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Original Research (Original Article) 


Eyad Mohammed Alodhaydan et al, 2019;3(7):609–612.

International Journal of Medicine in Developing Countries

Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University

Eyad Mohammed Alodhaydan1*, Khalid Saud Alshalhoub1, Bandar Mohammed Alotaibi1

Correspondence to: Eyad Mohammed Alodhaydan

*Al-Majmaah University, Al-Majmaah, Saudi Arabia.

Email: eyadm65 [at] gmail.com

Full list of author information is available at the end of the article.

Received: 25 January 2019 | Accepted: 05 February 2019


ABSTRACT

Background:

The prevalence of pediatric tumors has been increasing rapidly worldwide in recent years. It has become very important to investigate the awareness of physicians and pediatricians regarding childhood oncology and its diagnosis and referral. So this study was aimed to assess the perception, attitude, and awareness of pediatric oncology among undergraduate medical students.


Methodology:

The study was conducted among 500 undergraduate students in a pediatric clinical at Al-Majmaah University. A 12-point survey was formulated to assess the understanding of pediatric malignancies and the interest in childhood tumors among undergraduate medical students.


Results:

The majority (80%) of participants had pursued pediatrics as a career and only 20% of them had not pursued pediatric oncology as a career. Among the total, 54% of the students had not witnessed pediatric tumor patients in the ward. Furthermore, 52% had not received lectures on childhood oncology. Among the total, 58% of the students thought that they had enough knowledge of childhood cancer to diagnose and refer pediatric tumor patients correctly. Though, 98% believed that improvement was required in pediatric oncology teaching in their medical curriculum.


Conclusion:

There is a good perception of pediatric tumors among undergraduate medical students and the majority of them had confidence in their ability to recognize and manage pediatric malignancies. However, pediatric oncology curriculum needs to be improved.


Keywords:

Awareness, childhood cancer, undergraduates.


Introduction

The first cause of mortality in childhood period between 1 and 14 years is cancer. There are limited pediatric cancer institutes concerning the increasing number of pediatric malignancies. However, there is impressive progress both nationally and internationally in the field of childhood oncology [1]. It is hard to diagnose children tumors due to the presence of a lot of variables. Also, there is delayed referral due to lack of experience with symptoms and warning signs. Prognosis depends on early diagnosis which allows effective control of the disease before its spread, therefore, early recognition of tumors is an ultimate goal. Prognosis may improve, and cure can be achieved with minimal adverse effects.

To recognize the strategies to enhance the perception of the future primary physicians toward childhood tumors and to increase their interest in this field, this study was conducted [2].


Subjects and Methods

Several factors influence childhood tumor survival; this study focused on two main items: causes for delayed diagnosis and lack of dedicated pediatric oncologists.

The study was conducted on 500 students through a questionnaire to assess the knowledge of the final year medical students about their understanding of pediatric cancers and interest/attitude toward pediatric tumors as a career. The survey was conducted in a 2-day pediatric revision course for a final year of medical students. The undergraduates participated represented both Government and Private institutions. The study was a 12-point questionnaire to assess their knowledge and clinical exposure toward children’s malignancy. Data were analyzed by SPSS 18.V software.


Results

All the participated undergraduate medical students were volunteers for the study. One hundred (20%) of the respondents were males and 400 (80%) were females. The students were from various private and government medical colleges. Two hundred and ninety (58%) of them answered the fundamental questions about childhood cancer correctly. Two hundred and fifty (50%) of the individuals reported that they do not have a pediatric oncology unit in their institution. Two hundred and seventy (54%) of the undergraduates had attended pediatric oncology patients during their curriculum. However, 260 (52%) of the students have never participated in a lecture class on pediatric oncology; and out of the 240 (48%) who attended lectures, a majority of 200 (40%) had attended less than three lectures on pediatric oncology. To assess the contributing factors to the failure of effective treatment of childhood cancer, 200 (40%) undergraduates answered that late diagnosis and referral is the leading cause, while 150 (30%) of them said that the lack of treatment facilities available in the country was the leading cause of failure. In regard to the interest in pediatric oncology, interestingly, majority 400 (80%) of the participants were interested in working in pediatric oncology. While only 100 (20%) of the participants were not interested in pursuing pediatric oncology. One hundred and fifty (30%) of students did not want to seek the field due to its unpredictable outcome, and 120 (24%) said that it is a too depressing career. About the participant’s knowledge to suspect and refer a child with a suspected tumor to a specialized hospital, 210 (42%) of individuals did not have sufficient information in pediatric oncology. While 290 (58%) of individuals thought that they had adequate knowledge in pediatric oncology to suspect and refer a child during their practice. Four hundred and ninety (98%) of students who believe that there is a need to improve the teaching of pediatric oncology in their curriculum.

In regard to the participant’s opinions to increase awareness of childhood cancer in society, 199 (39.8%) believed that the best way was launching national cancer control programs by the government, while 170 (34%) considered improving pediatric oncology education in the medical curriculum as the best tool to raise awareness among the public. Twenty-three (11.2%) recognized seminars and lectures were the way. One hundred and thirty-one (26.2%) said that mass media could create awareness among the people. Concerning how to support children diagnosed with tumors, 320 (64%) of students wanted to volunteer. One hundred (20%) of the undergraduates reported that blood donation would be their way to help these patients. Seventy (14%) wanted to raise funds for these patients. And only 10 (2%) would take up a career in pediatric oncology (Table1).


Discussion

Advances in cancer research and targeted therapy are the mainstay of the overall pediatric oncology progress in developed countries. But the survival rates are still weak in developing countries [3].

Worldwide, studies aim to identify the barriers against the discovery, research, and development in oncology. While, developing countries are still fighting the gap between demands and availability of infrastructure, trained personnel, and funding resources [4]. Constraints in childhood cancer management made the subspecialty out of scope and a depressing field to choose for new graduate doctors [5]. The results of the present study showed that 30% of participants considered pediatric oncology as a subspecialty that has unpredictable outcomes among patients and 24% said it was too depressing. Financial constraints and cancer illiteracy have a significant role in delaying the progress of pediatric oncology in developing countries. These barriers led to a lack of critical diagnostic tools as immunophenotyping, nuclear imaging, and cytogenetics, as well as the scarcity of trained oncology nurses, nutritionists, the unfulfilled demands of radiation, and blood components [6]. Shortage of facilities and unpredictable outcome are the main contributing factors to classify the subspecialty as depressing. Multiple faceted techniques are highly required to help improve issues like infrastructure and cancer research support, training the involved personnel in cancer therapy, facilitate cancer funding for chemotherapy, blood products, promote free accommodation and palliative care. These techniques will help to increase the desire of medical students to pursue pediatric oncology as a specialty through increasing the survival rate, quality of life, and research work [7]. Latha et al., in their study concluded that the lack of attendance in pediatric oncology lectures leads to limited information and poor skill development to discover childhood tumors early. Also, the curriculum needed improvement to include clinical rounds for more exposure of medical students to cancer patients which will lead to an increase in their interest in childhood oncology specialty. Similar results were found in a study by Cull et al. [8] and in the present results too [9]. A lot of studies in both developed and developing countries emphasized to improve undergraduate students’ awareness of pediatric oncology; also, training should be provided in clinical oncology rotations and research studies should be included in the undergraduate syllabus [10]. Teaching, diagnosis, and treatment of children tumors, interactive case presentations, and discussions which include direct communications between patients and students can strongly increase awareness, perception, and possibility of pursuing the specialty [11]. The present data showed that the majority of students wanted to help pediatric tumor patients in any possible way as blood donations, raising funds, volunteering although they did not pursue the specialty; similar results were found in Latha et al. [9] study. Latha et al. study revealed that undergraduate medical curriculum improves childhood cancer awareness among medical students, which in turn will lead to early diagnosis and referral to an appropriate doctor. It was also noted that the curriculum needed consideration of the current demands and improve student’s perception for all cancer patients. The present study conducted the same results [9].

Table 1. Twelve items questionnaire to assess undergraduate medical students’ knowledge and attitude toward pediatric oncology.

Demographics and Knowledge N (%) N = 500
Age (years)
Mean ± SD

22.9 ± 2.7
Sex
Male
Female

100 (20%)
400 (80%)
Do you have a pediatric oncology unit in your institution?
Yes
No

250 (50%)
250 (50%)
Had you attended to any pediatric oncology patients during your curriculum?
Yes
No

270 (54%)
230 (46%)
Have you attended a lecture class on pediatric oncology?
Yes
No

240 (48%)
260 (52%)
If yes, how many lectures do you attend per week?
1–3
3–5
>5

200 (40%)
10 (2%)
15 (3%)
15 (3%)
Which factor contributed to the failure of effective treatment of childhood cancer?
-late diagnosis and referral was the leading cause the massive cost of therapy was the primary factor leading to failure
-less availability of trained physicians was the primary determinant leading to the failure
-unwillingness to undergo therapy due to misconception and social stigma was another cause
-the lack of treatment facilities in the country.

200 (40%)
75 (15%)
75 (15%)
150 (30%)
Are you interested in pursuing pediatric oncology?
Yes
No

400 (80%)
100 (20%)
If your answer in the last question is no, why?
-it was too depressing to be taken as a career
-I did not want to pursue the field as it had an unpredictable outcome among patients
-I did not possess adequate knowledge regarding this field which acted as a hurdle for them to take up this field
-insufficient financial compensation led to their lack of interest
-the huge workload involved.

120 (24%)
150 (30%)
30 (6%)
50 (10%)
50 (10%)
Do you have sufficient information in pediatric oncology to suspect and refer a child during their practice?
Yes
No

290 (58%)
210 (42%)
Do you think that there is a need to improve the teaching of pediatric oncology in your curriculum?
Yes
No

490 (98%)
10 (2%)
How can we increase the awareness of childhood cancer in our society?
-improving pediatric oncology education in the medical curriculum
-mass media can create awareness among the public
-conducting seminars and lectures
-launching national cancer control programs by the government.

170 (34%)
131 (26.2%)
199 (39.8%)
What is the best way to support pediatric oncology patients?
-donate blood as a way of support
-function as a volunteer
-raise funds for these patients
-take up a career in pediatric oncology.

100 (20%)
320 (64%)
70 (14%)
10 (2%)

Conclusion

The main contributing factor of late diagnosis and referral of pediatric oncology patients are limited exposure, lack of lectures, and training of undergraduates on childhood malignancies. It is highly recommended to improve pediatric oncology undergraduate curriculum to include clinical rounds in tumor institutes, interactive presentations, and discussions between students, patients, and lecturers.


List of Abbreviations

None.


Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.


Funding

None.


Consent for publication

Informed consent was obtained from all participants.


Ethical approval

The research was conducted under the supervision of Al-Majmaah University.


Author details

Eyad Mohammed Alodhaydan1, Khalid Saud Alshalhoub1, Bandar Mohammed Alotaibi1

  1. Al-Majmaah University, Al-Majmaah, Saudi Arabia

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How to Cite this Article
Pubmed Style

Alodhaydan EM, Alshalhoub KS, Alotaibi BM. Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. IJMDC. 2019; 3(7): 609-612. doi:10.24911/IJMDC.51-1548380495


Web Style

Alodhaydan EM, Alshalhoub KS, Alotaibi BM. Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. http://www.ijmdc.com/?mno=27858 [Access: August 20, 2019]. doi:10.24911/IJMDC.51-1548380495


AMA (American Medical Association) Style

Alodhaydan EM, Alshalhoub KS, Alotaibi BM. Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. IJMDC. 2019; 3(7): 609-612. doi:10.24911/IJMDC.51-1548380495



Vancouver/ICMJE Style

Alodhaydan EM, Alshalhoub KS, Alotaibi BM. Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. IJMDC. (2019), [cited August 20, 2019]; 3(7): 609-612. doi:10.24911/IJMDC.51-1548380495



Harvard Style

Alodhaydan, E. M., Alshalhoub, . K. S. & Alotaibi, . B. M. (2019) Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. IJMDC, 3 (7), 609-612. doi:10.24911/IJMDC.51-1548380495



Turabian Style

Alodhaydan, Eyad Mohammed, Khalid Saud Alshalhoub, and Bandar Mohammed Alotaibi. 2019. Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. International Journal of Medicine in Developing Countries, 3 (7), 609-612. doi:10.24911/IJMDC.51-1548380495



Chicago Style

Alodhaydan, Eyad Mohammed, Khalid Saud Alshalhoub, and Bandar Mohammed Alotaibi. "Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University." International Journal of Medicine in Developing Countries 3 (2019), 609-612. doi:10.24911/IJMDC.51-1548380495



MLA (The Modern Language Association) Style

Alodhaydan, Eyad Mohammed, Khalid Saud Alshalhoub, and Bandar Mohammed Alotaibi. "Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University." International Journal of Medicine in Developing Countries 3.7 (2019), 609-612. Print. doi:10.24911/IJMDC.51-1548380495



APA (American Psychological Association) Style

Alodhaydan, E. M., Alshalhoub, . K. S. & Alotaibi, . B. M. (2019) Knowledge, attitude, and awareness of pediatric oncology among undergraduate medical students in Al-Majmaah University. International Journal of Medicine in Developing Countries, 3 (7), 609-612. doi:10.24911/IJMDC.51-1548380495