Medicine

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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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Author: search.filters.author.Karunaratne, W.C.D.Has files: No

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    The dynamics of doctor-patient conversations:A linguistical analysis
    (Sri Lanka Medical Association, 2018) Wijesundara, B. M. E.; Karunatilake, K.M.M.G.S.L.; Karunaratne, W.C.D.; Chandratilake, M.N.
    INTRODUCTION AND OBJECTIVES: Concerns exist on the communication skills of doctors in medical practice. The aim of this study was to explore the linguistic dynamics of communication between doctors and patients in the Sri Lankan cultural context.METHODS: A qualitative study was conducted in wards of major disciplines in North-Colombo Teaching Hospital. 16 out of 48 audio-recorded patient consultations of intern house officers were subjected to preliminary linguistic analysis of the open vs closed ended questioning, tolerability of silence, time distribution between doctors and patients, use of technical jargon and emotional expressions.RESULTS: The average consultation time was l 7min 40s (Range: 4min, 45s - 30min, 56s) and was distributed between patient 4 min, 57s (Range: 34s - 18mins ,l ls), doctor 2 min (Range: 3ls - 4min, 36s) and other activities like documentation. Therefore, the average time distribution between doctor and the patient during a consultation was 1 :2.5. 74.66% of the doctors' questions were closed-ended. 83% of the time patients provided detailed answers to closed-ended questions. Doctors used repeating and paraphrasing to encourage non-respondents and rarely used technical jargon. Questioning was friendly but the tone of the conversation was hierarchical. However, it enabled developing good rapport with patients. Doctors rarely showed irritation and it was expressed implicitly through hurried questioning and high-toned voice.CONCLUSION: The linguistic dynamics of consultations demonstrated the presence of elements of the Eastern cultural norm of hierarchy. Limited patient-centredness of doctors was not observed negatively by patients. Patients appeared to be more empowered, may be due to the 'narrow power-gap' between junior-doctors and patients.
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    Using hermeneutic phenomenology approach to explore how junior doctors learn clinical reasoning in practice
    (Sri Lanka Medical Association, 2017) Karunaratne, W.C.D.; Chandratilake, M.; Marambe, K.
    INTRODUCTION & OBJECTIVES: Hermeneutic phenomenology is a qualitative study design to understand individual learning experiences from the beholder’s perspective (phenomenology) while appreciating the subjective interpretation of them by the researcher with essential prejudices for understanding the concept (hermeneutic). Clinical reasoning is a multifaceted, dynamic, individualized and evolving construct. Therefore, how junior doctors learn clinical reasoning in practice was explored using this approach. The aim is to share this methodological experience with prospective researchers to be used for similar purposes. METHODS: A total of 18 junior doctors (Males: 7, Females: 11) from four major clinical disciplines participated in individual in-depth semi-structured interviews. Lived-experiences were encouraged more during the interviews than the perceptions complying with phenomenology. The interviews were audio-recorded, transcribed verbatim and analyzed according to the Ritchie and Spencer framework using the Atlas.ti software. The above framework was chosen to maximize the diversity of interpretation. Three personnel with the same academic background but different levels of experience developed the coding framework. This resulted in identification of codes from participants’ expressions (first-order constructs; layered by the researcher’s interpretations of these constructs (second-order constructs). The second-order constructs gave the impetus for emerging themes for the coding framework. Three frameworks of three coders were compared; consensus and deviations were included in developing the final coding framework. RESULTS: The framework revealed rich and diverse accounts of how junior doctors conceptualized clinical reasoning, the presence of numerous interpersonal and contextual factors driving, facilitating and supporting learning and also hindering the learning process. CONCLUSION: Hermeneutic phenomenology can be used effectively to understand complex phenomena like clinical reasoning.
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    Usage analysis of student interactions in an online learning platform conducted at Faculty of Medicine, University of Kelaniya: Pedagogical considerations for implementing e-Learning
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Karunaratne, W.C.D.; Chandratilake, M.N.; Heiyantuduwage, S.
    BACKGROUND: Learning Management Systems (LMS) designed to support teaching and learning has changed how education is offered and consumed in higher education. OBJECTIVES: This study was conducted with the aim of identifying what inferences, educators can make through student usage statistics of the Moodle Learning Management System termed as the VLE (Virtual Learning Environment) on developing a pedagogical model for online learning. METHODS: Student and staff course usage statistics were recorded from the VLE of the Faculty of Medicine, University of Kelaniya for all the modules, and related resources and activities conducted from first to the fourth year students during the year 2015 and analyzed. RESULTS: A majority of students (88-90%) access the materials available in the VLE. The mean student access during the module is higher than following the completion of the module while the frequency of student access during faculty hours is similar to the frequency of use after faculty hours. As expected, student access was increased with availability of more learning materials in the modules and with incorporation of student activities and links to web resources. The mean usage frequency of staff were considerably low and limited whereas the support staff usage being more than ten times higher. CONCLUSIONS: The Virtual Learning Environment (VLE) of the faculty can be used as an effective platform to supplement didactic learning and to promote self-learning among students. It also highlights the necessity to form an eLearning development team for the institution consisting of instructional designers, graphic artists, multimedia developers and instructors with whom the content experts can work together to realize there requirements.
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