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Absenteeism of Medical Students from Subspecialty Clinical Rotations: A Qualitative Study.

OBJECTIVE
To explore in depth the phenomena of low attendance in subspecialty clinical ward rotation and how it can be improved among 4th year MBBS medical students.


STUDY DESIGN
Constructivist paradigm using qualitative transcendental phenomenological research design.


PLACE AND DURATION OF STUDY
Quaid-e-Azam Medical College, Bahawalpur, Pakistan, from February to March 2017.


METHODOLOGY
Two audio recorded focus group discussions (FGDs) of 4th year MBBS class consisting of six medical students (3 males and 3 females) were conducted using maximum variance purposeful sampling method based on students' performances. Group A included students among highest scorers in 2nd professional examination and group B included poorly performing students. Open-ended unstructured questions were posed in FGDs. Duration of discussion was approximately 45 minutes for each group. The recording was transcribed and analysed with NVivo software using thematic analysis technique generating themes and sub-themes. Member checking and triangulation with frequency of quotes were used for validation.


RESULTS
Students identified faculty related factors as the main theme with environment and students related contributory themes. Subthemes included improper teaching methodology, absence of a formal curriculum and teacher attitudes leading to little learning and students considering attending these wards a waste of time. Improvement suggested as an applied practical subspecialty curriculum implementation, continuing medical education for faculty development, effective interactive teaching/training strategies and record keeping.


CONCLUSION
This study found that the main reason of medical students' low attendance was faculty related factors. Continued professional development of faculty may help improve subspecialty clinical training.