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  1. Al-Naggar RA, Abdulghani M, Osman MT, Al-Kubaisy W, Daher AM, Nor Aripin KN, et al.
    Adv Med Educ Pract, 2014;5:177-84.
    PMID: 24959093 DOI: 10.2147/AMEP.S61805
    BACKGROUND:
    Students' perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students' perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex.

    METHODS:
    This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences.

    RESULTS:
    The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students' perceptions were positive. The students' perception toward educational environment was positive for all five DREEM subscales.

    CONCLUSION:
    The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement.

    KEYWORDS:
    DREEM; Malaysia; learning environment; medical education; students’ perceptions
  2. Zabidi-Hussin ZA
    Adv Med Educ Pract, 2016;7:247-8.
    PMID: 27217805 DOI: 10.2147/AMEP.S106507
    Having an organized, structured thinking process is critical in medicine. It is through this thinking process that enables one to go through the method of history-taking, which will eventually lead to making a definitive diagnosis and all other processes that follow. The use of mnemonic has been found to be useful for this purpose. The mnemonic VITAMINSABCDEK, is a convenient and practical way to assist in expanding the differential diagnoses and covers all possible causes of an illness. It is also easy to remember, as the vitamins whose letters are represented in this mnemonic cover the entire range of vitamins known.
  3. Ismail S, Salam A, Alattraqchi AG, Annamalai L, Chockalingam A, Elena WP, et al.
    Adv Med Educ Pract, 2015;6:231-7.
    PMID: 25878516 DOI: 10.2147/AMEP.S78441
    Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students' perceptions regarding lecture quality in a new medical school.
  4. Rahman NI, Aziz AA, Zulkifli Z, Haj MA, Mohd Nasir FH, Pergalathan S, et al.
    Adv Med Educ Pract, 2015;6:211-22.
    PMID: 25848333 DOI: 10.2147/AMEP.S78838
    The Dundee Ready Education Environment Measure (DREEM) was planned and designed to quantify the educational environment precisely for medical schools and health-related professional schools. DREEM is now considered a valid and reliable tool, which is globally accepted for measuring the medical educational environment. The educational environment encountered by students has an impact on satisfaction with the course of study, perceived sense of well-being, aspirations, and academic achievement. In addition to being measurable, the educational environment can also be changed, thus enhancing the quality of medical education and the environment, and the medical education process. The objective of this study was to assess the educational environment of the Universiti Sultan Zainal Abidin (UniSZA) undergraduate medical program from the students' perspective. The study expected to explore UniSZA medical students' overall perceptions, perceptions of learning, teachers, atmosphere, academic self-perception, and social self-perception using the DREEM questionnaire.
  5. Setia S, Tay JC, Chia YC, Subramaniam K
    Adv Med Educ Pract, 2019;10:805-812.
    PMID: 31572042 DOI: 10.2147/AMEP.S219104
    Continuing medical education (CME) is meant to not only improve clinicians' knowledge and skills but also lead to better patient care processes and outcomes. The delivery of CME should be able to encourage the health providers to accept new evidence-based practices, and discard or discontinue less effective care. However, continuing use of expensive yet least effective and inappropriate tools and techniques predominates for CME delivery. Hence, the evidence shows a disconnect between evidence-based recommendations and real-world practice - borne out by less than optimal patient outcomes or treatment targets not being met especially in low- to middle-income countries. There is an ethical and professional obligation on CME-providers and decision-makers to safeguard that CME interventions are appraised not only for their quality and effectiveness but also for cost-effectiveness. The process of learning needs to be engaging, convenient, user-friendly and of minimal cost, especially where it is most needed. Today's technology permits these characteristics to be integrated, along with further enhancement of the engagement process. We review the literature on the mechanics of CME learning that utilizes today's technology tools and propose a framework for more engaging, efficient and cost-effective approach that implements massive open online courses for CME, adapted for the twenty-first century.
  6. Gopakumar A, Sreedharan J, Premadasa G, Muttappallymyalil J
    Adv Med Educ Pract, 2014;5:237-9.
    PMID: 25120379 DOI: 10.2147/AMEP.S68534
    Comment on: Williams B, Sadasivan S, Kadirvelu A, Olaussen A. Empathy levels among first year Malaysian medical students: An observational study. Adv Med Educ Pract. 2014;5:149–156
  7. Bhagat V, Haque M, Simbak NB, Jaalam K
    Adv Med Educ Pract, 2016;7:341-6.
    PMID: 27354836 DOI: 10.2147/AMEP.S108477
    Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism) on the medical students' academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student's academic achievement regardless of the fact whether they study in their own country or overseas.
  8. Bhagat V, Haque M, Bin Abu Bakar YI, Husain R, Khairi CM
    Adv Med Educ Pract, 2016;7:575-584.
    PMID: 27790052
    Emotional maturity (EM) is defined as the ability of an individual to respond to situations, control emotions, and behave in an adult manner when dealing with others. EM is associated with adult learning skill, which is an important aspect of professional development as stated in the principles of andragogy. These principles are basically a characteristic feature of adult learning, which is defined as "the entire range of formal, non-formal, and informal learning activities that are undertaken by adults after an initial education and training, which result in the acquisition of new knowledge and skills". The purpose of this study is to find out the influence of EM on adult learning among Years I and II medical students of Universiti Sultan Zainal Abidin (UniSZA). The study population included preclinical medical students of UniSZA from Years I and II of the academic session 2015/2016. The convenient sampling technique was used to select the sample. Data were collected using "EM scale" to evaluate emotional level and adult learning scale to assess the adult learning scores. Out of 120 questionnaires, only six response sheets were not complete and the remaining 114 (95%) were complete. Among the study participants, 23.7% (27) and 76.3% (87) were males and females, respectively. The data were then compiled and analyzed using SPSS Version 22. The Pearson's correlation method was used to find the significance of their association. The results revealed a significant correlation between EM and adult learning scores (r=0.40, p<0.001). Thus, the study result supports the prediction, and based on the current findings, it can be concluded that there is a significant correlation between EM and adult learning and it has an effect on the students. Medical faculty members should give more emphasis on these aspects to produce health professionals. Henceforward, researchers can expect with optimism that the country will create more rational medical doctors.
  9. Williams B, Sadasivan S, Kadirvelu A, Olaussen A
    Adv Med Educ Pract, 2014;5:149-56.
    PMID: 24876799 DOI: 10.2147/AMEP.S58094
    BACKGROUND: The literature indicates that medical practitioners experience declining empathy levels in clinical practice. This highlights the need to educate medical students about empathy as an attribute early in the academic curriculum. The objective of this study was to evaluate year one students' self-reported empathy levels following a 2-hour empathy workshop at a large medical school in Malaysia.
    METHODS: Changes in empathy scores were examined using a paired repeated-measures t-test in this prospective before and after study.
    RESULTS: Analyzing the matched data, there was a statistically significant difference and moderate effect size between mean empathy scores before and 5 weeks after the workshop (112.08±10.67 versus 117.93±13.13, P<0.0001, d=0.48) using the Jefferson Scale Physician Empathy (Student Version).
    CONCLUSION: The results of this observational study indicate improved mean self-reported empathy scores following an empathy workshop.
    KEYWORDS: Malaysia; empathy; medical students
    Study site: Jeffry Cheah School of Medicine and Health Sciences, Monash University Malaysia.
  10. Spasenoska M, Costello S, Williams B
    Adv Med Educ Pract, 2016;7:331-9.
    PMID: 27350763 DOI: 10.2147/AMEP.S96591
    OBJECTIVE: The purpose of this present study was to investigate the psychometric properties of the Jefferson Scale of Physician Empathy - student version (JSPE-S).
    SUBJECTS AND METHODS: This study recruited 193 Malaysian medical students enrolled in year one and year two studies. A principal-component analysis with Varimax rotation was conducted. Procrustes rotation was used to confirm the item to model fit, which allows for a comparison of actual structure against an ideal hypothesized structure. Items were systematically removed based on low communalities of < 0.3 and poor loading of items onto components.
    RESULTS: A two-component solution was found, comprised of "perspective taking" and "compassionate care". Following item removal, eleven items remained. A Procrustes analysis revealed that this eleven-item measure demonstrated an excellent model fit. A possible third component was identified, though is not recommended for use, due to construct underrepresentation.
    CONCLUSION: This study found the Jefferson Scale of Physician Empathy fitted best to a two-component model using eleven items. Item, component, and overall congruence were very high, and scale reliabilities were adequate. The results of this study suggest that the eleven-item, two-component solution demonstrates excellent psychometric properties and structural validity in a Malaysian medical student population. Future research could consider using the short eleven-item measure in both student and health care profession samples to investigate the role of empathy in health care.
    Study site:; Jeffry Cheah School of Medicine and Health Sciences, Monash University Malaysia.
  11. Blebil AQ, Dujaili JA, Mohammed AH, Thiruchelvam K, Lee S, Elkalmi R, et al.
    Adv Med Educ Pract, 2022;13:95-102.
    PMID: 35082550 DOI: 10.2147/AMEP.S344872
    Introduction: There is a predicted growth of up to 17% in an older adult of Malaysian above 60 years of age by 2040. This will increase the workload of almost every healthcare provider to ensure optimal geriatric care.

    Purpose: This study aimed to assess pharmacy students' knowledge and attitudes towards geriatric pharmacy education and older patients to determine their preparation in delivering appropriate medical care to the geriatric population.

    Methods: Self-administered questionnaires were distributed among pharmacy students in different Malaysian universities. The survey included several sections to assess multiple aspects such as sociodemographic information, assessment of knowledge using a validated 28-item Geriatric Knowledge Assessment Scale (GKAS), and attitudes towards geriatrics education.

    Results: The response rate was around 70% of the respondents. The mean (± standard deviation) age of the cohort was 22.28 (±1.12) years. Despite around 78% of pharmacy students claiming that their knowledge of geriatric care is adequate, their GKAS score showed that only around 20% have high geriatric knowledge. Around 80% of them showed a positive attitude on the importance of taking courses focused on geriatric care and demonstrated interest to further knowledge and training in geriatric care. However, more than half of the students were uncertain of their answers towards their attitudes regarding older patients.

    Conclusion: Given the growing role of pharmacists in the ageing population, this study highlights the importance of geriatric care education among potential pharmacists. Therefore, we urge the need to improve/develop geriatrics education and training into the pharmacy curriculum to ensure sufficient preparation for actual practice after graduation.

  12. Hatem NAH, Mohamed Ibrahim MI, Halboup A, Kubas M
    Adv Med Educ Pract, 2023;14:109-121.
    PMID: 36816050 DOI: 10.2147/AMEP.S392886
    INTRODUCTION: Pharmaceutical care (PC) is the philosophy of the pharmacist's practice to achieve a better health-related outcome by designing, implementing and monitoring the therapeutic plans. It is in its infancy in Yemen. Hence, the study objectives were to examine the barriers to PC provision as perceived by Yemen pharmacy students and to assess their level of understanding of PC and their attitudes toward PC.

    METHODOLOGY: A cross-sectional study was conducted among ten pharmacy colleges in Yemen, offering undergraduate pharmacy programs. A stratified sample of 518 students from the included universities were surveyed using a well-structured, validated and self-administered questionnaire. Chi-square, Mann-Whitney U, and Kruskal-Wallis tests were conducted at an alpha level of 0.05.

    RESULTS: Four hundred and seventy-five (475) participants were included (92.9% response rate). More than 17% (n=84) of participants were involved in Pharm.D program, and nearly 29.9% (n=142) preferred pharmaceutical marketing as a career after graduation. About 65% of participants recognized the purpose of PC, and pharmacists' role within PC. However, only 43.8% (n=208) knew the difference between clinical pharmacy and PC. About 82% of respondents showed very good attitudes toward PC. Pharm.D students showed higher attitudes' total scores, median (IQR): 4.3 (4.1-4.4), 4.2 (4-4.2) and 4 (3.9-4.2) for Pharm.D, bachelor of pharmacy and bachelor of clinical pharmacy respectively, (p-value = 0.032). Moreover, students who currently employed in pharmacy-related job during their study were also associated with high attitudes scores compared to unemployed students, median (IQR): 4.2 (4-4.4) and 4(3.9-4.1) respectively (p-value = 0.023). "Lack of access to the patient medical record in the pharmacy" and "inadequate (hospital and community pharmacy) internship period" were the top reported barriers with 81.5% (n=387) agreement.

    CONCLUSION: Although PC is in its infancy in Yemen, pharmacy students showed positive attitudes toward practicing PC. Educational institutions should exert efforts for curricular revision to improve understanding, and overcome the reported barriers in the future.

  13. Lim WK
    Adv Med Educ Pract, 2023;14:1453-1460.
    PMID: 38164409 DOI: 10.2147/AMEP.S444566
    The introduction of problem-based learning (PBL) in 1969 is considered the greatest innovation in medical education of the past 50 years. Since then, PBL has been implemented in different educational settings across virtually all health professions. However, some PBL schools gradually faced resistance from academic staff who were more familiar with traditional teacher-centred curricula. At times this has resulted in reversion to tradition or compromise whereby PBL is implemented within a lecture-based curriculum. Resistance can also emerge in a traditional school when a PBL curriculum is being considered for implementation. One of the first signs of this erosion is doubts about PBL raised in the form of objections or criticisms. This perspective review describes eight objections raised to assert why PBL is inferior or untenable. The background to each objection is provided together with evidence-informed rebuttals derived from professional practice and the published literature. Best practices are discussed for sustainable management of a PBL-based curriculum. A well-implemented PBL curriculum with appropriate and cost-effective infrastructure, training, teaching-learning activities, and assessment will position schools to harness the full benefit of PBL in training medical and health professionals.
  14. Haque M, Zulkifli Z, Haque SZ, Kamal ZM, Salam A, Bhagat V, et al.
    Adv Med Educ Pract, 2016;7:407-22.
    PMID: 27524927 DOI: 10.2147/AMEP.S90737
    Defining professionalism in this constantly evolving world is not easy. How do you measure degrees of benevolence and compassion? If it is so obvious to our profession, what professionalism is, then why is it so difficult to teach it to medical students and residents? Today's definition of medical professionalism is evolving - from autonomy to accountability, from expert opinion to evidence-based medicine, and from self-interest to teamwork and shared responsibility. However, medical professionalism is defined as the basis for the trust in the patient-physician relationship, caring and compassion, insight, openness, respect for patient dignity, confidentiality, autonomy, presence, altruism, and those qualities that lead to trust-competence, integrity, honesty, morality, and ethical conduct. The purpose of this study is to explore professionalism in terms of its fundamental elements among medical students of Universiti Sultan Zainal Abidin (UniSZA). This was a cross-sectional study carried out on medical students of UniSZA. The study population included preclinical and clinical medical students of UniSZA from Year I to Year V of academic session 2014/2015. The simple random sampling technique was used to select the sample. Data were collected using a validated instrument. The data were then compiled and analyzed using SPSS Version 21. Out of 165 questionnaires distributed randomly among Year I to Year V medical students of UniSZA, 144 returned, giving a response rate of 87%. Among the study participants, 38% (54) and 62% (90) were males and females, respectively. The grand total score was 170.92±19.08. A total of 166.98±20.15 and 173.49±18.09 were the total professionalism score of male and female study participants, respectively, with no statistically significant (P=0.61) differences. This study found almost similar levels of familiarity with all fundamental issues of professionalism with no statistically (P>0.05) significant differences. Medical faculty members should give more effort for the professional development of medical doctor. Henceforth, researchers believe and expect that the country will produce more rational and holistic medical doctors.
  15. Jamshed SQ, Ibrahim MI, Hassali MA, Sharrad AK, Shafie AA, Babar ZU
    Adv Med Educ Pract, 2015;6:359-66.
    PMID: 26028981 DOI: 10.2147/AMEP.S27762
    GENERAL OBJECTIVE: To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan.

    METHODS: A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach's alpha was found to be 0.62.

    RESULTS: Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001).

    CONCLUSION: The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan.

  16. Al-Ashwal FY, Syed Sulaiman SA, Sheikh Ghadzi SM, Harun SN, Halboup A, Kubas MA
    Adv Med Educ Pract, 2024;15:357-368.
    PMID: 38707544 DOI: 10.2147/AMEP.S445610
    INTRODUCTION: Understanding the latest guideline recommendations is crucial for healthcare professionals to apply statin therapy effectively. Thus, the purpose of this study was to evaluate the efficacy of an educational intervention in enhancing the awareness and understanding of physicians and pharmacists concerning risk assessment of Atherosclerotic cardiovascular disease (ASCVD) and the role of statin therapy.

    METHODS: This pre- and post-intervention study was conducted in Sana'a, Yemen's capital city, at the University of Science and Technology Hospital. The study was done between 11/2021-12/2021, and two separate educational sessions were ‎held. The McNemar's test and Wilcoxon signed-rank test were employed as necessary.

    RESULTS: Participants' awareness of the Framingham CVD risk calculator improved significantly from 40.4% pre-intervention to 78.7% post-intervention. Similarly, understanding of the parameters used in the 10-year ASCVD Risk calculator rose from 46.8% pre-intervention to 76.6% post-intervention. The ability to identify high, moderate, and low-intensity statin therapy, for instance, increased from 34% to 63.8% post-intervention. Regarding statins' contraindications, safety, and efficacy monitoring parameters, pre-intervention knowledge was unsatisfactory, and the educational intervention improved it significantly (p <0.05). For physicians, the median ASCVD risk assessment knowledge score was significantly improved from ‎‎4 (IQR = 3-5) pre-intervention to 7 (6.25-8) immediately post-intervention, while the statin therapy clinical knowledge median score ‎significantly improved from 3 (1.25-6.5) to 9 (7.25-14.75) post-education intervention, p-values were 0.002 and 0.003; respectively. For pharmacists, a similar significant improvement (p <0.05) in the overall knowledge scores for both ASCVD risk ‎assessment and statin therapy was noted.

    CONCLUSION: The educational intervention improved participants' knowledge of statin therapy and ASCVD risk assessment. Therefore, further education lectures and training programs through continuing ‎medical ‎education on the up-to-date guidelines' recommendations should be regularly implemented to raise ‎awareness and improve ‎the clinical knowledge and appropriateness of statins use in clinical settings.‎.

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