Research

Family Medicine is a discipline that encompasses all aspects of patient care - biomedical, psychological and social. It emphasizes continuity of care and chronic disease management, via a strong doctor-patient relationship. Primary care also focuses on health promotion and health education, to empower patients to take responsibility for their own health. The Family Medicine department focuses on carrying out research into these domains. Additionally, as much time is spent teaching students and physicians how to practice such patient centered principles, the department also carries out medical education research into how one should teach family medicine within the Middle East. 

Communication Skills for an Arab setting

Interactive electronic portfolios to enhance studentsí reflective practice

Academic Collaboration

 

Family Medicine is a discipline that encompasses all aspects of patient care - biomedical, psychological and social. It emphasizes continuity of care and chronic disease management, via a strong doctor-patient relationship. Primary care also focuses on health promotion and health education, to empower patients to take responsibility for their own health. The Family Medicine department focuses on carrying out research into these domains. Additionally, as much time is spent teaching students and physicians how to practice such patient centered principles, the department also carry out medical education research into how one should teach family medicine within the Middle East. 

Communication Skills for an Arab setting

The Family Medicine Department concentrates on communication skills as a key qualitative research area. Dr Deen Mirza is looking into how Arabic language and Muslim culture affects the way in which doctors and students communicate with patients. He has produced a new conceptual model for teaching physicians in the Arab world how to communicate with patients- the ‘REACH consultation model for communicating with Arab patients’. He is also carrying out research into how well primary care doctors understand and utilize communication skills concepts in everyday practice. In addition to this he is carrying out a focus group study on Western patients’ experience of bad news delivery in the UAE. Dr Deen Mirza is also developing a new framework to examine how Muslim physicians respond internally to traditional health beliefs that derive from core Islamic belief: the ‘Four Choices Model for responding to religious health beliefs in a Muslim setting’.  Dr Jawad Hashim is carrying out research into which patient-centered ‘micro-skills’ Arab medical students struggle with mastering when taught communication skills in English. Professor Laeth Nasir and Dr Stella Major are investigating Emirati medical students’ perceptions on how bad news is broken to patients.

Interactive electronic portfolios to enhance students’ reflective practice

The Department of Family Medicine has decided to include portfolios as part of the teaching strategy.  Since the academic year 2009/2010 a four cycle reflective ‘plan, act, revise,’ action research study involving faculty and students is in progress. The first cycle was completed and data was obtained from 16 student questionnaires, two focus group discussions, two SWOT analysis, minutes of three departmental clerkship meetings, assessment reports and written communications from students and faculty members. Definitions and concept clarification informed by extensive literature review guided the development of questionnaires and moderators guide for use during the second cycle of the study.  Cycle 2 will be completed within the next three months. 

Self assessment, reflection and portfolio writing are innovative themes. Implementing these ideas as practical, acceptable and assessable activities is challenging. The terminologies - reflection and self assessment are confusing. Resource intensive activities like formative assessment and feedback are often viewed with suspicion opposed to an opportunity to achieve excellence. Implementing and harnessing ownership of this process in a culturally diverse setting is challenging.  Students find documenting knowledge and competency gaps difficult, while lecturers, juggling multiple teaching, service and research obligations, reluctantly participate in processes lacking evidence based benefits.

Achievements and challenges identified in cycle 1:
Tutors:   Themes identified include 1) Mentoring, 2) on-line interaction  and support, 3) preference of paper format and face to face interaction, 4) complexity of assessment criteria, 5) interpretation of terminology, and 6) labour intensity.
Students: Themes identified are 1) tutor support, 2) computer technology support, 3) repetition and duplication, 4) lack of literature search skills, 5) time commitment, 6) peer interaction.

Issues identified and changes implemented in Cycle 2:
Students eagerly participated in the focus group discussions and offered to assist peers in novice groups to implement the portfolio. Themes identified are 1) willingness to conduct self assessment and develop learning plans 2) need for regular face to face feedback with opportunity to respond 3) Curiosity  and excitement and caution about formal reflection 4)  Frustration with duplication and non-functional technology 5) Willingness to interact and share knowledge and resources with peers.

Blackboard and other media are being explored as part of the online portfolio.

Faculty Development in Research Skills

Institutional development in research capacity requires support for research skills training. Dr Jawad Hashim has been conducting research workshops for faculty, PhD students, research assistants and students. These hands-on tutorials include step-by-step instructions, visual demonstration and practical exercises. Research workshops conducted so far include: statistical data analysis, randomization, bibliographic citation with Zotero, personal digital assistants (PDAs) and common errors in statistical analysis.

Research and Academic Collaboration
           
Dr Adri Prinsloo acts as study leader for residency students in the Department of Family Medicine, University of the Free State, South Africa. She is also involved in ongoing research and publication with residents and undergraduate students of this department on obesity as well as trauma related emergency department  consultations by children in Bloemfontein.  She is an International member of the Editorial Board of the South African Family Practice Journal and a frequent reviewer of articles for the African Journal of Primary Healthcare & Family Medicine.
Dr Stella Major is an Honorary Senior Lecturer at Imperial College London. She is currently contributing to several chapters of a new textbook of General Practice which is being published together with her colleagues from Imperial College, Department of Primary Care and Social Medicine. After spending 12 years as an academic faculty member at the American University of Beirut, she continues to collaborate with family physicians from the American University of Beirut with whom she has a number of publications. In 2010, as one of two representatives from the RCGP (UK) International, she was officially invited to the Lebanon as a guest of the British Foreign Office and the Lebanese Ministry of Health, to explore ways of professionalizing General Practice in Lebanon. Her active collaboration with Imperial College has led to her travelling to Malaysia as an external examiner for the Masters in Family Medicine. In 2011, she has been awarded Fellowship of the Royal College of General Practice – UK.

Dr Deen M Mirza is the international editor for the London Journal of Primary Care, a peer reviewer for Advances in Health Sciences Education and a GP appraiser in the UK. In 2009 he attended the MRCGP International Development Workshop in the UK. In 2010 he was invited to be an observer for the MRCGP International clinical exam being held in Dubai. He collaborates with different primary care doctors in the UK attached to St George’s University of London and the University of Edinburgh Medical School, as well as doctors in the family medicine departments of Qatar Petroleum and King Faisal Specialist Hospital and Research Centre (Saudi Arabia).

Professor Laeth Nasir has ongoing research into physician impairment in Arab countries and medical student specialty choice in the UAE. He is also developing a novel depression screening instrument in the Emirates. He is also examining Arab and Western perceptions of cooperative ventures in the Middle East within a conceptual theme called ‘the business of medicine ‘.

Associate Professor Engela A M Prinsloo is exploring the use of reflective portfolios, tutor support and feedback to students in a family medicine clerkship.  It is the first time that students are exposed to reflection and portfolio writing as formal requirement for assessment and educational purposes.  An ongoing action research project is being conducted.  Dr Prinsloo’s other research area is the implementation and use of obesity guidelines in primary health care settings and exploring the perceptions and attitudes of patients regarding body image and risks of obesity.  She is also interested in developing and researching a sustainable conceptual model for experiential teaching sites for Family Medicine through collaboration between different partners including universities, communities and service providers.

Associate Professor Stella Major: My research interests are influenced by the fact that I am both a practicing clinician and an educator. Since joining the UAEU, I have started looking at a variety of issues which are known to present challenges to medical students. As we are teaching the OSC1 students clinical and communication skills, my research is looking at the students perceived challenges when learning to perform clinical examination of a patient, and similarly challenges which they might face; when required to break bad news to their patients. At Clinical Clerkship level, our department has developed an online portfolio to assist the student learning process, and I join my colleagues in looking into the impact of this on the senior clerkship students learning. As a faculty member responsible for providing CME/CPD to colleagues; I am looking into the practice of CME/CPD activities that physicians in the UAE engage in; with a particular emphasis on seeing how these activities impact their daily clinical decision-making.

Assistant Professor M Jawad Hashim is working on improving health education in the region by studying how patients perceive health messages and how the design and delivery of health education materials can be optimized. He has received a grant from the Emirates Foundation to develop and test educational materials for patients with limited literacy. This mixed methods study will help highlight regional cultural and linguistic factors for patient empowerment for chronic disease self-care. Dr Hashim’s other research areas include development of tools for assessment of health literacy and design of healthcare symbols for use in navigation of health facilities such as hospitals. Collaborating with researchers in other departments as well as PhD students and visiting scholars, he conducts statistical analysis of data and advises on study design.

Assistant Professor Deen M Mirza is exploring doctor-patient communication skills within an Arab setting. He is also carrying out research into professionalism, investigating student perceptions of unprofessionalism in the clinical setting and comparing how well family medicine residents recognize ‘cases of unprofessionalism’ as compared to medical students. He has presented new methods to insert professionalism into the ‘hidden curriculum’ of a PBL curriculum. He also carries out research into the MRCGP International exam held in Dubai, looking at local primary care doctors’ attitudes to this exam, as well as how different modules of the exam are assessed. Deen Mirza has also been involved in two Diabetes research projects: one investigating the link between patients’ knowledge of Diabetes and glycaemic control; and another looking at the role of insulin in Type 2 Diabetic control.