Professor Samy Azer | King Saud University (original) (raw)
azer sa by Professor Samy Azer
Journal of Research …, Jan 1, 2007
The American Journal of Gastroenterology, Jan 1, 2000
TO THE EDITOR: Your recent case by Yamagishi and Watanabe ( 1 ) on obstructive jaundice as a pres... more TO THE EDITOR: Your recent case by Yamagishi and Watanabe ( 1 ) on obstructive jaundice as a presenting symptom of recurrent small cell lung cancer is interesting. The authors, however, claimed that there are no other reports in the literature that have demonstrated ...
Medical Teacher, Jan 1, 2011
Worldwide many universities are changing their curricula and introducing integrated problem-based... more Worldwide many universities are changing their curricula and introducing integrated problem-based learning (PBL) programs. However, the introduction of a PBL program is a demanding process and requires resources, a lot of planning, and organisation. This article aims at providing practical tips for preparing a PBL program. It highlights key challenges to create such programs and offers possible solutions to common challenges encountered. Personal experience in introducing PBL programs in several universities together with key principles highlighted in the literature have been presented and discussed in light of the current medical education research. Introducing an integrated PBL program requires continuous support from the Dean and the Vice Chancellor. An essential step in this process is preparation and engagement of the faculty so that academics and clinicians become aware of the rationales for the change and work as part of a team in the construction of the new program. Consulting with other Departments of Medical Education that have introduced PBL, may help in avoiding common mistakes and providing a practical advice. Although there is no panacea for the introduction of a PBL program, this article addresses keys for successful introduction of such programs.
medscape.com
... Samy A Azer, MD, PhD, MPH Professor of Medical Education and Head of Curriculum Development U... more ... Samy A Azer, MD, PhD, MPH Professor of Medical Education and Head of Curriculum Development Unit, King Saud University, Riyadh, Saudi Arabia; Visiting Professor of Medical Education, Faculty of Medicine, University of Toyama, Japan; former Professor of Medical ...
The American journal of gastroenterology, Jan 1, 2003
TO THE EDITOR: I read with great interest the paper by Caldwell and Hespenheide ( 1 ) on subacute... more TO THE EDITOR: I read with great interest the paper by Caldwell and Hespenheide ( 1 ) on subacute liver failure in obese women. The authors reported five obese female patients, aged 4165 yr with no past history of liver disease, who presented with subacute liver failure.
Saudi medical journal, Jan 1, 2001
Saudi medical journal, Jan 1, 2000
Surgical and Radiologic Anatomy, Jan 1, 2007
Background The introduction of a problem-based learning (PBL) curriculum at the School of Medicin... more Background The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of diVerent body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are:
Annals of Saudi medicine, Jan 1, 2007
Over the last 30 years, several changes have been introduced in medical education including the i... more Over the last 30 years, several changes have been introduced in medical education including the introduction of new contextualized approaches to instruction (e.g., problem-based learning [PBL]), the use of multimedia to enhance self-directed learning, the use of an integrated curriculum to address basic and clinical sciences, and the introduction of new formative and summative assessment tools that match with the curriculum changes. However, several challenges face medical education and need to be carefully researched. The list may be long and these challenges may vary depending on the needs of local and international health systems, the availability of resources, the vision of medical leaders and how they see these challenges and their impact. This paper discusses a number of challenges facing medical education including the selection of medical students and the validity of selection tools, students' learning skills, what makes a good medical curriculum, and the challenges facing a PBL curriculum.
Medical Teacher, Jan 1, 2004
Problem-based learning (PBL) serves as an educational method to foster self-directed learning, in... more Problem-based learning (PBL) serves as an educational method to foster self-directed learning, integration across disciplines, small-group learning and decision-making strategies. The approach is student centred. During the discussion of a PBL case there are a number of important issues to be considered by students, such as keeping ground rules, knowing their roles, keeping group dynamics, becoming a purposeful learner, planning how to use tutors' feedback to enhance group discussion and boost student's learning skills, as well as striving to become a winning team. This paper provides 12 practical tips to PBL students to enhance their skills in discussing a case in their group.
The Kaohsiung Journal of Medical Sciences, Jan 1, 2009
Problem-based learning (PBL) is an excellent opportunity for students to take responsibility for ... more Problem-based learning (PBL) is an excellent opportunity for students to take responsibility for their learning and to develop a number of cognitive skills. These include identifying problems in the trigger, generating hypotheses, constructing mechanisms, developing an enquiry plan, ranking their hypotheses on the basis of available evidence, interpreting clinical and laboratory findings, identifying their learning needs, and dealing with uncertainty. Students also need to work collaboratively in their group, communicate effectively, and take active roles in the tutorials. Therefore, interaction in the group between students and their tutor is vital to ensure deep learning and successful outcomes. The aims of this paper are to discuss the key principles for successful interaction in PBL tutorials and to highlight the major symptoms of superficial learning and poor interactions. This comprises a wide range of symptoms for different group problems, including superficial learning. By early detection of such problems, tutors will be able to explore actions with the group and negotiate changes that can foster group dynamics and enforce deep learning.
Journal of the Royal Society of Medicine, Jan 1, 2005
The Kaohsiung Journal of Medical Sciences, Jan 1, 2008
Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as... more Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as students' attitudes, professionalism and teamwork. However, their use early in a problem-based learning (PBL) course to foster deep learning and enhance students' self-directed learning has not been adequately studied. The aims of this paper are to: (1) understand the uses of portfolios and the rationale for using reflection in the early years of a PBL curriculum; (2) discuss how to introduce portfolios and encourage students' critical thinking skills, not just reflection; and (3) provide students with tips that could enhance their skills in constructing good portfolios.
ANNALS-ACADEMY OF MEDICINE …, Jan 1, 2008
Over the last 3 decades, the rate of knowledge accumulation in drug development has been enhanced... more Over the last 3 decades, the rate of knowledge accumulation in drug development has been enhanced by advances in molecular modelling, the molecular genetics of drug action and the screening from natural sources for novel therapeutic agents. These advances mandate the need for a more adaptive and responsive educational structure to arm students with skills to access the rapidly moving knowledge base. Medical educators have also realised the need to teach undergraduate students "how to think" in addition to "what to think". With the widespread use of computers and web-based educational resources, finding new information has not become a priority in medical education, what is more important is to train medical students to become critical thinkers, able to use information learnt in clinical situations and apply common principles which underpin therapeutic decision making and selection of therapeutic agents. Enhancement of community awareness, the worldwide availability of access to the internet for self-education, and the emerging ethical and legal issues in relation to the changes in our life with availability of new therapeutic approaches such as organ transplantation, genetic engineering in disease management, stem-cell research and its potential therapeutic uses, have necessitated the need to restructure medical curricula and undergraduate medical training to fulfill these needs. The aims of this paper were: (i) to discuss the model we used in introducing clinical pharmacology and therapeutics in our curriculum at the University of Melbourne and the educational principles behind the model, and (ii) to discuss the new tools of assessment used with this structure.
Medical Teacher, Jan 1, 2007
A trigger is the starting point of problem-based learning (PBL) cases. It is usually in the form ... more A trigger is the starting point of problem-based learning (PBL) cases. It is usually in the form of 5-6 text lines that provide the key information about the main character (usually the patient), including 3-4 of patient's presenting problems. In addition to the trigger text, most programs using PBL include a visual trigger. This might be in the form of a single image, a series of images, a video clip, a cartoon, or even one of the patient's investigation results (e.g. chest X-ray, pathology report, or urine sample analysis). The main educational objectives of the trigger image are as follows: (1) to introduce the patient to the students; (2) to enhance students' observation skills; (3) to provide them with new information to add to the cues obtained from the trigger text; and (4) to stimulate students to ask questions as they develop their enquiry plan. When planned and delivered effectively, trigger images should be engaging and stimulate group discussion. Understanding the educational objectives of using trigger images and choosing appropriate images are the keys for constructing successful PBL cases. These twelve tips highlight the key steps in the successful creation of trigger images.
Australian Journal of Rural …, Jan 1, 2001
The aim of this project is to investigate the relationship between medical students' background a... more The aim of this project is to investigate the relationship between medical students' background and their perception of the state of rural health services; willingness to undertake internship training or work as a doctor in a rural hospital; expected benefits and disadvantages of training or working as a doctor in a rural hospital; and factors interfering with acceptance of a job as a doctor in rural areas. A questionnaire-based survey was distributed to 100 first-year medical students attending the Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne at the end of semester 1. The response rate was 97%, including 44 males and 53 females. A strong relationship was found between rural background and an intention to undertake internship training in a rural hospital (86% of students from a rural background expressed this desire vs 30% of students from an urban background). Furthermore, all students from a rural background expressed a desire to work as a doctor in a rural hospital after completing postgraduate training. Compared to urban students, students from a rural background showed a more positive attitude towards health services in rural areas including public hospitals ( P = 0.02), private general practice ( P = 0.004), ambulance service ( P = 0.0002) and baby health centres ( P = 0.005). Citizenship or gender was not significantly related to the perception of any of these services. The ranking of factors interfering with acceptance of a job as a doctor in rural areas were different for rural and urban students. Students from rural backgrounds reported spouse/partner needs (76% vs 49%, P = 0.038) and school availability for children (59% vs 30%, P = 0.023) as barriers more frequently than urban students, respectively). On the other hand, urban students rated the following factors higher: personal factors (76% vs 53%, respectively), education opportunities (56% vs 24%), social/cultural facilities (50% vs 41%) and the need for frequent travel (29% vs 12%). None of these interfering factors were significantly different. Urban students were more likely than rural students to report that their views were a result of adverse media reports. In conclusion, students from a rural background were more willing to be trained or to work as doctors in rural areas. This was associated with a greater adverse influence by the media upon students.
Medical Teacher, Jan 1, 2005
One of the main tasks of a problem-based leaming (PBL) tutor is to facilitate group discussion. G... more One of the main tasks of a problem-based leaming (PBL) tutor is to facilitate group discussion. Group facilitation is about process rather than content. In this process, a tutor helps the group increase their skills and progress in their discussion. Several studies have highlighted strategies and training used in preparing PBL tutors. However, PBL tutors usually feel that it is not that easy to change their teaching style to the PBL format. They are sometimes unsure about their role or what strategy they might use to facilitate their students' discussion. This article in the '12 Tips' series is a detailed description of, and provides answers to, common challenges faced by PBL tutors. The tips provided in this manuscript should help tutors with practical answers. The article may be useful to PBL tutors, medical and health educators and those responsible for PBL training workshops.
ANNALS-ACADEMY OF MEDICINE SINGAPORE, Jan 1, 2005
Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and t... more Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and the use of specific educational tools that enhance cognitive skills, students might deprive themselves of achieving the deep learning experience expected to take place in a PBL course. One of the educational tasks in PBL is the creation of mechanisms for hypotheses made by the students, based on their knowledge of the basic sciences and the psychosocial issues raised in a particular case scenario. The whole task is student-constructed and should enhance their ability to explain the scientific basis of the symptoms and clinical signs of the patient enlisted in the case. Because students usually discuss the case without enough prior related knowledge, they might find it difficult to address different aspects of their mechanisms. These gaps in knowledge may be considered part of their "learning issues". In tutorial 2 (a PBL case is usually discussed in 2 or 3 tutorials at the maximum; each tutorial is 2 hours long), students should be able to build a comprehensive mechanism reflecting their deep understanding of the problem. However, students might not be able to integrate information learnt and their mechanisms might show a number of shortcuts and/or lack integration of information, and the flow of the pathophysiological changes may not be logical. This manuscript describes 5 key open-ended questions in PBL tutorials to facilitate students' discussions as they create their mechanisms.
Advances in physiology education, Jan 1, 2005
Azer, Samy A. A multimedia CD-ROM tool to improve student understanding of bile salts and bilirub... more Azer, Samy A. A multimedia CD-ROM tool to improve student understanding of bile salts and bilirubin metabolism: evaluation of its use in a medical hybrid PBL course. Over the last 35 years our understanding of bile salts, bilirubin metabolism, and hepatobiliary transport has progressively increased. From 1965 to the end of 2002, 3,610 articles and review papers have been published on hepatobiliary and enterocyte transport of bile salts. However, there is a lack of information in the content of current textbooks about hepatobiliary physiology, bile salt transporters, bile formation, mechanisms underlying cholestasis, and drug-induced liver injury. The use of an integrated multimedia program on the liver covering these gaps in textbooks may be useful to student learning. This study aims to 1) assess student views on a multimedia CD-ROM ("The Liver") integrating basic and clinical sciences related to the liver, bile salts, and bilirubin metabolism, 2) assess the usefulness of problem-based learning (PBL) cases included in the multimedia CD-ROM, and 3) assess student learning before and after use of the multimedia CD-ROM. A total of 106 first-year medical students (27 with and 79 without a prior university degree) at the University of Melbourne participated in this study. Students were tested on the liver, bile salts, and bilirubin metabolism before and after using the multimedia CD-ROM. After completing the multimedia CD-ROM, each student filled out a 5-point Likert scale questionnaire evaluating the features of the program and its usefulness to their learning. Results show that the aims of the package were clear to participants, the contents were logically organized and clear, the key concepts were easy to identify, the contents were pitched to an appropriate level, and the package was interactive and encouraged participants to reflect on their learning. Students also agreed that the assessment tools used in the program and the feedback provided were meaningful and helpful to their learning. No differences were found when responses were compared on the basis of academic background, gender, citizenship, or first language of participants. Students agreed that the PBL cases in the CD-ROM kept them engaged, were useful to their learning, and matched with the overall philosophy of the program. Compared with graduate-entry students (those with a prior university degree), school leavers (those with no prior university degree) showed a more positive attitude toward the PBL cases included in the multimedia CD-ROM and agreed that cases kept them engaged (P ϭ 0.033). Students who completed the test after using the multimedia CD-ROM scored higher compared with those who completed the test before using the multimedia CD-ROM (P Ͻ0.001). In conclusion, using bile salts, bilirubin metabolism, and their hepatobiliary transport as an example, the incorporation of a multimedia CD-ROM into the first-year medical course has the potential to improve student understanding of the main concepts in a variety of body systems. medical education; basic sciences; problem-based learning; the liver transporters
Journal of Research …, Jan 1, 2007
The American Journal of Gastroenterology, Jan 1, 2000
TO THE EDITOR: Your recent case by Yamagishi and Watanabe ( 1 ) on obstructive jaundice as a pres... more TO THE EDITOR: Your recent case by Yamagishi and Watanabe ( 1 ) on obstructive jaundice as a presenting symptom of recurrent small cell lung cancer is interesting. The authors, however, claimed that there are no other reports in the literature that have demonstrated ...
Medical Teacher, Jan 1, 2011
Worldwide many universities are changing their curricula and introducing integrated problem-based... more Worldwide many universities are changing their curricula and introducing integrated problem-based learning (PBL) programs. However, the introduction of a PBL program is a demanding process and requires resources, a lot of planning, and organisation. This article aims at providing practical tips for preparing a PBL program. It highlights key challenges to create such programs and offers possible solutions to common challenges encountered. Personal experience in introducing PBL programs in several universities together with key principles highlighted in the literature have been presented and discussed in light of the current medical education research. Introducing an integrated PBL program requires continuous support from the Dean and the Vice Chancellor. An essential step in this process is preparation and engagement of the faculty so that academics and clinicians become aware of the rationales for the change and work as part of a team in the construction of the new program. Consulting with other Departments of Medical Education that have introduced PBL, may help in avoiding common mistakes and providing a practical advice. Although there is no panacea for the introduction of a PBL program, this article addresses keys for successful introduction of such programs.
medscape.com
... Samy A Azer, MD, PhD, MPH Professor of Medical Education and Head of Curriculum Development U... more ... Samy A Azer, MD, PhD, MPH Professor of Medical Education and Head of Curriculum Development Unit, King Saud University, Riyadh, Saudi Arabia; Visiting Professor of Medical Education, Faculty of Medicine, University of Toyama, Japan; former Professor of Medical ...
The American journal of gastroenterology, Jan 1, 2003
TO THE EDITOR: I read with great interest the paper by Caldwell and Hespenheide ( 1 ) on subacute... more TO THE EDITOR: I read with great interest the paper by Caldwell and Hespenheide ( 1 ) on subacute liver failure in obese women. The authors reported five obese female patients, aged 4165 yr with no past history of liver disease, who presented with subacute liver failure.
Saudi medical journal, Jan 1, 2001
Saudi medical journal, Jan 1, 2000
Surgical and Radiologic Anatomy, Jan 1, 2007
Background The introduction of a problem-based learning (PBL) curriculum at the School of Medicin... more Background The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of diVerent body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are:
Annals of Saudi medicine, Jan 1, 2007
Over the last 30 years, several changes have been introduced in medical education including the i... more Over the last 30 years, several changes have been introduced in medical education including the introduction of new contextualized approaches to instruction (e.g., problem-based learning [PBL]), the use of multimedia to enhance self-directed learning, the use of an integrated curriculum to address basic and clinical sciences, and the introduction of new formative and summative assessment tools that match with the curriculum changes. However, several challenges face medical education and need to be carefully researched. The list may be long and these challenges may vary depending on the needs of local and international health systems, the availability of resources, the vision of medical leaders and how they see these challenges and their impact. This paper discusses a number of challenges facing medical education including the selection of medical students and the validity of selection tools, students' learning skills, what makes a good medical curriculum, and the challenges facing a PBL curriculum.
Medical Teacher, Jan 1, 2004
Problem-based learning (PBL) serves as an educational method to foster self-directed learning, in... more Problem-based learning (PBL) serves as an educational method to foster self-directed learning, integration across disciplines, small-group learning and decision-making strategies. The approach is student centred. During the discussion of a PBL case there are a number of important issues to be considered by students, such as keeping ground rules, knowing their roles, keeping group dynamics, becoming a purposeful learner, planning how to use tutors' feedback to enhance group discussion and boost student's learning skills, as well as striving to become a winning team. This paper provides 12 practical tips to PBL students to enhance their skills in discussing a case in their group.
The Kaohsiung Journal of Medical Sciences, Jan 1, 2009
Problem-based learning (PBL) is an excellent opportunity for students to take responsibility for ... more Problem-based learning (PBL) is an excellent opportunity for students to take responsibility for their learning and to develop a number of cognitive skills. These include identifying problems in the trigger, generating hypotheses, constructing mechanisms, developing an enquiry plan, ranking their hypotheses on the basis of available evidence, interpreting clinical and laboratory findings, identifying their learning needs, and dealing with uncertainty. Students also need to work collaboratively in their group, communicate effectively, and take active roles in the tutorials. Therefore, interaction in the group between students and their tutor is vital to ensure deep learning and successful outcomes. The aims of this paper are to discuss the key principles for successful interaction in PBL tutorials and to highlight the major symptoms of superficial learning and poor interactions. This comprises a wide range of symptoms for different group problems, including superficial learning. By early detection of such problems, tutors will be able to explore actions with the group and negotiate changes that can foster group dynamics and enforce deep learning.
Journal of the Royal Society of Medicine, Jan 1, 2005
The Kaohsiung Journal of Medical Sciences, Jan 1, 2008
Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as... more Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as students' attitudes, professionalism and teamwork. However, their use early in a problem-based learning (PBL) course to foster deep learning and enhance students' self-directed learning has not been adequately studied. The aims of this paper are to: (1) understand the uses of portfolios and the rationale for using reflection in the early years of a PBL curriculum; (2) discuss how to introduce portfolios and encourage students' critical thinking skills, not just reflection; and (3) provide students with tips that could enhance their skills in constructing good portfolios.
ANNALS-ACADEMY OF MEDICINE …, Jan 1, 2008
Over the last 3 decades, the rate of knowledge accumulation in drug development has been enhanced... more Over the last 3 decades, the rate of knowledge accumulation in drug development has been enhanced by advances in molecular modelling, the molecular genetics of drug action and the screening from natural sources for novel therapeutic agents. These advances mandate the need for a more adaptive and responsive educational structure to arm students with skills to access the rapidly moving knowledge base. Medical educators have also realised the need to teach undergraduate students "how to think" in addition to "what to think". With the widespread use of computers and web-based educational resources, finding new information has not become a priority in medical education, what is more important is to train medical students to become critical thinkers, able to use information learnt in clinical situations and apply common principles which underpin therapeutic decision making and selection of therapeutic agents. Enhancement of community awareness, the worldwide availability of access to the internet for self-education, and the emerging ethical and legal issues in relation to the changes in our life with availability of new therapeutic approaches such as organ transplantation, genetic engineering in disease management, stem-cell research and its potential therapeutic uses, have necessitated the need to restructure medical curricula and undergraduate medical training to fulfill these needs. The aims of this paper were: (i) to discuss the model we used in introducing clinical pharmacology and therapeutics in our curriculum at the University of Melbourne and the educational principles behind the model, and (ii) to discuss the new tools of assessment used with this structure.
Medical Teacher, Jan 1, 2007
A trigger is the starting point of problem-based learning (PBL) cases. It is usually in the form ... more A trigger is the starting point of problem-based learning (PBL) cases. It is usually in the form of 5-6 text lines that provide the key information about the main character (usually the patient), including 3-4 of patient's presenting problems. In addition to the trigger text, most programs using PBL include a visual trigger. This might be in the form of a single image, a series of images, a video clip, a cartoon, or even one of the patient's investigation results (e.g. chest X-ray, pathology report, or urine sample analysis). The main educational objectives of the trigger image are as follows: (1) to introduce the patient to the students; (2) to enhance students' observation skills; (3) to provide them with new information to add to the cues obtained from the trigger text; and (4) to stimulate students to ask questions as they develop their enquiry plan. When planned and delivered effectively, trigger images should be engaging and stimulate group discussion. Understanding the educational objectives of using trigger images and choosing appropriate images are the keys for constructing successful PBL cases. These twelve tips highlight the key steps in the successful creation of trigger images.
Australian Journal of Rural …, Jan 1, 2001
The aim of this project is to investigate the relationship between medical students' background a... more The aim of this project is to investigate the relationship between medical students' background and their perception of the state of rural health services; willingness to undertake internship training or work as a doctor in a rural hospital; expected benefits and disadvantages of training or working as a doctor in a rural hospital; and factors interfering with acceptance of a job as a doctor in rural areas. A questionnaire-based survey was distributed to 100 first-year medical students attending the Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne at the end of semester 1. The response rate was 97%, including 44 males and 53 females. A strong relationship was found between rural background and an intention to undertake internship training in a rural hospital (86% of students from a rural background expressed this desire vs 30% of students from an urban background). Furthermore, all students from a rural background expressed a desire to work as a doctor in a rural hospital after completing postgraduate training. Compared to urban students, students from a rural background showed a more positive attitude towards health services in rural areas including public hospitals ( P = 0.02), private general practice ( P = 0.004), ambulance service ( P = 0.0002) and baby health centres ( P = 0.005). Citizenship or gender was not significantly related to the perception of any of these services. The ranking of factors interfering with acceptance of a job as a doctor in rural areas were different for rural and urban students. Students from rural backgrounds reported spouse/partner needs (76% vs 49%, P = 0.038) and school availability for children (59% vs 30%, P = 0.023) as barriers more frequently than urban students, respectively). On the other hand, urban students rated the following factors higher: personal factors (76% vs 53%, respectively), education opportunities (56% vs 24%), social/cultural facilities (50% vs 41%) and the need for frequent travel (29% vs 12%). None of these interfering factors were significantly different. Urban students were more likely than rural students to report that their views were a result of adverse media reports. In conclusion, students from a rural background were more willing to be trained or to work as doctors in rural areas. This was associated with a greater adverse influence by the media upon students.
Medical Teacher, Jan 1, 2005
One of the main tasks of a problem-based leaming (PBL) tutor is to facilitate group discussion. G... more One of the main tasks of a problem-based leaming (PBL) tutor is to facilitate group discussion. Group facilitation is about process rather than content. In this process, a tutor helps the group increase their skills and progress in their discussion. Several studies have highlighted strategies and training used in preparing PBL tutors. However, PBL tutors usually feel that it is not that easy to change their teaching style to the PBL format. They are sometimes unsure about their role or what strategy they might use to facilitate their students' discussion. This article in the '12 Tips' series is a detailed description of, and provides answers to, common challenges faced by PBL tutors. The tips provided in this manuscript should help tutors with practical answers. The article may be useful to PBL tutors, medical and health educators and those responsible for PBL training workshops.
ANNALS-ACADEMY OF MEDICINE SINGAPORE, Jan 1, 2005
Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and t... more Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and the use of specific educational tools that enhance cognitive skills, students might deprive themselves of achieving the deep learning experience expected to take place in a PBL course. One of the educational tasks in PBL is the creation of mechanisms for hypotheses made by the students, based on their knowledge of the basic sciences and the psychosocial issues raised in a particular case scenario. The whole task is student-constructed and should enhance their ability to explain the scientific basis of the symptoms and clinical signs of the patient enlisted in the case. Because students usually discuss the case without enough prior related knowledge, they might find it difficult to address different aspects of their mechanisms. These gaps in knowledge may be considered part of their "learning issues". In tutorial 2 (a PBL case is usually discussed in 2 or 3 tutorials at the maximum; each tutorial is 2 hours long), students should be able to build a comprehensive mechanism reflecting their deep understanding of the problem. However, students might not be able to integrate information learnt and their mechanisms might show a number of shortcuts and/or lack integration of information, and the flow of the pathophysiological changes may not be logical. This manuscript describes 5 key open-ended questions in PBL tutorials to facilitate students' discussions as they create their mechanisms.
Advances in physiology education, Jan 1, 2005
Azer, Samy A. A multimedia CD-ROM tool to improve student understanding of bile salts and bilirub... more Azer, Samy A. A multimedia CD-ROM tool to improve student understanding of bile salts and bilirubin metabolism: evaluation of its use in a medical hybrid PBL course. Over the last 35 years our understanding of bile salts, bilirubin metabolism, and hepatobiliary transport has progressively increased. From 1965 to the end of 2002, 3,610 articles and review papers have been published on hepatobiliary and enterocyte transport of bile salts. However, there is a lack of information in the content of current textbooks about hepatobiliary physiology, bile salt transporters, bile formation, mechanisms underlying cholestasis, and drug-induced liver injury. The use of an integrated multimedia program on the liver covering these gaps in textbooks may be useful to student learning. This study aims to 1) assess student views on a multimedia CD-ROM ("The Liver") integrating basic and clinical sciences related to the liver, bile salts, and bilirubin metabolism, 2) assess the usefulness of problem-based learning (PBL) cases included in the multimedia CD-ROM, and 3) assess student learning before and after use of the multimedia CD-ROM. A total of 106 first-year medical students (27 with and 79 without a prior university degree) at the University of Melbourne participated in this study. Students were tested on the liver, bile salts, and bilirubin metabolism before and after using the multimedia CD-ROM. After completing the multimedia CD-ROM, each student filled out a 5-point Likert scale questionnaire evaluating the features of the program and its usefulness to their learning. Results show that the aims of the package were clear to participants, the contents were logically organized and clear, the key concepts were easy to identify, the contents were pitched to an appropriate level, and the package was interactive and encouraged participants to reflect on their learning. Students also agreed that the assessment tools used in the program and the feedback provided were meaningful and helpful to their learning. No differences were found when responses were compared on the basis of academic background, gender, citizenship, or first language of participants. Students agreed that the PBL cases in the CD-ROM kept them engaged, were useful to their learning, and matched with the overall philosophy of the program. Compared with graduate-entry students (those with a prior university degree), school leavers (those with no prior university degree) showed a more positive attitude toward the PBL cases included in the multimedia CD-ROM and agreed that cases kept them engaged (P ϭ 0.033). Students who completed the test after using the multimedia CD-ROM scored higher compared with those who completed the test before using the multimedia CD-ROM (P Ͻ0.001). In conclusion, using bile salts, bilirubin metabolism, and their hepatobiliary transport as an example, the incorporation of a multimedia CD-ROM into the first-year medical course has the potential to improve student understanding of the main concepts in a variety of body systems. medical education; basic sciences; problem-based learning; the liver transporters
Advances in Physiology Education, 2015
The aim of the present study was to critically evaluate the accuracy and readability of English W... more The aim of the present study was to critically evaluate the accuracy and readability of English Wikipedia articles on the respiratory system and its disorders and whether they can be a suitable resource for medical students. On April 27, 2014, English Wikipedia was searched for articles on respiratory topics. Using a modified DISCERN instrument, articles were independently scored by three assessors. The scoring targeted content accuracy, frequency of updating, and quality of references. The readability of articles was measured using two other instruments. The mean DISCERN score for the 40 articles identified was 26.4 ± 6.3. Most articles covered causes, signs and symptoms, prevention, and treatment. However, several knowledge deficiencies in the pathogenesis of diseases, investigations needed, and treatment were observed. The total number of references for the 40 articles was 1,654, and the references varied from 0 to 168 references, but several problems were identified in the list ...
AMA journal of ethics, 2017
Social media channels such as Twitter, Facebook, and LinkedIn have been used as tools in health c... more Social media channels such as Twitter, Facebook, and LinkedIn have been used as tools in health care research, opening new horizons for research on health-related topics (e.g., the use of mobile social networking in weight loss programs). While there have been efforts to develop ethical guidelines for internet-related research, researchers still face unresolved ethical challenges. This article investigates some of the risks inherent in social media research and discusses how researchers should handle challenges related to confidentiality, privacy, and consent when social media tools are used in health-related research.
Journal of clinical medicine, Jan 27, 2018
Human hepatocellular carcinoma (HCC) is the fifth most common cancer and is associated with poor ... more Human hepatocellular carcinoma (HCC) is the fifth most common cancer and is associated with poor prognosis worldwide. The molecular mechanisms underlying the pathogenesis of HCC have been an area of continuing interest, and recent studies using next generation sequencing (NGS) have revealed much regarding previously unsettled issues. Molecular studies using HCC samples have been mainly targeted with the aim to identify the fundamental mechanisms contributing to HCC and identify more effective treatments. In response to cellular stresses (e.g., DNA damage or oncogenes), activated p53 elicits appropriate responses that aim at DNA repair, genetic stability, cell cycle arrest, and the deletion of DNA-damaged cells. On the other hand, the murine double minute 2 (MDM2) oncogene protein is an important cellular antagonist of p53. MDM2 negatively regulates p53 activity through the induction of p53 protein degradation. However, current research has shown that the mechanisms underlying MDM2-p...
Journal of Cancer Education, 2017
The aim of this study was to assess the scientific accuracy and the readability level of websites... more The aim of this study was to assess the scientific accuracy and the readability level of websites on kidney and bladder cancers. The search engines Google™, Yahoo™ and Bing™ were searched independently by assessors in November 2014 using the following keywords: "bladder cancer", "kidney cancer", "patient bladder cancer", "patient kidney cancer" and "bladder and kidney cancer". Only English-language websites were selected on the bases of predetermined inclusion and exclusion criteria. Assessors independently reviewed the findings and evaluated the accuracy and quality of each website by using the DISCERN and the LIDA instruments. The readability of the websites was calculated using the Flesch-Kincaid Grade Level Index and the Coleman-Liau Readability Index. Sixty-two websites were finally included in the study. The overall accuracy scores varied; for the DISCERN, the range was 28 to 76; out of 80 (mean ± SD, 47.1 ± 12.1; median = 46.0, interquartile range (IQR) = 19.2), and for the LIDA, the range was 52 to 125; out of 144 (mean ± SD, 101.9 ± 15.2; median, 103; IQR, 16.5). The creators of these websites were universities and research centres (n = 25, 40%), foundations and associations (n = 10, 16%), commercial and pharmaceutical companies (n = 13, 21%), charities and volunteer work (n = 4, 6%) and non-university educational bodies (n = 10, 16%). The readability scores (mean ± SD) were 11.2 ± 2.2 for the Flesch-Kincaid Grade Level Index and 11.2 ± 1.6 for the Coleman-Liau Readability Index. The accuracy and the quality of the websites on kidney and bladder cancers varied. In most websites, there were deficiencies in clarity of aims, presenting symptoms, investigations and treatment options. The readability matched grades 10-11 literacy levels-a level above the public readability level. The study highlights the needs for further improvement of the online information created for public and patients with kidney and bladder cancers.
Journal of Continuing Education in the Health Professions, 2016
The citations received by a scientific publication have been used as a proxy measurement of scien... more The citations received by a scientific publication have been used as a proxy measurement of scientific quality and in ranking researchers. Although these practices have been observed in several institutes, careful assessment of top-cited articles may provide more insight into exploring their characteristics. The aim of this study was to analyze the top-cited articles in medical education identified by Azer 2015 and explore the characteristics of these articles that can provide insight into their assessment. The most frequently cited articles identified by searching the Web of Science under the category "Education, Scientific Discipline" were included in the analysis. The following issues were further analyzed: 1) comparing the mean yearly citations received by articles published before the year 2000 and those published after, 2) assessing whether there was a correlation between the number of grants, number of authors, number of institutes, or number of countries involved and the number of citations received, 3) assessing the number of female representation in authorship, 4) assessing the representation of none-medical staff in the authorship, and 5) exploring any association between top authors identified and those who were awarded the Karolinska Institutet Prize for research in medical education. Although there was no correlation between the number of citations and the number of years since publications, the mean number of citations received by articles published before the year 2000 varied from zero to 18.2 ± 16.6, whereas for those published after the year 2000 the mean varied from 2.0 ± 2.1 to 35.3 ± 26.8. No correlation was found between the number of citations obtained and number of grants, number of authors, number of institutes, or number of countries involved. Females comprised 50% of the total number of authors. However, no correlation was found between the number of females in authorship and the number of citations obtained. Similarly, the number of authors with non-medical degrees did not correlate with the number of citations obtained. An association was found between authoring more than one article in the list and receiving the Karolinska Institutet Prize for research in medical education. The analysis shows that the higher number of citations received are not necessarily related to funding, working collaboratively with a big team from several institutes or from several countries. The finding that authors of more than one top-cited article received the Karolinska Institutet Prize for research in medical education indicates that this could be a parameter in selecting the candidates for the award.
Saudi medical journal, 1998
Full text is available as a scanned copy of the original print version.
American Journal of Public Health, 2016
Surg Radiol Anatomy, 2007
Background The introduction of a problem-based learning (PBL) curriculum at the School of Medicin... more Background The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of diVerent body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are: (1) to assess the views of Wrstand second-year medical students on the importance of dissection in learning about the anatomy, (2) to assess if students' views have been aVected by demographic variables such as gender, academic background and being a local or an international student, and (3) to assess which educational tools helped them most in learning the anatomy and whether dissection sessions have helped them in better understanding anatomy. Methods First-and second-year students enrolled in the medical course participated in this study. Students were asked to Wll out a 5-point Likert scale question
Annals of the Academy of Medicine, Singapore
For about 50 years, clinical pharmacology and therapeutics have been taught in the medical school... more For about 50 years, clinical pharmacology and therapeutics have been taught in the medical schools via traditional lectures and practical classes. During this time, significant changes have occurred in our understanding of medicine and basic sciences. Also the needs for our community have changed dramatically. The explosion of scientific discoveries, the use of new technologies in disease diagnosis, the availability of a wide range of therapeutic options, and the availability of knowledge to everyone via the Internet have necessitated new approaches for teaching medical and other health professional students. Finding information related to a topic has not become a priority in teaching, what has become more important is to teach undergraduate students how to think in addition to what to think. Applying information learnt and assessing its significance in real life situations has become mandatory. The aims of this paper were: (i) to discuss the model we used in introducing clinical ph...
This title is directed primarily towards health care professionals outside of the United States. ... more This title is directed primarily towards health care professionals outside of the United States. Many medical and health professional schools have replaced their traditional curriculum with problem based learning, or a derivative. This book is designed to provide a comprehensive guide and resource for students in the early years of these courses, and will assist them to adapt their learning style to working with others in small groups. The book explains the differences between PBL and traditional learning, the aims and essential elements of PBL, and provides the keys for successful group discussion. Students are shown how to define the learning issues and how to construct their own mechanisms for each case they study, before moving on to the aims and tools commonly used in assessment, and tips for increasing scores in examinations. The book will also assist tutors to design cases.
Annals of the Academy of Medicine, Singapore
Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and t... more Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and the use of specific educational tools that enhance cognitive skills, students might deprive themselves of achieving the deep learning experience expected to take place in a PBL course. One of the educational tasks in PBL is the creation of mechanisms for hypotheses made by the students, based on their knowledge of the basic sciences and the psychosocial issues raised in a particular case scenario. The whole task is student-constructed and should enhance their ability to explain the scientific basis of the symptoms and clinical signs of the patient enlisted in the case. Because students usually discuss the case without enough prior related knowledge, they might find it difficult to address different aspects of their mechanisms. These gaps in knowledge may be considered part of their "learning issues". In tutorial 2 (a PBL case is usually discussed in 2 or 3 tutorials at the maxim...
World Journal of Gastroenterology, 2017
Author contributions: Azer SA participated in the study design and development and analysis and i... more Author contributions: Azer SA participated in the study design and development and analysis and interpretation of data, construction of figures and tables and writing the manuscript; AlOlayan TI, AlGhamdi MA and AlSanea MA participated in the data collection, data analysis, interpretation of data, construction of tables, and review of the manuscript.
Navigating Problem Based Learning, 2008
Medicine 2 0 Conference, May 15, 2014
whether YouTube videos on pharmacokinetics can be a useful learning resource for medical students... more whether YouTube videos on pharmacokinetics can be a useful learning resource for medical students. ". Only videos in the English and those matching the inclusion criteria were included. For each video, the following characteristic data were collected: title, URL, duration, number of viewers, date uploaded, and viewership per day, like, dislike, number of comments, number of video sharing, and the uploader /creator. Using standardized criteria comprising technical, content, authority and pedagogy parameters, three evaluators independently assessed the videos for educational usefulness. Data were analyzed using SPSS software and the agreement between the evaluators was calculated using Cohen's kappa analysis.
BMJ Open, 2015
To evaluate accuracy of content and readability level of English Wikipedia articles on cardiovasc... more To evaluate accuracy of content and readability level of English Wikipedia articles on cardiovascular diseases, using quality and readability tools. Wikipedia was searched on the 6 October 2013 for articles on cardiovascular diseases. Using a modified DISCERN (DISCERN is an instrument widely used in assessing online resources), articles were independently scored by three assessors. The readability was calculated using Flesch-Kincaid Grade Level. The inter-rater agreement between evaluators was calculated using the Fleiss κ scale. This study was based on 47 English Wikipedia entries on cardiovascular diseases. The DISCERN scores had a median=33 (IQR=6). Four articles (8.5%) were of good quality (DISCERN score 40-50), 39 (83%) moderate (DISCERN 30-39) and 4 (8.5%) were poor (DISCERN 10-29). Although the entries covered the aetiology and the clinical picture, there were deficiencies in the pathophysiology of diseases, signs and symptoms, diagnostic approaches and treatment. The number of references varied from 1 to 127 references; 25.9±29.4 (mean±SD). Several problems were identified in the list of references and citations made in the articles. The readability of articles was 14.3±1.7 (mean±SD); consistent with the readability level for college students. In comparison, Harrison's Principles of Internal Medicine 18th edition had more tables, less references and no significant difference in number of graphs, images, illustrations or readability level. The overall agreement between the evaluators was good (Fleiss κ 0.718 (95% CI 0.57 to 0.83). The Wikipedia entries are not aimed at a medical audience and should not be used as a substitute to recommended medical resources. Course designers and students should be aware that Wikipedia entries on cardiovascular diseases lack accuracy, predominantly due to errors of omission. Further improvement of the Wikipedia content of cardiovascular entries would be needed before they could be considered a supplementary resource.
Academic Medicine, 2015
To identify and examine the characteristics of the 50 top-cited articles in medical education. Tw... more To identify and examine the characteristics of the 50 top-cited articles in medical education. Two searches were conducted in the Web of Knowledge database in March 2014: a search of medical education journals in the category "Education, Scientific Discipline" (List A) and a keyword search across all journals (List B). Articles identified were reviewed for citation count, country of origin, article type, journal, authors, and publication year. Both lists included 56 articles, not 50, because articles with the same absolute number of citations shared the same rank. The majority of List A articles were published in Academic Medicine (34; 60.7%) and Medical Education (16; 28.6%). In List B, 27 articles (48.2%) were published in medical education journals, 19 (33.9%) in general medicine and surgery journals, and 10 (17.9%) in higher education and educational psychology journals. Twenty-six articles were included in both lists, with different rankings. Reviews and articles constituted the majority of articles; there were only 8 research papers in List A and 13 in List B. Articles mainly originated from the United States, Canada, the Netherlands, and the United Kingdom. The majority were published from 1979 to 2007. There was no correlation between year and citation count. The finding that over half of List B articles were published in nonmedical education journals is consistent with medical education's integrated nature and subspecialty breadth. Twenty of these articles were among their respective non-medical-education journals' 50 top-cited papers, showing that medical education articles can compete with subject-based articles.