Talha Mahmud.
Chronic obstructive pulmonary disease. a common disease with vague concept among medicine trainees.
Pak J Chest Med Jan ;18(03):29-33.

Introduction: The optimal knowledge of medicine trainee residents about utility of spirometry in routine care of chronic obstructive pulmonary disease (COPD) patients is of utmost importance as spirometry is the corner stone for the diagnosis and severity assessment of COPD after which a plan of management can be constructed according to stage of the disease. Objective: The objective of the study was to assess the existing status of basic spirometric definition and severity staging of COPD among trainee residents. Methods: A cross-sectional survey of internal medicine trainees participating in the simulated task oriented assessment of clinical skills (TOACS) 2011 course at Sheikh Zayed Hospital, FPGMI Lahore, was carried out. The two written questions in the study questionnaire (data interpretation) were consisted of; defining the presence of COPD by < 70 post bronchodilator FEV1/FVC ratio and defining severity of COPD according to FEV1. The third direct oral question was about the gold standard test for COPD diagnosis. The number and percentages of positive answers were analyzed and positive responses of the participants regarding three questions were compared by chi-square likelihood ratio. Results: A total of 52 medicine trainees attended the COPD clinical scenario simulated TOACS author’s attended station. Among the participants, 17 were FCPS Part II medicine trainees who had completed their training (group A), 21 were FCPS intermediate module trainees having 2-3 years training experience (group B) and 14 (group C) were the first & second year trainees. Only 17.3% (9) could precisely define COPD presence according to the post bronchodilator spirometric FEV1/FVC ratio of 56% (< 70%), while 9.6% (5) could define COPD severity according to spirometric data (FEV1 45% predicted consistent with severe COPD) and 19.2% (10) agreed spirometry as gold standard for COPD diagnosis. The association of training duration with basic knowledge about COPD revealed no difference among the three groups (p-value > 0.05).

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