Rania Zaini - Academia.edu (original) (raw)

Papers by Rania Zaini

Background With the increasing number of Medicine Colleges in Saudi Arabia and the absence of ana... more Background With the increasing number of Medicine Colleges in Saudi Arabia and the absence of analysis of the relevance and effectiveness of medical programmes; the autonomy of Saudi medical schools is being questioned. This study aims to develop a national consensus of the "Saudi Future Doctor" through the identification of core competencies and learning outcomes that must be addressed by all medical programmes. This vision is based on doctors' duties and obligations towards the patient, practice, community and professionalism. Method A two round Delphi study was undertaken to identify agreed competencies and learning outcomes of various stakeholders. Validity, practicality and applicability of the consensus were investigated and appropriate implementation strategies recommended. Data collection was triangulated with other qualitative research methods: focus groups, interviews and documentary analysis of curricula Results: The first round of the Delphi study defined 290 learning outcomes within the pre-defined 14 competences. In general, the data included outcomes covered by most of the international trends and requirements. Items of % agreement in the second round of the Delphi study identified the emerging consensus of the desirable essential learning outcomes of all medical curricula. The generated consensus focused on knowledge and clinical practice. There was less agreement about aspects of professional behaviours. Conclusion: The national consensus reflects the vision of the "Saudi Future Doctor" and is the initial step in defining a national core-curriculum. The study demonstrated the need to integrate the role of doctors with in the health service into medical curricula.

Advances in Medical Education and Practice

This study aimed at developing a national consensus on entrustable professional activities (EPAs)... more This study aimed at developing a national consensus on entrustable professional activities (EPAs) for Saudi undergraduate medical education and mapping them with the "Saudi Meds" competency framework. Methods: A three phased approach was used. Phase 1 consisted of identifying and developing EPAs; Phase 2 consisted of building a national consensus on developed EPAs (validation process); and Phase 3 consisted of mapping the validated EPAs with the Saudi Meds competency framework. Nominal group and modified Delphi techniques were used to develop consensus on EPAs. Classical test theory-based item analysis was conducted to establish validity and reliability of finalized EPAs. Results: Fifteen expert medical educationists and 109 academic leaders from 23 medical schools participated in the validation process. The study achieved a consensus on 10 core EPAs with an overall reliability (Cronbach's Alpha) of 0.814. The item-total correlation ranged from 0.341 to 0.642. Conclusion: This study results in a national consensus on generic, comprehensive and region-specific EPAs that have been mapped with Saudi Meds competency framework. Our study is the first step in the direction of facilitating EPA-based curricular reforms in Saudi medical schools.

2015 Fifth International Conference on e-Learning (econf), 2015

An electronic portfolio (e-portfolio), defined as a collection of student work, plays an importan... more An electronic portfolio (e-portfolio), defined as a collection of student work, plays an important role for students since it insures several pedagogical and educational benefits. In fact, e-portfolio involves students in their learning and increases their ability to self evaluate in order to concentrate on their needs, challenges and objectives. On the market, there are many software for developing e-portfolio. The selection of the appropriate building software of e-portfolio is a challenge for educational organizations that should choose the right solution according to their specific requirements and situation. The aim of this paper is to improve the process of software selection for supporting decision makers. This paper focuses on multi criteria decision making approach specially on the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS).

Education for Health: Change in Learning & Practice, 2004

of Yemen are traditional, like most of the medical schools in the Middle East region. The curricu... more of Yemen are traditional, like most of the medical schools in the Middle East region. The curriculum in Dundee University Medical School, UK, claims to follow the prescriptions of the UK General Medical Council to be outcome based with three interlocking phases and students encouraged to take responsibility for their own learning. The aim of this study is to measure the educational environment, using the 50-item Dundee Ready Education Environment Measure (DREEM), in each medical school and to compare the educational environment as perceived by the responding students of the traditional medical schools in developing countries with that of the ''modernised'' medical school in Dundee University, UK. Methods: The DREEM was administered to 1072 medical students in the four different universities. Using SPSS, data were expressed as means of scores. Comparisons between schools, years of study and gender were made using non-parametric tests. Results: For all three traditional medical schools, the mean scores of the inventory were lower compared with Dundee Medical School. Students from traditional schools rated their learning and teaching environment significantly lower than their counterparts in

Eastern Mediterranean Health Journal, 2011

Medical education has been changing rapidly in Saudi Arabia. Within a decade, the number of medic... more Medical education has been changing rapidly in Saudi Arabia. Within a decade, the number of medical colleges increased from 5 medical schools with traditional disciplined-based curricula to 21 medical colleges with varied curricula ranging from the traditional to more innovative, problem-based, communityoriented programmes. The private sector has started investing in higher education generally and medical education in particular. Also other government sectors that provide advanced health services have started established new medical colleges. The expansion of quantity in medical education has been associated with a drive for greater quality assurance. Accreditation of higher education institutes began with the establishment of the National Commission for Academic Assessment and Accreditation in 2005. This review focuses on documenting developments in Saudi medical education up to 2008 and discussing the future potential and challenges facing the sector.

InTech eBooks, Mar 21, 2012

MSK symptoms are the most common health complications that require medical attention, accounting ... more MSK symptoms are the most common health complications that require medical attention, accounting to 20% of both primary care and emergency-room visits (Rasker 1995). In a health survey, MSK disorders were ranked first in prevalence as the cause of chronic health www.intechopen.com Systemic Lupus Erythematosus 220 problems, long term disabilities, and consultations with a health professional (Badley, Rasooly et al. 1994). In Saudi Arabia, MSK disorders is the second major cause of outpatients visit in primary care centers and private clinics (MOH 2009). A number of different medical specialties are involved in treating patients with musculoskeletal complaints, including general practitioners, family physicians, internists, orthopedic and surgeons, working in teams with other health professionals, but often without a multispecialty focus. In order to truly improve the outcome of treatment for musculoskeletal conditions, it is important that experts in the various specialties work more closely together and look for commonality of approach, as they often treat the same patients but from different angles. Despite the high prevalence of musculoskeletal disorders in all fields of clinical practice, studies show a lower level of competence and confidence in MSK cognitive and clinical skills (including physical examinations) across clinicians (Akesson, Dreinhofer et al. 2003; Almoallim, Khojah et al. 2007; Beattie, Bobba et al. 2008). Also, a continuous neglect of musculoskeletal examination skills in clinical practice is observed. We reported a case of SLE with active arthritis where the diagnosis was delayed for seven days after hospital admission due to the lack of basic skills in MSK examination (Almoallim, Khojah et al. 2007). The patient in the report presented to the emergency room with fever and pancytopenia and apparently the focus of the treating medical team was mainly on these presenting findings. This might had restricted the clerking done on admission to "hematology and infectious diseases" while what should had been done was a complete history and thorough physical examination regardless of initial impression. Musculoskeletal assessment should be a part of routine clerking (Lillicrap, Byrne et al. 2003). Assuring such attitude among clinicians will prevent unnecessary delay in diagnosis. If a simple musculoskeletal screening examination focused mainly on range of motion testing to assess function was done, this patient's active arthritis would have been picked up on admission. This would have initiated early search for a rheumatological disease and start treatment without a delay. Despite this impact of MSK disorders on health care, rheumatological diseases are often overlooked or inadequately assessed by doctors (Jones, Maddison et al. 1992). Thus, patients with complaints about bones and joints are often ignored and their problems underestimated by doctors. In a study among 200 general medical inpatients in a teaching hospital, it was found out that the signs and symptoms of MSK disorder which were recorded in the hospital notes was only 5.5% and 14% respectively. This compared poorly with recorded examinations of other systems and regions for example, cardiovascular symptoms were recorded in 100% of the cases; respiratory and abdominal symptoms were recorded in 99%, the nervous system , skin and female breasts symptoms were recorded in 77% and 13% respectively (Doherty, Abawi et al. 1990). In another report, only 40%of patients admitted to general medicine ward had the history of their MSK symptoms recorded and only 14.5% of these patients received comprehensive MSK examination (Ahern, Soden et al. 1991). Furthermore, 80% of symptomatic patients received either no treatment for their rheumatic disorders, or treatment that was regarded as suboptimal or inappropriate (Ahern, Soden et al. 1991). Another report showed even a higher percentage of patients-63% of all patient admitted to general medicine ward-had MSK symptoms or its signs, but relevant MSK history was missed in 49% of the patients records, while signs were missed in 78%; 42% of those with MSK conditions would have benefitted from additional treatment (Lillicrap, Byrne et al. 2003). A more recent report reviewed 150 patient notes in three different hospitals from the acute admission wards for medicine and surgery and the medical assessment unit. Factors considered included whether GALS screenings

Creative Education, 2016

Background: Musculoskeletal (MSK) conditions are among the most common complains presented at the... more Background: Musculoskeletal (MSK) conditions are among the most common complains presented at the clinical practice, accounting about 15%-30% of all primary care encounters. However, clinical doctors continue to document a low level of confidence in their musculoskeletal clinical skills. Objectives: The aim of this study is to evaluate the internal medicine (IM) residents for confidence and perception in demonstrating musculoskeletal clinical skills. Methods: 37 items paper-based questionnaire was developed and piloted to investigate IM residents in Saudi Arabia during June-December 2011. Results: The study indicates residents' low self-confidence in demonstrating MSK physical examinations with total mean (10/24). Respondents also show general agreement that MSK problems are very common in patient visits, and indicate the importance of MSK clinical screening in all standard clinical examination of patients, yet they point to current inappropriate practice in handling most cases. Respondents show lower perception of undergraduate and postgraduate training, regarding the inadequate training and assessment in MSK. Conclusions: The study shows inadequate MSK education, during and post, medical school training and that there are different training approaches for the different specialties, which undermines MSK training altogether.

Medical science, May 30, 2022

Background: Burnout is considered a work-related stress syndrome. We investigate the burnout prev... more Background: Burnout is considered a work-related stress syndrome. We investigate the burnout prevalence and the risk factors associated with burnout during the coronavirus disease-2019 (COVID-19) pandemic online teaching at Umm Al-Qura University (UQU) medical school. Method: During online teaching, an analytical cross-sectional study was conducted among UQU medical students. Data were collected between February to March 2021. Burnout was assessed using a validated tool. Result: About 568 students from year two to six medical school completed the survey. The study revealed that a total of 224 (39.44%) students experience burnout. Multiple logistic regression exhibited students with chronic disease were 2-times likely to have burnout. Moderate GPA students (GPA of 3-3.4 out of 4) scored high burnout compared to peers with GPA 3.4-4. There was a statistically higher likelihood between burnout and students who reported negative effects of studying on their social life, high family expectation, and dissatisfaction with blended learning experience. Conclusion: The overall burnout prevalence was 39.44% among UQU medical students. Many factors were associated with student's burnout, such as chronic disease, moderate GPA, and high family expectations.

Advances in Medical Education and Practice

The purpose of the Saudi Medical Education Directives Framework (SaudiMEDs) is to assure the esse... more The purpose of the Saudi Medical Education Directives Framework (SaudiMEDs) is to assure the essential level of competencies for medical graduates, which should be reflected in the Saudi Medical Licensure Examination (SMLE). This study explored the opinions of key stakeholders of the alignment and integration of the SMLE's blueprint and contents with the SaudiMEDs competency framework's themes and domains. Participants and Methods: This was a qualitative case study, using a purposive sampling technique. Ten participants participated in the study representing the main stakeholders. The participants were four deans, an assistant dean, two residents, and three interns of various colleges of medicine (COM). In-depth interviews were conducted through a semi-structured format, either online or in-person. The interviews were recorded, transcribed verbatim and analyzed according to the general guidelines of qualitative content analysis. Results: Four major themes emerged from the data, including the current alignment practices of the COM, competencies enhanced through preparing according to the SMLE, the SaudiMEDs representation in the SMLE, and finally a roadmap to achieve optimum alignment between the SaudiMEDs and the SMLE. Conclusion: The participants were knowledgeable about the SaudiMEDs and perceived the SMLE blueprint and contents to be partially aligned with the themes and domains of the SaudiMEDs competency framework. The responses suggested that additional effort is required to improve the current alignment to assess the competencies of COM graduates appropriately.

Medical Science

Systemic lupus erythematosus (SLE) is a wide spectrum disease with many clinical manifestations. ... more Systemic lupus erythematosus (SLE) is a wide spectrum disease with many clinical manifestations. Lack of awareness of the disease itself, with its common and rare presentations results in significant delay in diagnosis and consequently serious compromise of patients’ care. Physical examination will always retain its importance as the most common diagnostic test used by doctors and as an essential tool for modern practice(Joshua, Celermajer et al. 2005). Findings from proper musculoskeletal (MSK) examination is extremely useful in diagnosing rheumatologic disorders especially where gold standard diagnostic tests are lacking. From this perspective there should be much emphasis on basic bedside skills among clinicians searching for arthritis. Asking about morning stiffness and joint swelling are simple enough to pick up early arthritis (Paget 2007). Performing an active range of motion testing of joints as a screening method would pick up limitations in joints mobility from active arth...

Health Professions Education, 2018

The fundamental pillar of a safe and efficient healthcare system is the competence of the healthc... more The fundamental pillar of a safe and efficient healthcare system is the competence of the healthcare providers. Judging whether a provider is competent is usually decided about by medical licensing boards. The dire need of competent practitioners has led to pushing the boundaries of mere licensing, and has led to the development of an approach that ensures the proficiency of a medical graduate, culminating into the conception of competency-based medical education (CBME). CBME is an approach to preparing physicians for practice who possess the desired knowledge, skills, and attitude outlined by the careful consideration of societal and patient needs. CBME has gained immense popularity and is broadly implemented in the health sciences during the past couple of decades. Gradually, many undergraduate as well as postgraduate training programs are shifting their curriculum to align with so-called "competency frameworks." The most well-known among these are the Canadian CanMEDS framework, the Accreditation Council for Graduate Medical Education proposal, the Scottish Doctor learning outcomes, and the Dutch national framework. Recently, in response to the national vision titled "the Saudi Future Doctor", a competency framework namely Saudi MEDS has been developed for Saudi medical graduates. 1 The idea behind developing this generic competency framework was to formulate minimum competency standards that any medical graduate has to meet. The collaborative team, consisting of representatives from five major Saudi health sciences universities, chalked out the competencies framework that reflect the principles of medical practice in Saudi Arabia.

Medical teacher, Jan 17, 2018

Medical education has a longstanding tradition of using logbooks to record activities. The portfo... more Medical education has a longstanding tradition of using logbooks to record activities. The portfolio is an alternative tool to document competence and promote reflective practice. This study assessed the acceptance of portfolio use among Saudi undergraduate medical students. Portfolios were introduced in the 2nd through 5th years at King Abdulaziz University over a two-year period (2013-2015). At the end of each academic year, students completed a mixed questionnaire that included a self-assessment of skills learned through the use of portfolio. The results showed a difference in focus between basic and clinical years: in basic years students' focus was on acquiring practical skills, but in clinical years they focused more on acquiring complex skills, including identifying and managing problems. The questionnaire responses nonetheless revealed a positive trend in acceptance (belief in the educational value) of portfolios among students and their mentors, across the years of the ...

Creative Education, 2016

Advances in Medical Education and Practice

2015 Fifth International Conference on e-Learning (econf), 2015

Education for Health: Change in Learning & Practice, 2004

Eastern Mediterranean Health Journal, 2011

InTech eBooks, Mar 21, 2012

Creative Education, 2016

Medical science, May 30, 2022

Advances in Medical Education and Practice

Medical Science

Health Professions Education, 2018

Medical teacher, Jan 17, 2018

Creative Education, 2016