relief within first two weeks. Forty Four (44) patients required two injections and 12 patients required three injections. Twelve (12) patients reported no relief after first injection. The duration between two injections was two to three weeks. Average duration of pain relief was 17days. At the end of three months, good results were seen in 49%, fair in 32% and bad results in 18%. Overall 69% of patients were able to do activities of daily living. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. Conclusion: Epidural Steroid Injection is a simple, cost effective and minimally invasivemode of treatment of Low Back Pain and sciatica. It provides pain free period to enable the patient for physiotherapy which helps in early recovery.
Education in Medicine Journal, 2015
Education in Medicine Journal, 2015
Kathmandu University medical journal (KUMJ)
Medical Journal of Australia, 2020
Journal of Educational Evaluation for Health Professions, 2011
Concern has been raised about inadequate pharmacology teaching in medical schools and the high in... more Concern has been raised about inadequate pharmacology teaching in medical schools and the high incidence of prescribing errors by doctors in training. Modifications in pharmacology teaching have been carried out in many countries. The present study was carried out using a semi-structured questionnaire to obtain students??perceptions of their knowledge, attitudes, and skills with regard to different subject areas related to rational prescribing at the end of two-year activity-based pharmacology practical learning sessions in a private medical school in Nepal. The effectiveness of the sessions and strengths and suggestions to further improve the sessions were also obtained. The median total knowledge, attitude, skills and overall scores were calculated and compared among different subgroups of respondents. The median effectiveness score was also calculated. Eighty of the 100 students participated; 37 were male and 43 female. The median knowledge, attitude, and skills scores were 24, 3...
Academia Medicine, Jun 11, 2024
The distribution of publications in selected health professions education (HPE) journals accordin... more The distribution of publications in selected health professions education (HPE) journals according to the income status of the country where the first author was located during the period from January 2020 to December 2022 was studied. The Scopus quartile one (Q1) journals Academic Medicine, BMC Medical Education, Medical Education, Medical Education Online, Medical Teacher, and Teaching and Learning in Medicine were examined. The year of publication, the type of article, and the income status of the country of the first author were noted. Instances where the first and the corresponding author were the same and different were noted. There were 5,714 unique articles published. There were 26 instances where the first author had multiple affiliations in countries of differing income levels, and the articles were duplicated/triplicated providing a total of 5,740 articles. Most articles (87%) were published by authors from high-income countries and only 0.8% were from low-income countries, with the remainder from middle-income countries. BMC Medical Education had the maximum percentage of authors from low- and middle-income countries. Nations having most of the world’s population and medical schools are significantly underrepresented in publications in the assessed journals impacting diversity and inclusivity in HPE publishing. This is a matter of concern requiring further studies.
■ Self directed learning (SDL) which is associated with the management of lifelong learning, is c... more ■ Self directed learning (SDL) which is associated with the management of lifelong learning, is considered as a central theme of adult learning. ■ Readiness for SDL can be improved among students. ■ Measuring the SDL readiness of the students and using the results to develop teaching and learning methods for them is a new concept in Nepal. ■ Studies which have been done to find the relationship between the SDL readiness score and the academic performance of the students are lacking.
Indian Journal of Pharmacy Practice, 2010
International Journal of User-Driven Healthcare, 2012
Medical students and the number of medical schools are increasing in Nepal and South Asia. The st... more Medical students and the number of medical schools are increasing in Nepal and South Asia. The student perspective does not receive sufficient attention in most schools. In this paper, the author shares initiatives in creating a user-driven student perspective in a private medical school in Lalitpur, Nepal. Communication was a key component and the author used the internet extensively to communicate with students in addition to printed written materials.
IGI Global eBooks, Nov 10, 2015
Medical Teacher, Mar 1, 2006
Introduction: In Nepal, there are no mandatory clinical trials for new products. Drugs are approv... more Introduction: In Nepal, there are no mandatory clinical trials for new products. Drugs are approved based on the data from developed countries. Manipal Teaching Hospital is one of the pioneers in establishing the Pharmacovigilance program in Nepal. For the past three years, the students of Pokhara University visit the Pharmacovigilance center, Drug information center and the Hospital Pharmacy of MTH for a 15 days training program. In the year 2007, the students were also trained in pharmacovigilance. Objectives: To study the demographical details of the students who participated in the pharmacovigilance training and to obtain student feedback regarding the sessions. Methodology: The session module was activity based and emphasized the following four areas: sketching out the current National Pharmacovigilance programme, designing an adverse drug reaction reporting form, carrying out the causality assessment and severity assessment. The feedback of the students on the training module was evaluated using the specially designed feedback form. Results: Altogether, thirty students [males 18 (60%) and females 12 (40%)] were present and all of them participated in the study. The Mean ± SD overall feedback score was 81.5 ± 4.4 (maximum possible score was 100). In general, male students had a higher score (82.29 ± 4.88) than females (80.33 ± 3.75). Conclusion: Overall, the students liked the session and were interested in having similar sessions in the future. This module can be taken as a model for other researchers who would like to carry out educational sessions in pharmacovigilance for pharmacy students.
Learning: Research and Practice
Journal of BP Koirala Institute of Health Sciences
Background: Medical humanities (MH) uses subjects like literature, music, drama, and painting for... more Background: Medical humanities (MH) uses subjects like literature, music, drama, and painting for specific purposes in medical education. We aimed to assess its medium-term impact on medical alumni whose curriculum incorporated a module on MH which was named as Sparshanam. Methods: After approval from the Institutional Review Committee of KIST Medical College, this cross-sectional online survey was performed from December 2020 to January 2021on the 2008 batch medical alumni who had experienced Sparshanam in their medical education curriculum 10 years before. A mixed modal design (both qualitative and quantitative) was applied. The participants’ perception of the module, like its strengths, weaknesses, and its contribution to personal and professional development were assessed. Results: Out of the 75 first batch alumni, 39 (52%) participated. Most of them were working in the Kathmandu valley. The perceived strengths were teamwork, interactive group sessions, and imparting a holistic ...
Rural and Remote Health, 2010
Education in Medicine Journal, 2018
The article examines various initiatives undertaken by the curriculum committee at an offshore Ca... more The article examines various initiatives undertaken by the curriculum committee at an offshore Caribbean medical school to strengthen teaching-learning. The authors examined various initiatives undertaken by the committee since September 2017. They also searched the scientific literature for brief descriptions of similar initiatives at other medical schools in the Caribbean and other regions. A number of initiatives have been introduced to strengthen the curriculum and teaching-learning. Among the new initiatives were creating a structured outline for course syllabi, initiating online modules on nutrition in medicine and patient safety, introducing a health humanities module, starting a module on integrative medicine, system-wise sequencing of the fourth semester, conducting sessions on critical appraisal of scientific literature, and introducing a day long orientation programme. The impact of these initiatives can be assessed in the future.
BMC pediatrics, Feb 5, 2018
Earthquakes impact child health in many ways. Diseases occurring immediately following an earthqu... more Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7.8 magnitude Nepal earthquake on 25th April 2015. The admitted children were grouped based on direct effect of earthquake on their family (house damaged or family member injured or dead) and on whether their place of residence was located in an earthquake affected district. Most common diagnoses were identified and their distribution between the aforementioned groups analyzed to examine differences, if any, in disease occurrence or presentation. The fifteen weeks study duration was divided into three parts of five weeks each, to study tre...
Asian Journal of Medical Sciences, 2016
SPs have been used for teaching-learning and assessment of basic science medical students since J... more SPs have been used for teaching-learning and assessment of basic science medical students since January 2013. The opinion of SPs about their involvement in teaching-learning and assessment of students has been recently studied. The present study had the objective of studying student perception about various aspects of the program. Materials and Methods: The study was conducted towards end of March and beginning of April 2016. Student perception regarding the program was studied by noting their degree of agreement with a set of 25 statements. Free text comments were also obtained. Gender, nationality and semester of study of the respondents was noted. The total score was compared among different subgroups of respondents. Results: Ninety-eight of the 107 students (91.6%) participated. The mean ± SD total score was 92.33 ± 13.68 (maximum possible score being 125). The scores were significantly higher among first semester students compared to other semesters. Students agreed that interacting with SPs will prepare them for interacting with patients, for their licensing exams and improve their clinical skills. Students learn how to interact with persons from a different cultural background. Suggestions for further improvement were also obtained. Conclusions: The response rate was high and students' perception of the SP program was positive. Our experiences would be of special interest to educators in other medical schools with small and/or new SP programs. Similar feedback could be obtained from other Caribbean schools with SP programs.
The Internet Journal of Orthopedic Surgery, 2012
Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial... more Background: Low back pain (LBP) and sciatica is a common clinical condition worldwide.The initial treatment of Low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a reliable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of ongoing study of the use of epidural steroid injection the management of low back pain cases coming to the orthopaedic department of Government Medical College Jammu. Methods: 150 Patients reporting with low back pain and sciatica not responding to other modes of conservative treatment were prospectively followed over a two year period. The caudal epidural steroid injections were performed, as many as three injections two week apart .The patients were assessed before and after the procedure clinically and the Level of pain, improvement in physical signs and ability to do activities of daily living were noted. Results:150 patients were observed for the duration of 2 years. Average duration of symptoms was for six months. After first epidural steroid injection 80% [120] of patients reported relief within first two weeks. Forty Four (44) patients required two injections and 12 patients required three injections. Twelve (12) patients reported no relief after first injection. The duration between two injections was two to three weeks. Average duration of pain relief was 17days. At the end of three months, good results were seen in 49%, fair in 32% and bad results in 18%. Overall 69% of patients were able to do activities of daily living. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. Conclusion: Epidural Steroid Injection is a simple, cost effective and minimally invasivemode of treatment of Low Back Pain and sciatica. It provides pain free period to enable the patient for physiotherapy which helps in early recovery.
Education in Medicine Journal, 2015
Education in Medicine Journal, 2015
Kathmandu University medical journal (KUMJ)
The Coronavirus disease has caused widespread suffering and has had devastating economic conseque... more The Coronavirus disease has caused widespread suffering and has had devastating economic consequences. Province number 2 in the terai region of Nepal is densely populated and shares an open border with India. Knowledge, attitude, and practice regarding the disease was previously studied and published. In this manuscript the authors describe respondents' degree of satisfaction with government and hospital efforts to control the pandemic and with the degree of fear and uncertainty caused by the disease. A cross-sectional study was done between May 27 to June 7, 2020, among patients visiting three eye hospitals of province 2. Most respondents were satisfied with government efforts to contain the pandemic. They were highly satisfied with the efforts at the hospitals they visited. Most experienced a lot of fear and uncertainty due to the pandemic. The study had several limitations and was carried out last year before the second deadly wave which happened during April-May this year.