Factors associated with neonatal mortality among 2500 g. babies born in hospital setting in district Thatta, Pakistan, A nasted case control study

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Transitions especially from pre-clinical to clinical training are found to be stressful and resulted in curricular innovations such as integration of clinical skills and knowledge in the pre-clinical years to ease the transition process. Most evaluations used students' levels of satisfaction to determine the usefulness of these curricular changes. Recently many theoretical models have been proposed to explore transition process where self-efficacy is identified as an important mediator to facilitate transition process. Since self-efficacy is task-specific and correlates well with academic achievements, therefore it can be used more appropriately for these evaluations. The purpose of this study is to evaluate the application of clinical skills and knowledge of the pre-clinical years during transition into clinical training using self-efficacy as an evaluation tool. Methods Clinical competence self-efficacy (CC-SE) tool was validated on 55 fourth year medical students. The CC-SE tool was administered on 91 third year medical students at LNH & MC to measure self-efficacy during transition to clinical training using paired-samples t-test. Pearson correlation was used to correlate transitional self-efficacy with pre-clinical performance scores and pre-clinical performance (OSPE scores) with first end of rotation test scores respectively. Results Results showed significant differences between CC-SE pre (at the beginning of clinical training) and post (after completion of first rotation) scores of medical students (p=0.000). Weak positive significant correlations were found between sub-scales of CC-SE and OSPE for procedural and examination skills (r = 0.267, p=0.025). Also there was no significant correlation found between overall OSPE scores and transition self-efficacy scores (r = 0.077) and first end of rotation exam scores respectively (p=0.066). Conclusion Students' satisfaction with curricular innovations do not reflect their capabilities to perform adequately especially in new clinical environment. SE is more specific to behavior change and thus can be used more appropriately for program evaluations with the help of validated tools when mapped particularly against expected outcomes of a program.

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