Background: This paper discusses the benefits of designing a blended learning programme that combines the use of self-directed E-learning and collaborative face-to-face sessions in respiratory medicine at the undergraduate level. Objectives: The paper discusses the Blended Learning Design Tool (BLEnDT^©) used to support the design process. This paper presents the findings of the evaluation carried out to identify learning gains and students' attitudes towards the use of tablet devices (iPads) to support the blended learning experience. Materials and Methods: The sample analysed, included 283 full-time year 1 undergraduate medical students of an average age of 19 years. Results: The analysis carried out shows the evidence of learning gains as students engaged in the full blended learning programme with the evidence of an association between higher overall marks in the final year exam and the post-quiz scores (P = 0.006). Conclusion: The attitude components collected via the survey 'my learning experience after the interactive session using iPads' also highlighted the interesting findings in relation to the perceived control component with students that own a tablet device (P = 0.094) feeling much more in control when using an iPad to support their learning.

Background: Until recently training, assessment and certification of technical procedural skills (surgical and other interventional procedures) has been a matter of subjective evaluation by a faculty or senior peer. A few new technical skills courses have begun quantifying surgical performance, however none have required benchmark scores that must be met to guarantee proficiency. Based on nearly 100 years of technical skills simulation in other high-risk sectors (aviation, military, nuclear industry, etc.), a new, comprehensive procedural skills curriculum development process, entitled 'full life-cycle curriculum development' and which uses the principles of proficiency-based progression, has been developed and implemented for the Fundamentals of Robotic Surgery (FRS) curriculum – a simulation course for technical skills with quantitative metrics. Methodology: Four consensus conferences by Delphi method, with official representatives of 14 surgical specialties that use robotic surgery was conducted to develop Outcomes Measures/metrics, Didiactic Curriculum, Simulation Content for a novel simulator, and Validation Trial. Proficiency-based progression, based upon expert performance benchmarks, was used to establish the scores which the novices must complete in order to pass. Results: An initial pilot study for validation of this new curriculum process has been completed to determine rough-order-magnitude of parameters and usability and practicality, as well as a preliminary evaluation of suitability as an educational course. A final full validation study is in progress to confirm the initial results of both the validity and educational value of this course. A validated course for gynecologic robotic surgery has been completed and validated using the same templates as the FRS. Conclusion: The FRS use a new process (full life-cycle curriculum development with proficiency-based progression) which can be used in order to develop any quantitative procedural curriculum, through generic templates that have been developed. Such an approach will dramatically decrease the cost, time and effort to develop a new specific curriculum, while producing uniformity in approach, inter-operability among different curricula and consistency in objective assessment. This process is currently online, open source and freely available, to encourage the adoption of a scholarly and rigorous approach to curriculum development which is flexible enough to be adopted and adapted to most technical skills curriculum needs.

Background: Saudi Commission for Health Specialties (SCFHS) has adopted CanMEDS competency framework for developing curriculum for postgraduate training programmes. Purpose: The purpose of this paper is to share the process of developing postgraduate curricula under SCFHS's patronage and to identify potential barriers to implement newly developed curricula and suggest strategies to overcome the barriers. Methods: The process of consensus building started with one-one interview with key stakeholders, review of literature, and comparison of various curricular models. A prototype curriculum was developed with inputs from international advisors. The proposal for the curriculum development and outcomes was reviewed amongst SCHS education committee members and approved. Two medical education experts have been involved in coordinating the process of curriculum development. Results: Over the last two years, SCFHS has been working with several residency and fellowship programmes to develop formal curricula. The goal is to complete formal curriculum for all residency and fellowship programmes using CanMEDS competency frameworks.

Establishing a simulation centre remains a real challenge for many experts in the field of clinical simulation. A panel of experts presented some guidelines during the International Conference on Advanced Clinical Simulation that was held in Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia, in October 2014. The round table discussion addressed eight themes: The planning stage, stakeholders' involvement, strategic planning, centre design, partnership development, faculty development, curriculum development and establishing a research strategy. The conclusions are presented in this paper.

Aims: Aim of the study was to explore the experiences of interns and preceptors to develop a rich conceptual understanding of their experiences during the internship. Settings and Design: Purposeful sampling was used to recruit 22 interns and 11 preceptors during an internship program at a tertiary public hospital in Riyadh. Methods: We used qualitative research based on a phenomenological approach. The data was collected through semi-structured interviews. Data Analysis: Interviews were transcribed verbatim and analysed concurrently using thematic analysis. Results: The internship program had a positive impact on interns and their preceptors. However, both groups reported negative issues related to their preparations (training) and emphasised the need for better cooperation between education and practical healthcare services. Conclusions: The findings lead the researchers to develop a new model for clinical education, future healthcare professionals and those who assist them during the internship, "The Triple Ps and Cs to solve the trouble of transition".

Aim: The aim of this audit was to examine diabetic patients' follow-up at Aohoud Primary Care Clinic during the year 2013 and then compare the results with a recommended standard. Subjects and Methods: Chronic conditions' database at Aohoud Primary Care Clinic was accessed, diabetic patients were identified and inactive patients were excluded. Computerised and paper records were then reviewed. The number of follow-up investigations and visits (glycated haemoglobin [HbA1c], albumin-creatinine ratio [ACR], fasting lipids, retinal screening and podiatry visits) during 2013 were recorded. Annual follow-up criteria were set as follows: Having an HbA1c blood test at least twice and having ACR, fasting lipids, retinal screening and a podiatry visit at least once. A target of 75% of diabetics meeting the criteria was set up for this audit. Results: The total number of diabetics in Aohoud Clinic was 116 with the majority of them (96.5%) being type 2 diabetics. Sixty-nine percent of diabetics were above the age of 45 and 55.2% of them were females. In the year 2013, 58.6% diabetics had their HbA1c tested at least twice, 47.4% had their ACR measured once, 83.6% had their fasting lipids measured at least once, 29.3% had one retinal screening and only 4.3% had a formal podiatry visit. Conclusion: Deficiencies were observed regarding the diabetics' annual follow-up at our clinic during the year 2013. A more consistent approach is needed in requesting the lab investigations and referrals for diabetics in order to meet the clinic's target. Repeat auditing in a year's time is recommended to monitor improvement.

Background: Paediatric cancer patients who receive radiation and chemotherapy (CT) suffer from various risks of oral complications and odontogenesis. Materials and Methods: This study was conducted at a regional cancer centre of North East India from 2010 to 2013. The impact of cancer treatment by CT and radiation on orodental health was studied on a total of 100 paediatric cancer patients. Results: The common dental abnormalities were microdontia, hypodontia, root abnormalities, abnormal enamel, teeth loss, xerostomia and gingivitis. Treatment with CT and radiation exposure of >20 gray to head and neck region were mostly associated with orodental abnormalities. Conclusion: Dental abnormalities such as microdontia, over-retention of deciduous teeth and hypoplasia were the major findings. Close dental follow-up should be advised to paediatric cancer survivors and their parents during therapy and upon completion of the therapy.

Foreign body ingestion in children is a common clinical problem. They are often asymptomatic and passed out spontaneously. Oesophageal foreign bodies are prone to complications such as perforation, mucosal ischaemia and necrosis due to pressure. We present a case of a 10 month-old girl child with an open safety pin lodged in the lower oesophagus. The safety pin was retrieved by a cystoscope through a small incision in the stomach. It is a safe and easy procedure to perform, which has not been published previously in the literature. Hence, we are reporting this case.

Filariasis is a common health problem in India. Lymphatic filariasis is mostly caused by Wuchereria bancrofti and Brugia malayi. Microfilariae are often found in cytology smears from swelling at various sites and it is rarely associated with neoplasms. However, filarial breast nodule is a very rare finding even in an endemic region. Here, we present a rare case of filarial breast lump diagnosed by fine needle aspiration cytology.