Reviewer ’s report  
Title: The Knowledge and Perceptions of the First Year Medic al Students of an International 
University on Family Planning and Emergency Contraception in Nicosia (TRNC)  
 
Version: 4 Date: 23 Jun 2018  
 
Reviewer: Julie Hernandez  
 
Reviewer's report:  
BMC Women's Health  
The Knowledge and Perceptions of First Year Students of an International Medical Faculty on 
Family Planning and Emergency Contraception in Nicosia.  
 
The reviewer appreciate the efforts made by the auth ors in addressing some of the issues raised 
in Review #1. The current manuscript is much improved and the appendices (survey instrument 
and tables) are very helpful for the reader to understand the study results.  
 
However, a number of structural and langu age issues remain in the text that need to be addressed 
before it is acceptable for publication. Those are detailed below for each of the manuscript 
sections.  
 
Title  
Reviewer recommended using « International University » rather than « International Facult y » 
(Faculty is standard English refers to the professors rather than the institution)  
Also, for readers unfamiliar with the location of Nicosia, it might be useful to add Turkish 
Republic of Northern Cyprus or TRNC.  
 
Abstract  
In the abstract, « family pla nning and emergency contraception » read as if these were two 
distinctive issues. Consider reformulating.  
 
Out of curiosity, were the students given further information on how to handle question 10 in the 
survey instrument? What should they be doing if th ey had received information about FP but not 
EC? The formulation of the question is problematic (asks about two different things)  
 
Background section  
 
Background section needs to be edited to specifically present information relevant to the 
manuscript (rat her than juxtaposed general considerations on family planning, mCPR around the 
world, description of all EC methods, etc…)  
Transition between paragraphs should clearly present the links between different aspects of the 
problem at hand. (Current translation  are abrupt or nonexistent)  
 
In particular:  
- Present available findings re: EC awareness from studies conducted in the region (article 
mentions Turkey as a focus of some articles but does not specify findings)  
- Explain why students are a particularly impo rtant target for this type of studies (« Hence » 
p.6. L.21 is not sufficient) Are there studies that suggest these populations are at increased 
risk for unsafe sex / unintended pregnancies?  
-  
 
Formatting issues  
- Throughout the manuscript, stay consistent with the number of decimals you use when 
presenting numbers / percentages  
- P.6.L34 « payment out of their pockets »  
 
Methods  
- NEUFM —> Spell out name entirely when it first appears in the manuscript, then use 
acronym  
- P.16,l7 —> the program (do not capitalize)  
 
 
Results  
Thank you to the authors for providing the survey instrument. The reviewer found a number of 
issues with the survey items that should be clarified and / or addressed in the limitation section of 
the manuscript.  
* How was the « knowledge » section scored in the survey instrument? QST15 alone is not 
sufficient to determine knowledge (correct answer can be guessed by elimination)  
* QST16 —> Neither of the answers are correct (EC does not have a p roven effect on 
implantation)  
* QST17 —> Correct answers can be guessed from the next set of questions (20 & 21)  
* QST23 —> What does « this service » refer to? EC?  
* QST28 —> What does « regular » mean? Were students provided with guidance on how to 
meas ure / answer that question?  
 
Minor editing  
P.10l.9 « expressed both of the EC methods » —> replace « express »  
P.10l.12 -14 —> What does « the status of the participants on their information » mean? 
Reformulate  
 
Discussion  
Discussion section should not rep eat results presented above but present their possible validity / 
implications / limitations and consequences for future FP research and programming.  
 
P.12l.38 « being informed on FM » —> Do you mean FP?  
Review entire sentence (possibly break in two?) - very unclear  
 
As mentioned in previous round of review, simply comparing one -on-one results from the study 
to results from other settings is not enough to support / infer external validity of findings. Please, 
re-organize to clearly show similarities and di screpancies / unexpected findings from your study 
and explain possible reasons for these.  
 
In the limitation / results, international first year medical students are a very self -selected sample 
of their countries populations, thus it is not surprising that there were no significant differences 
by country of origin. (I.e. A Senegalese medical stu dent in Nicosia probably has more in 
common with a peer student from Japan at this same university than he / she does with other 
young men / women in his / her home country). The reviewer suggest dropping the consideration 
of nationality as an independent variable in the analysis.  
 
Minor editing  
In section titles and table names, do not use « the » in the beginning, e.g. « Study limitation » , « 
The Knowledge and Perception… » etc.  
 
Conclusion  
 
Review first sentence? The authors state that EC knowledge is low yet that ECPs are one of the 
most commonly used FP methods for sexually active students?  
 
Comparison with study in India should be included in Discussion section rather than Conclusion. 
Conclusion section should focus on implications for future resear ch and programming.  
 
Conclusion advocates for the development of counseling services by health professionals on 
campus, however, the study results showed that the latter are not a very commonly used source 
of FP information for the students. Explain?  
 
List of acronyms  
 
Acronyms should appear in alphabetical order.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments  to the authors.  
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical revi ew? 
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
I recommend additional statistical review  
Quality of written English  
Please indicate the quality of language in the man uscript:  
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially f rom the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial com peting interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details b elow.  
 
I declare that I have no competing interests  
 
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I agree to the open peer review policy of the journal