Objective: To determine perception of medical students about learning from integrated simulated clinical skills sessions in Respiration and Circulation module of Year 1 undergraduate medical curriculum at Aga Khan University. Subjects & Methods: This cross-sectional study was conducted at the Centre for Innovation in Medical Education, Aga Khan University (AKU) from July 2018 to February 2019. Integrated clinical skills session involves use of a combination of live simulated patient and mechanical simulator to teach clinical skills.  These sessions were conducted in Respiration and Circulation Module of MBBS Year I curriculum after which quantitative data was collected by a questionnaire that assessed usefulness of integrated clinical skills teaching method and confidence gained by students. The responses acquired were assessed on a Likert scale ranging from 1-5, (strongly agree -strongly disagree).  Descriptive analysis was performed. A focused group discussion (FGD) with students and an in-depth interview with a facilitator conducting the clinical skills sessions was arranged. Simple verbatim transcription of FGD recordings and thematic analyses was executed. Results: Quantitative analysis showed that more than 90% of the students believed integrated sessions were effective in acquiring the learning objectives and found them enjoyable and motivating. 80% expressed confidence that they had accomplished learning objectives and felt they have learned practical clinical skills. Qualitative analysis revealed that these sessions enhanced understanding of subject matter and student engagement during sessions. Conclusion: Integrated clinical skills sessions improved student interest, engagement and promoted student confidence. It should be implemented in undergraduate medical teaching curriculum. Continuous...

This study was conducted to assess the safety of the radiological procedure called percutaneous trans-hepatic biliary drainage (PTBD) performed to drain the obstructed biliary system. A retrospective review of the data of 210 patients, who underwent PTBD from January 2015 to December 2018, was conducted at the Aga Khan University Hospital, Karachi. No post procedure complications were seen in 151(71.9%) patients. Infection was the most common complication seen in 18(8.6%) patients, catheter/stent occlusion or displacement in 14(6.7%), bleeding in 6(2.9%), and prolonged hospital stay (> 5 days) in 21(10%) patients. One hundred and seventy-nine (85.2%) patients showed clinical improvement, 21(10%) died in the hospital, of whom 5(2.3%) died due to PTBD complications and PTBD failed in 10(4.8%) patients. Key words: PTBD, Biliary drainage, Pakistan, retrospective study.

As per the reviewers comments more references were added to strengthen reflective account and conclusions derived from them. A limitations section was also written and minor changes in the manuscript for better flow were made.

Experiences in medical education have changed significantly in the last two decades. This evolution is apparent in the teaching/ learning environment, types of education resources and learners. In this article two students provide a reflective account of their individual journeys in medical education spanning across 20 years. While some things remain unchanged, significant differences emerge that stress upon the educators and institutions to stay mindful of these transitions in order to develop learning environments that nurture the growth of future physicians.Experiences in medical education have changed significantly in the last two decades. This evolution is apparent in the teaching/ learning environment, types of education resources and learners. In this article two students provide a reflective account of their individual journeys in medical education spanning across 20 years. While some things remain unchanged, significant differences emerge that stress upon the educators and institutions to stay mindful of these transitions in order to develop learning environments that nurture the growth of future physicians.