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   2017|   | Volume 7 | Issue 5  
    Online since December 20, 2017

 
 
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EDITORIAL
Learning theories: The basics to learn in medical education
Dinesh K Badyal, Tejinder Singh
2017, 7(5):1-3
DOI:10.4103/ijabmr.IJABMR_385_17  PMID:29344448
  2,902 1,660 5
ORIGINAL ARTICLES
Motivating students for project-based learning for application of research methodology skills
Ranjana Tiwari, Raj Kumar Arya, Manoj Bansal
2017, 7(5):4-7
DOI:10.4103/ijabmr.IJABMR_123_17  PMID:29344449
Introduction: Project-based learning (PBL) is motivational for students to learn research methodology skills. It is a way to engage and give them ownership over their own learning. Aims and Objectives: The aim of this study is to use PBL for application of research methodology skills for better learning by encouraging an all-inclusive approach in teaching and learning rather than an individualized tailored approach. Methodology: The present study was carried out for MBBS 6th- and 7th-semester students of community medicine. Students and faculties were sensitized about PBL and components of research methodology skills. They worked in small groups. The students were asked to fill the student feedback Questionnaire and the faculty was also asked to fill the faculty feedback Questionnaire. Both the Questionnaires were assessed on a 5 point Likert scale. After submitted projects, document analysis was done. Results: A total of 99 students of the 6th and 7th semester were participated in PBL. About 90.91% students agreed that there should be continuation of PBL in subsequent batches. 73.74% felt satisfied and motivated with PBL, whereas 76.77% felt that they would be able to use research methodology in the near future. Conclusions: PBL requires considerable knowledge, effort, persistence, and self-regulation on the part of the students. They need to devise plans, gather information evaluate both the findings, and their approach. Facilitator plays a critical role in helping students in the process by shaping opportunity for learning, guiding students, thinking, and helping them construct new understanding.
  2,037 1,364 1
Introducing mentoring to 1st-year medical students of a private medical college in North India: A pilot study
Sahiba Kukreja, Namrata Chhabra, Amandeep Kaur, Rohit Arora, Tejinder Singh
2017, 7(5):67-71
DOI:10.4103/ijabmr.IJABMR_160_17  PMID:29344462
Background: The stress of complex medical course, emotional immaturity, and adaptations to new surroundings are the challenges faced by the new medical entrants. Therefore, mentorship program was introduced to support them for their academic and personal development. Aim and Objectives: The aim of this study is to introduce and to assess the perception of mentors and mentees on mentorship program. Materials and Methods: A mentorship program was designed for Bachelor of Medicine and Bachelor of Surgery (MBBS) First Professional students. A 1-day workshop was conducted to sensitize the faculty. Seventeen faculty members from various departments volunteered to be mentors. After sensitization, 150 MBBS First Professional students were divided among these faculty members by lottery system. A regular visit of mentees was scheduled with the mentor. At the end of mentorship program, the perception of mentors and mentees was taken using a validated and semi-structured feedback questionnaire. A focus group discussion of students was also conducted. Results: A total of 112 students and 16 faculty members completed the feedback questionnaire. The mentors considered this program helpful in their self-improvement, teaching, and communication skills. Most of the mentees felt that this program helped them emotionally and academically. It was a good way to develop a strong student–teacher relationship. All the mentors and mentees were satisfied with the mentorship program. Conclusions: The newly introduced mentorship program helped in the overall development of mentors and mentees. Both mentors and mentees were extremely satisfied with this program and considered this as a successful intervention.
  2,074 223 2
Team-based learning strategy in biochemistry: Perceptions and attitudes of faculty and 1st-Year medical students
Namrata Chhabra, Sahiba Kukreja, Sarah Chhabra, Sahil Chhabra, Sameenah Khodabux, Harshal Sabane
2017, 7(5):72-77
DOI:10.4103/ijabmr.IJABMR_150_17  PMID:29344463
Background: Team-based learning (TBL) strategy has been widely adapted by medical schools all over the world, but the reports regarding the perceptions and the attitudes of faculty and undergraduate medical students towards TBL approach have been conflicting. Aim: The study aimed to introduce TBL strategy in curriculum of Biochemistry after evaluating its effectiveness through perceptions and attitudes of faculty and 1st-year medical students. Materials and Methods: One hundred and fifty students of first professional M.B.B.S and five faculty members participated in the study. Their responses regarding perceptions and attitudes towards TBL strategy were collected using structured questionnaires, focus group discussions, and in-depth interviews. Data were analyzed using Wilcoxon signed-rank test, paired sample t-test, and Mann–Whitney U-test. Results: Majority of the students expressed satisfaction with team approach and reported improvement in the academic scores, learning styles, and development of problem-solving, interpersonal, and professional skills. The faculty, however, recommended a modified TBL approach to benefit all sections of the students for the overall success of this intervention. Conclusion: TBL is an effective technique to enable the students to master the core concepts and develop professional and critical thinking skills; however, for the 1st-year medical students, a modified TBL approach might be more appropriate for the effective outcomes.
  2,013 198 4
Qualitative assessment of learning strategies among medical students using focus group discussions and in-depth interviews
Anuradha Sujai Joshi, Jaishree Deepak Ganjiwale, Jagdish Varma, Praveen Singh, Jyoti Nath Modi, Tejinder Singh
2017, 7(5):33-37
DOI:10.4103/ijabmr.IJABMR_144_17  PMID:29344455
Background: Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. Aims and Objectives: The objective is to identify effective learning strategies used by medical students. Methodology: This study was carried out among the MBBS students of Final Professional Part I. Students were categorized into three groups namely: high, average, and low rankers based on overall academic performance in second Professional University examination. First, a questionnaire consisting of closed- and open-ended questions was administered to students, to find their learning strategies. Subsequently, focus group discussion and in-depth interviews were conducted for high- and low-rankers. Discussions were audio-recorded, transcribed, and analyzed. Key statements were highlighted, collated, and categorized into general themes and sub-themes. Results: Evident themes which emerged as effective strategies were hard work in the form of regularity of studies, meticulous preparation of notes, constructive use of time, utilization of e-learning, learning styles and deep learning approach and regular ward visits. Intrinsic motivation, family support, balancing physical activities and studies, guidance by seniors, teachers, dealing with nonacademic issues such as language barriers and stress were also identified as important strategies. Conclusions: Disseminating effective learning strategies in a systematic manner may be helpful to students in achieving better academic outcomes. Furthermore, educationists need to modulate their teaching strategies based on students' feedback.
  1,890 216 2
Evaluation of brainstorming session as a teaching-learning tool among postgraduate medical biochemistry students
Binita Goswami, Anju Jain, Bidhan Chandra Koner
2017, 7(5):15-18
DOI:10.4103/ijabmr.IJABMR_191_17  PMID:29344451
Background: The thrust for postgraduate teaching should be self-directed learning with equal participation by all students in academic discussions. Group discussions involve conduction of the discourse by a leader who guides the discussion as well as points out any wrong information. This discourages quieter students from participation with the fear of rebuke. Brainstorming is devoid of all such fallacies with no judgment and reprimand. Aim: The aim of this study was to use brainstorming as a teaching-learning tool among postgraduate students of medical biochemistry. Materials and Methods: The project was commenced after due approvals from the research and ethical committee. The participants were enrolled after informed consent and sensitization. All the pro forma and questionnaires were duly validated by experts. After piloting and incorporation of the suggestions for improvisation, the main sessions were planned and implemented. The response was judged by posttest scores and feedback forms. Results: There was an improvement of understanding of the biochemical concepts as assessed by the posttest scores and solving of a similar clinical problem. The students expressed satisfaction with the conduction, timing, and discussion of the clinical problems. The drawbacks of traditional teaching as expressed during the feedback stage were also taken care of by the brainstorming sessions. Conclusions: Our project made the students and the faculty aware about the utility of brainstorming for teaching purposes in medical education which till now was considered efficacious only for troubleshooting in advertising and management institutions. The students were satisfied with this technique for understanding of biochemical concepts.
  1,776 226 1
The acceptability and feasibility of mini-clinical evaluation exercise as a learning tool for pediatric postgraduate students
Sarika Gupta, Monika Sharma, Tejinder Singh
2017, 7(5):19-22
DOI:10.4103/ijabmr.IJABMR_152_17  PMID:29344452
Background: The mini-clinical evaluation exercise (Mini-CEX) is a valid and reliable tool that facilitates the assessment of skills essential for a physician and provision of immediate feedback. Aims: This study aimed to assess the acceptability and feasibility of Mini-CEX as a learning tool for pediatric residents. Materials and Methods: Following the sensitization with the concept of Mini-CEX, the actual process of assessment of residents was done using the “standardized American Board of Internal Medicine Mini-CEX evaluation form.” Feedback about the Mini-CEX was taken from the residents and faculty on separate questionnaires consisting of close- and open-ended questions. A total of 87 Mini-CEX encounters were done with 13 faculty and 29 residents over 6-month study period. Results: Residents perceived that it is a method that does the assessment of skills, prerequisite for good clinical performance with provision of immediate feedback. Most of the residents felt that it improved their clinical skills, uplifted the personal development, and impart a better one to one student–teacher interaction. Almost all the faculty were satisfied with this method of assessment. They found it useful for improved learning of themselves also. Both residents and faculty suggested to incorporate Mini-CEX in curriculum. Conclusions: Mini-CEX is an acceptable learning tool as reflected by the residents and faculty. It is feasible to use mini-CEX for assessment of residents.
  1,718 232 1
Using role-plays as an empathy education tool for ophthalmology postgraduate
Kirti Singh, Mainak Bhattacharyya, Vikas Veerwal, Arshi Singh
2017, 7(5):62-66
DOI:10.4103/ijabmr.IJABMR_145_17  PMID:29344461
Purpose: To assess the role of an “empathy sensitizing module” (ESM) in ophthalmology postgraduates in promoting effective empathetic communication. Methodology: Thirty-nine ophthalmology postgraduates were taught effective empathetic communication using specially designed module, comprising of five illustrative role-plays. We evaluated the impact of the training by (a) self-assessment of empathy quotient by residents using Jefferson Scale of Empathy (JSE scale) before and 6 weeks after ESM training and (b) nonparticipant observation (NPO) by trained faculty in real-life settings over the next 4 months. A peer-validated, self-designed checklist was used for NPO. The change in score was analyzed using Student's paired t-test. The faculty observed the use of empathy in real-life patient encounters of the trainees over the next 6 months. In addition, secondary qualitative data were collected and analyzed to assess the impact of the module on other stakeholders such as the role-playing undergraduate students and core faculty. Results: Pretraining assessment revealed that concept of empathy during patient communication was understood by only 10% students. PostESM training, the self-rated mean empathy score, on JSE, significantly increased from 95.9 to 106.7 (of a maximum of 140). This was also confirmed by a significant improvement in externally rated empathy and soft skills scores (from 29.3 to 39.1; of a maximum of 55) using the NPO tool. Focus group discussion was done on the continued display of empathy by the trainees in real-life situation over 6 months of observation by the faculty. The group agreed that there was a gradual attrition of initial gain in empathy behavior over the observation period of 6 months. The spillover benefits of the training process were observed among the role-playing undergraduates as well. A thematic analysis of their reflections on the process revealed a substantial change with an improved understanding of effective communication. Conclusions: There is a definite scope for introducing empathetic communication in medical training. Empathetic communication can be improved by effective training in a contextual manner with a need for regular reinforcement. Sensitization at all levels including the faculty is required to implement effective communication skills in medical profession.
  1,631 168 2
Hybrid tool for assessment of professionalism among dental undergraduate students
Eswara Uma, Abdul Hj Ismail Rashid, Adinegara Lutfi Abas, Sowmya Nettem, Sumanth Kumbargere Nagraj, Noorliza Mastura
2017, 7(5):8-14
DOI:10.4103/ijabmr.IJABMR_133_17  PMID:29344450
Context: Of the several methods available for assessment of professionalism, there is still no consensus on an ideal tool for dental undergraduate (UG) students. Aims: The study aims to use a hybrid tool for assessment of professionalism among dental undergraduate students. Settings and Design: Cross-sectional design with purposive sampling. Subjects and Methods: All final year UG dental students participated in this study. Evaluation of knowledge about professionalism was through written test. Professional behavior of each final year student in a clinical setting was assessed with a prevalidated questionnaire of multisource feedback (MSF). The scores of written test and the MSF were calculated for each student. Data were analyzed to evaluate scores of knowledge and MSF scores as per assessor category. Correlation between knowledge scores and MSF was evaluated. Student perceptions were taken toward assessment of professionalism. Statistical Analysis Used: Statistical analysis was done using descriptive statistics. Pearson's coefficient was used to determine the correlation between average knowledge scores and the MSF scores. Results: Knowledge scores were significantly more for female students (P < 0.05, t-test). Patients rated the students highest. Correlation between knowledge and MSF scores was found to be statistically significant (Pearson's correlation, P < 0.01). Students gave feedback that assessment of professionalism should be done from the beginning of the clinical years. Conclusions: Evaluation revealed that knowledge toward professionalism correlated with the professional behavior implying association between knowledge and reasons for a particular action.
  1,506 190 -
Early clinical exposure as a learning tool to teach neuroanatomy for first year MBBS students
Maitreyee Kar, Chinmaya Kar, Hironmoy Roy, Parmod Goyal
2017, 7(5):38-41
DOI:10.4103/ijabmr.IJABMR_143_17  PMID:29344456
Context: Early clinical exposure (ECE) is one of the important tools to teach basic science to the MBBS students. It is one form of vertical integration between basic science and clinical subjects. This study is an effort at exploring the use of ECE as a motivational tool toward better learning in neuroanatomy for first year MBBS students. Aim: This study aims to make the students interested and motivated to study neuroanatomy by using ECE as learning tool in neuroanatomy and to make the students enable to retain the knowledge of neuroanatomy more efficiently and correlate the knowledge of neuroanatomy with neuromedicine. Settings and Design: This study was conducted in collaboration with the Departments of Anatomy, General Medicine and Medical Education Unit in the year 2016. This was cross-sectional study. Subjects and Methods: One hundred and fifty students of 1st Professional MBBS were subdivided into two groups. After preliminary classes on brain, brainstem, and spinal cord for both groups, conventional lecture classes were taken for Group A only on upper motor neuron (UMN) and lower motor neuron (LMN) paralysis, and only Group B visited General Medicine ward where HOD, General Medicine showed and examined patients of UMN paralysis and LMN paralysis, elicited different symptoms, and discussed different investigation. It was followed by assessment of all by problem-based multiple choice questions (MCQ) and short answer questions. Then, Group B attended lecture class on different cranial nerve palsy whereas Group A visited medicine ward. It was followed by assessment of both groups by problem-based MCQ and short answer questions. The performance was compared. Then, the feedback of the students on ECE was collected by means of reflection writing followed by administration of questionnaire. Then, the perception of teachers regarding ECE was recorded by focused group discussion. Statistical Analysis Used: Student's t-test was used to compare the performance of both batches. Reflection writing and focus group discussion were analyzed qualitatively. Results: There was a significant difference in Group A (P = 0.019) but no significant difference in Group B (P = 0.679). All the teachers opined that ECE was an efficient method but more time and interdepartmental collaboration were necessary. Conclusions: Group A improved performance due to ECE but Group B maintained the motivational effect of it. Therefore, ECE can be used as an effective learning tool.
  1,512 173 -
Introduction of medical humanities in MBBS 1st year
Shaista M Saiyad, Swapnil J Paralikar, Anita P Verma
2017, 7(5):23-26
DOI:10.4103/ijabmr.IJABMR_138_17  PMID:29344453
Context: Most vital areas of patient management such as empathy, professionalism, and ethics are lacking in fresh undergraduates. These areas are considered to be part of hidden curriculum, and as these are not formally taught, we lack competent medical graduates. Introduction of medical humanities (MH) early in the medical curriculum can help to inculcate required soft skills. Aims: This study aims to develop, administer, and evaluate MH module in 1st year MBBS students. Settings and Design: Module of MH was introduced among 150 1st year MBBS medical students. Subjects and Methods: After taking permission from ethical committee of the institute, a core committee for development of MH module was formed. A standardized validated module for MH comprising of three sessions was formed and was introduced in 1st year MBBS 150 students. Evaluation was done in the form of student and faculty feedback questionnaire, consisting of open- and closed-ended questions. Statistical Analysis Used: Analysis was done using descriptive statistics using mean and standard deviation. Results: According to participants' feedback and perception, mean overall rating of MH module was 4.69, indicating that it was received well by the students. Out of 3 sessions conducted, students gave maximum grades to session 2: cinemeducation. Results of faculty feedback questionnaire indicated that MH is needed and should be introduced in every batch of 1st year MBBS and should be continued longitudinally. Conclusions: Awareness, knowledge, and attitude of students improved as a result of MH module. Our results indicate that such modules should be implemented in undergraduate medical curriculum.
  1,481 175 -
Module for interns in medical ethics: A developmental diegesis
Rajiv Mahajan, Parmod Kumar Goyal, Tanvir Kaur Sidhu, Upinder Kaur, Sandeep Kaur, Vitull Gupta
2017, 7(5):52-56
DOI:10.4103/ijabmr.IJABMR_170_17  PMID:29344459
Background: Media report is rife with incidences of doctor-patients' conflict, and this partly is due to communication gap and unethical practices being adopted by the doctors. Our regular curriculum fails to impart any training in ethical issues in patient care. Imparting training to students in these soft-skills is the need of the hour. Aim and Objectives: To develop a module for interns in medical ethics (MIME) in patient care, validate it and pilot run the module for standardization. Methodology: After conducting faculty development workshop in curriculum designing and three rounds of Delphi with alumni, a module in medical ethics was developed and peer validated. The questionnaire for pilot run, questionnaire for future use of module delivery and pre- and post-test were also peer validated. The module was delivered to 17 interns as pilot run in the form of 4 days' workshop. After pilot run, the module was standardized to 10 broad topics and 3 days' workshop. The questionnaire for future delivery of module in regular routine was also validated during pilot run. Results: Twenty-five faculty members participated in 1 day faculty development workshop and 59 alumni completed three rounds of Delphi. After peer review by five experts, a module of 11 broad areas was developed and was pilot run on 17 interns. Based on the feedback from pilot run, a standardized, validated 18 h teaching MIME in patient care was developed. Conclusion: Pilot study proves that curriculum innovation in the form of medical ethics training to interns; when as undergraduate students, they actively participate in patient care under supervision will go a long way in inculcating soft skills like ethics, compassion and communication in them.
  1,466 147 -
Case-based learning in microbiology: Observations from a North West Indian Medical College
Anita Singhal
2017, 7(5):47-51
DOI:10.4103/ijabmr.IJABMR_146_17  PMID:29344458
Background: Microbiology is usually taught by conventional lectures, and its retention and application is observed to be poor among medical graduates/practitioners. Aim and Objectives: Introduction of case-based learning (CBL) in microbiology for second-year professional MBBS students. Materials and Methods: Students were divided into two groups of fifty each. Four clinical cases were used for CBL. One group had two CBL sessions whereas the other had didactic lectures (DLs) and then the groups were crossed over. Case scenario handouts were given to students a week before the session, and smaller groups were formed for discussions and presentations in CBL sessions. Posttest, in multiple choice questions format, was conducted in two phases: First, immediately after the completion of the four CBL and DL sessions, and second, 6 weeks after the first posttest. Student and faculty feedback was taken about CBL sessions. Results: Hundred MBBS students of the fourth semester voluntarily participated in the CBL study. The CBL scores were significantly higher than DL session scores (P = 0.015). This difference was more marked in scoring done after 6 weeks of session completion (P < 0.001). Student reported satisfaction in being taught by CBL method in 5-point Likert scale feedback form. Faculty feedback was positive for CBL. Conclusions: CBL helped in retention of knowledge and its application better than DL in our observation. More sessions on commonly encountered case scenarios will be useful for students in recalling basic science knowledge in their later years as practitioners.
  1,383 166 -
Impact of integrated teaching sessions for comprehensive learning and rational pharmacotherapeutics for medical undergraduates
Sneha Ambwani, Bhavisha Vegada, Rimple Sidhu, Jaykaran Charan
2017, 7(5):57-61
DOI:10.4103/ijabmr.IJABMR_130_17  PMID:29344460
Background: It is postulated that integrated teaching method may enhance retention of the knowledge and clinical applicability of the basic sciences as compared to the didactic method. Aim: The present study was undertaken to compare the integrated teaching method with the didactic method for the learning ability and clinical applicability of the basic sciences. Materials and Methods: The 2nd year MBBS students were divided into two groups randomly. The study was conducted into two stages. In the first stage, conventional didactic lectures on hypertension (HT) were delivered to one group and multidisciplinary integrated teaching to another group. For the second stage, diabetes mellitus groups were swapped. Retention of the knowledge between the groups were assessed through a multiple choice questions (MCQ) test. Feedback of the students and faculty was obtained on a 5 point Likert scale. For the comparison, student's data were regrouped into four groups, i.e., integrated HT, didactic HT, integrated diabetes and didactic diabetes. Results: There was no significant difference of MCQ score between integrated HT, didactic HT, and integrated diabetes group. However, the score obtained in didactic diabetes was significantly more (P = 0.00) than other groups. Majority of the students favored integrated teaching for clinical application of basic science and learning of the skill for the future clinical practice. Faculties considered integrated method as a useful method and suggested frequent use of this method. Conclusion: There was no clear difference in knowledge acquisition; however, the students and faculties favored integrated teaching method in the feedback questionnaire.
  1,250 138 1
Critical review of “Family health advisory services” assessment in MBBS training program in community medicine
Kiran Goswami, H Salve, S Malhotra, Y Kumar
2017, 7(5):27-32
DOI:10.4103/ijabmr.IJABMR_155_17  PMID:29344454
Context: Family Health Advisory Services (FHAS) posting as well as its assessment is resource demanding but fails to enjoy priority. Study focuses on a holistic overview of the assessment process to understand need for change. Aims: The aim of this study is to identify perceived gaps in current assessment practices related to FHAS posting. Settings and Design: A cross-sectional mixed method study among all the V semester students currently undergoing assessment for the posting, past students (selected VII semester students and interns), preceptors (supervising residents – postgraduate students in department and senior resident, health assistants, medical social service officer), and involved faculty. Subject and Methods: Self-administered questionnaire, in-depth interview, focus group discussions (two) as well as observations using checklist were used for data collection and triangulation. Statistical Analysis Used: Quantitative data used in this study were statistical measures of central tendency and dispersion. Qualitative data transcript repeatedly read to identify underlying common themes, compared to draw inference. Results: There was a lack of guidelines and communication regarding assessment. Formative assessment was not performed and replaced by one time end assessment. All components of learning were not assessed. End-posting assessment was not standardized and unrelated to learning objectives. Award of scores was skewed toward right for intervention and toward left for analysis and community diagnosis. Conclusions: There is a need to focus on proper implementation of programme to strengthen formative assessment. Assessment should be relevant to learning objectives of posting. Faculty has to lead by example.
  1,236 126 -
Development and implementation of module for medical graduates to improve socio-cultural sensitivity towards people living with HIV
Sushanta Kumar Mishra, Somanath Dash
2017, 7(5):42-46
DOI:10.4103/ijabmr.IJABMR_153_17  PMID:29344457
Background: Health professionals are documented as an important cause for stigmatizing people living with HIV (PLHIV). Since traditional teaching on HIV in India does not address cultural competencies, medical graduates lack sociocultural sensitiveness while addressing the health needs of PLHIV. Aim: The aim of this study is to develop and to implement a module for medical graduates to improve their sociocultural sensitivity toward PLHIV. Methodology: A module was designed and introduced to address the core sensitive issues in HIV among medical graduates with the help of trained faculty. It included community education sessions including interaction with PLHIV to address cross-cultural issues and understand their health needs. Feedback for the perception of faculty and students was obtained. Knowledge and skills improvement was assessed through pre- and post test and direct observation of procedural skills (DOPS). Results: Mean feedback score was high for all the components covered by the module. It was found to be more for “usefulness of module” (4.91 ± 0.27836 on a scale of 5) than other components of the module. Feedback by faculty showed almost perfect agreement on “improvement of student's clinical skills” and “bringing perfection in their future practice” across multiple raters. Multiple response open-ended feedback showed, 78 (19%) responses affirmed improvement in communication skills with training in this module. Pre- and post test mean score for knowledge showed an increase (22.1 to 26.49). Mean skills improvement as per expectations were 86.81 and beyond expectations were 5.34. Conclusions: Training the medical graduates in structured HIV specific module improves their socio-cultural sensitivity toward PLHIV and is perceived useful.
  1,099 110 -
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