Evaluation of the educational environment of a new medical school in southeast Nigeria

Background

Educational environment (EE) affects transfer/acquisition of knowledge and skills needed in training medical students. Evaluation of EE by students is paramount to rating the EE of a medical school as well as evaluate effects of interventions. Assessing EE of medical schools is a current global trend.

Objectives

: To evaluate EE at the new medical school of the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka, Anambra State, Nigeria; calculate the total and subscale (Dundee Ready Educational Environment Measure) DREEM scores and assess differences in these scores amongst the different classes, age groups, and sexes.

Methodology

This was a descriptive cross-sectional study using census survey. We administered DREEM questionnaire to 4^th, 5^th, and 6^th year medical students in the 2018/2019 academic session after ethical approval from Health Research and Ethics Committee (HREC). Data entry and analysis done using SPSS. ANOVA was used for association between level of study, age group, and total DREEM/Subscale scores. Test for association between sex and mean subscale/total score was done using independent sample t-test. P value <0.05 was adjudged significant. Cronbach's alpha for internal consistency was calculated.

Results

Of 206 students, 185 filled in the questionnaire. Total DREEM score was 119.66, Students' perception of teachers 26.74, Students' academic self Perception 21.94, Students' Perception of Learning 30.75, Students' Social Self Perception 15.04, Students' Perception of Atmosphere 25.26. Three items scored above 3 while 11 items scored ≤2. Fourth year students significantly scored higher than others for all subscale and total DREEM score. No significant associations between age or gender and subscale or total DREEM scores. Cronbach's alpha for all scores was 0.91.

Conclusions

The EE was not excellent but "more positive than negative." Improvements are necessary in all domains of DREEM to ensure better quality of the educational environment.

Sub-classification of Breast Masses by Fine Needle Aspiration Cytology

OBJECTIVE

The aim of this study is to evaluate the accuracy of sub-classification of breast diseases using Fine Needle Aspiration cytology (FNAC).

MATERIALS AND METHODS

A one-year prospective study of 180 consecutive patients with palpable breast lesions who underwent FNAC and subsequently open surgical biopsy for histological confirmation. FNAC was used to sub-classify breast lesions and then correlated with histological diagnosis.

RESULTS

A total of 180 patients were enrolled into the study but only 110 patients with histology report were used for test validity. Seventeen (15.5%) smears were C1; while 46 (41.8%), 5 (4.5%), 4 (3.6%) and 38 (34.6%) were C2, C3, C4 and C5, respectively. FNAC achieved sensitivity of 90.0%, specificity of 95.5%, false positive rate of 5.3%, false negative rate of 8.7%, positive predictive value of 94.7%, negative predictive value of 91.3% and overall diagnostic accuracy of 92.9%. Only 86 (78.2%) of the 110 smears could be sub-classified into different disease conditions of the breast on cytology. FNAC accurately sub-classified 25(78.1%) of fibroadenoma and 28(87.5%) of invasive ductal carcinoma.

CONCLUSION

FNAC can reasonably sub-classify fibroadenoma, invasive ductal carcinoma and mastitis but there is still a challenge with lobular carcinomas, metaplastic carcinomas, papillary carcinomas and fibrocystic changes.