Context: Evaluating the prevalence of Staphylococcus aureus nasal carriage and methicillin-resistant Staphylococcus aureus (MRSA) that are sources of nosocomial infection among medical students. Evidence Acquisition: Electronic databases were searched by preferred subject headings and free-text keywords. After omitting duplicates, retrieved articles were screened by two independent reviewers in a three-step process based on inclusion criteria. Then, reviewers critically appraised the selected studies by JBI checklists and extracted the required data. Finally, the pooled prevalence rates of S. aureus nasal carriage and MRSA were meta-analyzed by Stata V.16 software. The heterogeneity of included studies was calculated by I2 and chi-square. Subgroup analysis was carried out according to study designs, as well as the continent origin of clinical and preclinical students. Results: Of 858 retrieved studies, 15 were included in the meta-analysis. The results showed that the pooled prevalence of nasal S. aureus carriage was 28% [prevalence rate: 0.028, 95% CI: 0.21 - 0.34, P < 0.001, I2: 96.40%, chi2: 360.98 (df = 14)]. The prevalence of S. aureus among clinical students was 33% (pooled prevalence rate: 0.33, 95% CI: 0.18 - 0.47) whereas, in preclinical students, it was 25% (pooled prevalence rate: 0.25, 95% CI: 0.23 - 0.28). Also, in a subgroup analysis of continents, Australia (Oceania) had the highest prevalence rate. According to an evaluation of publication bias, the distribution of studies was very high. Moreover, pooled MRSA prevalence among medical students was 2% (prevalence rate: 0.02 95% CI: 0.01 - 0.03, P < 0.001). Conclusions: In this meta-analysis, S. aureus and MRSA prevalence rates among medical students were estimated at 28% and 2%, respectively. More attention should be given to the prevention of MRSA colonization and screening strategies among medical students across the world.
Background: This study aimed to evaluate the effectiveness of debate as a learning tool for changing audiences’ views regarding the use of clinical guidelines in routine clinical practice. Methods: A debate scenario including different rationales for and against using guidelines in clinical practice, presented by the student section of Iranian Evidence Based Medicine Center of Excellence, was held at the first International Student Congress of Research Integrity and Evidence-Based Practice (Kish Island, Iran, December, 2015). The audience was first asked to check the papers given to them, and if they agreed to the terms, they were asked to choose,"Yes", "No", or "I don’t know". Results: Of the 400 individuals participating in the congress, 100 were present during the scheduled debate time. Among the 71 people completing pretest questionnaires, 73% (52)answered "yes" to the question, "Should we use guidelines? "About 7% (5) claimed that we shouldn’t use guidelines, and 20% (14) had no opinion about using them. Following the debate,the participants who chose "yes" to the guidelines remained in favor of their use in clinical practice. Of the 14 who did not have an opinion for guideline use, all agreed to use guidelines in clinical practice. Surprisingly, the five participants who were against guideline implementation remained fixed in their view, continuing to disagree regarding their use in clinical encounters. Conclusion: Although we were unable to change the attitudes of physicians who were against the use of guidelines in clinical practice, the debate caused a positive shift among participants who did not have an opinion regarding their use in clinical scenarios.
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