Background: One of important educational climate roles is to provide an environment that promotes positive development of medical students' psychological wellbeing during training. Unfortunately, many studies have reported that educational climate in medical education are not favourable to them. Therefore, it is a real need for a simple, valid, reliable and stable tool that will help medical schools to screen psychological wellbeing of their students so that early intervention could be done.
Objective: This study aimed to explore the psychometric properties of the Medical Student Wellbeing Index (MSWBI) to measure psychological wellbeing at different interval of measurements in a cohort of medical students.
Method: A prospective study was done on a cohort of medical students. MSWBI was administered to the medical students at five different intervals. The confirmatory factor analysis, Cronbach's alpha and intra-class correlation analysis were applied to measure construct validity, internal consistency and agreement level at different interval of measurements.
Result: A total of 153 (89.5%) medical students responded completely to the MSWBI. The MSWBI showed that the one-factor model had acceptable values for most of the goodness of fit indices signified its construct was stable across multiple measurements. The overall Cronbach's alpha values for the MSWBI at the five measurements ranged between 0.69 and 0.78. The ICC coefficient values for the MSWBI total score was 0.58 to 0.59.
Conclusion: This study found that the MSWBI had stable psychometric properties as a screening tool for measuring psychological wellbeing among medical students at different time and occasions. Continued research is required to refine and verify its psychometric credentials at different educational settings.
Teaching stress management skills for medical students has been echoed as an important educational component in medical education. Discussions about approaches to teaching stress management in medical education context are largely unexplored despite of a large number of articles have emphasized on its importance. This paper describes four elements in a framework as an approach to teaching stress management skills in medical education. As one moves through the framework, it provides a greater degree of insight on stress management ability as is acquired through one's awareness, experience and conscious effort that allow stressful situations to be handled effectively and efficiently. It may provide a useful educational framework for medical teachers to teach and assess stress management skills of medical students. It also may be used as an aid in planning, implementing and evaluating stress management programs in medical schools. The authors discuss about the implications of this framework for future research in medical education.
Background: Tertiary education environment has always been regarded as highly stressful to students. Medical training further adds to the already stressful environment. The stress of medical training was associated with negative consequences to the mental and physical health of medical students. We describe in this article a stress-management program known as the 'Medical Student Well-Being Workshop' in our medical school.
Methodology: The workshop was run over two half-days over a weekend. Prior to the workshop the society announced the workshop to the students and participation was voluntary. It was open to students from all years of the medical course except for first year students. A separate stress management workshop is planned for them.
Results: A total of 55 students participated in the workshop, out of which 55 (82%) were female students. The years of study were almost equally represented; 14 students (26%) from years two and three, 20 (37%) from year four and 6 (11%) from year five. All sessions were rated as highly useful; the lowest rated, the introduction session, obtained an overall usefulness rating of 3.73 out of the possible 5 (74.6%).
Conclusion: Medical Students Well-being Workshop is a promising intervention program in improving medical students' ability in managing stress. Perhaps similar approach can be considered relevant to be incorporated in other medical schools.
Background: Recently many medical schools have incorporated Evidence Based Medicine (EBM) as part of their undergraduate teaching. The aim is to provide a firm base of EBM to the medical students early on, so that they can understand the importance of EBM. Medical schools are encouraged to teach EBM to students but yet the education setting, learner level, modes of instruction, skills covered and teaching methods are not standardised and varies worldwide. In Cyberjaya University College of Medical Sciences (CUCMS), EBM was incorporated in the curriculum since 2009. EBM concepts was taught formally to the MBBS students during four weeks Research and Evidence Based Medicine Course (REBM). Students were exposed to the various thinking processes, formulation of clinical questions, searching evidence, intermediate biostatistics, research methodology and critical appraisal. Besides that, Good Clinical Practice (GCP) and research proposal development also include in the course. The objective of this paper is to describe
CUCMS experience of teaching EBM for undergraduate medical students.
Methods: This report analysed students feedback using a questionnaire which included a Likert scale and open-ended questions.
Result: Overall, three batches of students gave positive feedbacks regarding the course with constructive suggestions on room for improvement.
Conclusion: From our first three years’ experience in conducting the course, we concluded that the four-week EBM course offered was practical in instilling EBM principles.
Many researchers have emphasized the importance of teaching stress management and self-care skills to medical students as they are vulnerable to develop psychological health problems. The researchers designed a 4-hour intervention based on the DEAL model to address these problems. This study aimed to determine outcomes of the DEAL-based intervention on medical students’ stress, anxiety and depression symptoms. Methods: A randomized controlled trial study was conducted on 171 medical students. Their stress, anxiety and depression symptoms were measured by the 21-item Depression Anxiety Stress Scale at five intervals; at 2 weeks before the intervention, and at 1 week, 8 weeks, 16 weeks and 32 weeks after the intervention. The mixed model ANCOVA was applied to determine the effect of the intervention on the participants’ psychological health at five intervals. Results: A total of 153 medical students (intervention = 73 and control = 80) completed this study. Results showed that the intervention group experienced significantly lower stress and depression symptoms than the control group. Although anxiety scores are consistently lower in the intervention group, no significant differences between groups were found. Conclusion: These results support the favourable outcomes of the intervention on psychological health of medical students. It is a promising intervention to be considered by medical schools as it consumes minimal amount of time, money, training and man power as well can be implemented easily.
Introduction: Poor sleep quality among university students has become an important issue to be concerned as it can hugely influence the students especially on their academic performance. However, there are inadequate studies published on the sleep quality of medical students in Malaysia.
Objective: This study aimed at determining the sleep quality of pre-clinical medical students in Universiti Putra Malaysia (UPM) and Universiti Malaya (UM). Methods: This is a cross-sectional study that used self-administered questionnaire to collect data from the pre-clinical medical students
of UPM and UM. Sleep quality of the students was measured using Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data were analysed by SPSS version 21.
Results: Findings revealed that 63.9% respondents with poor sleep quality (PSQI score: more than 5). The prevalence of poor sleepers
in UM (67%) was slightly higher compared to UPM (60.9%). However, the comparison of PSQI score showed no significant difference between UPM and UM respondents (p = 0.082). Meanwhile, the average sleep duration per night among respondents was 5 hours 39 minutes (± 1.21 hrs), whereas
only 6.1% students practiced recommended sleep value per night (> 7 hrs). Significant association was found between caffeine intake and sleep quality. Besides, this present study showed no association between sleep quality with gender and year of study.
Conclusion: Majority of the pre-clinical students in UPM and UM had poor sleep quality and short sleep duration. Only a small number of students practiced recommended sleep value per night.
Background: Faculty’s role as educators is over looked in clinical education, even though the teaching has a direct reflection of performance of clinical competence and professional development of graduating doctors. Two major problems of clinical education are the lack of uniform teaching and learning strategies in postgraduate as well as later years of undergraduate clinical teaching and the professional development of faculty in teaching in medical institutions. Objective: The survey has two major objectives. First objective was to know about the faculty response to a survey on teaching while trying to create awareness for teaching and research in teaching. The second objective was to know the faculty members’ understanding with principles of learning and teaching with strengths and weaknesses of respondents’ performance in clinical teaching on completing The Educator’s Self-Reflective Inventory (ESRI). Method: The ESRI was administered to approach 214 faculty members in SMS at USM. Appraisal of self-reflection inventory as medical teacher and personal development with respect to challenges, opportunities, innovations and need assessment of teaching were explored in response to 35 items grouped in 5 clusters through a questionnaire-based survey utilizing ESRI. Result: Statistical analysis of respondent’s data indicates a mixed response with lab-based disciplines 54.54% followed by surgical-based disciplines 50% and medical-based disciplines 30%. Individual discipline best response is received from Plastic Surgery and ORL-HNS (100%) and Hematology (77.77%). A result of individual item response in each cluster WAS also analyzed. Conclusion: The survey evaluated the faculty’s response to ESRI and concern shown to develop their abilities as teachers and researchers in clinical teaching. However, the initial response suggested the need for more survey to continue creating the awareness for faculty development and research in teaching. Conclusion drawn from analysis of each items in inventory is encouraging for teaching in medical education.
Introduction: Ratings are known to have a generosity error, provide limited discrimination and distorted interpretation, and often fail to document serious deficits. A potential source of these problems is rater judgement. These problems compromise the capability of raters to maintain the standards of rating. The authors propose a simple grading system to improve this situation including providing feedback to raters. Method: The authors developed a grading system named the Discrepancy-Agreement Grade (DAG) to provide feedback on rater judgments. Dependent-t and intraclass correlation tests were applied to determine discrepancy and agreement levels of raters. Rater judgments were then classified into grades A, B, C or D. This grading system was tested in an examination and a student selection interview to assess rating judgments of examiners and interviewers. The purpose was to evaluate the practicability of the grading system to provide feedback on examiners’ and interviewers’ rating judgements. Results: in the examination, five short essays were rated by five pairs of senior lecturers. Out of 5 pairs, 2 (40%) obtained grade A and 3 (60%) obtained grade B. In the student selection interview, a total of 48 pairs of interviewers interviewed ten applicants. Out of 48 pairs, 20 (41.7%) obtained grade A, 1 (2.1%) obtained grade B, 23 (47.9%) obtained grade C and 4 (8.3%) obtained grade D. Conclusion: The grading system showed variability of rater judgments on medical students’ and applicants’ performance in an examination and interview session respectively. It provided feedback on the examiners’ and interviewers’ judgments on candidate performances. This exercise demonstrated practicability of the grading system to provide feedback on rater judgements.
Situated learning characterises the learning that takes place in the clinical environment. Learning in the workplace is characterised by transferring classroom knowledge into performing tasks and this may take various forms. In the medical education field, the cognitive apprenticeship instructional model developed by Collins (2016) supported this learning in the workplace setting due to its common characteristics of apprenticeship. This paper analysed two concrete learning situations in a Malaysian undergraduate and an Omani postgraduate learning environment. Both learning situations occurred in the primary healthcare outpatient setting. The cognitive apprenticeship model was used to identify characteristics of the individual learning environments and discusses factors that stimulate learning. Attention was paid to the role of reflection in stimulating learning in the described settings. The paper provided the context in both institutes, described the learning situation and provided an analysis based on the theoretical framework. Based on the analysis of the situations, solutions to problems in the two settings were suggested.
Several studies reveal high rates of alcohol use among college students affecting their health and performances. This cross-sectional survey was done to study medical students' drinking pattern, its predictors and to develop any possible link between their academic performance and alcohol consumption. Data was collected using newly designed, validated questionnaire from students (n= 348) who consumed and not consumed alcohol. The response rate was 60% (209/348). 94% of drinkers started consuming alcohol before entering into the medical school. Most of them (85%) drank with parents' awareness. Among drinkers, 63% were of Chinese race and 35% of Indian race. None of the Malay respondents reported of drinking. 63% of drinkers and 23% of non-drinkers reported that most of their friends consumed alcohol. Drinking was not associated with smoking or drug abuse. There were no statistically significant differences in exam scores between drinkers and nondrinkers. Non-drinkers considered religious and moral obligations for not consuming alcohol. In conclusion, at our Institute, students did not allow their alcohol use to interfere with their academic performance. The drinking habit developed during school time is more likely to continue during college years. Those who have non-drinking friends are more likely not to consume alcohol themselves. Moral and religious obligations have positive impact on alcohol intake.
Universiti Sains Malaysia (USM) Attitudes toward Statistics (USM-AS) is a newly developed, selfadministered inventory for measuring attitudes toward statistics among postgraduate students. The
USM-AS consists of three factors (affect, cognition, and behavior) and 58 items. This study was
aimed to validate the USM-AS and provide evidence of its construct validity by investigating its
internal structure. This study consists of four validation studies, which were conducted consecutively
among postgraduate students (master’s degree and PhD students) in the medical and health sciences.
The revised USM-AS, consisting of three factors and 12 items, was found to have good construct
validity, which was demonstrated by good model fit, high factor loadings (0.62 to 0.92), high
construct reliability (0.84 to 0.89), good discrimination between factors and good test-retest reliability
(intraclass correlation coefficients = 0.63 to 0.82). However, validity was limited to postgraduate
students in the medical and health sciences in Malaysia. Further validation studies among
postgraduate students in other scientific fields are recommended to provide additional construct
validity evidence of the USM-AS.
For pre-post and cross-over design analysis of numerical data, paired t-test is the simplest analysis to perform. Planning such study, it is imperative to calculate appropriate sample size required for the test to detect hypothesized difference. However, the sample size formula requires determination of standard deviation of difference, which is not commonly reported. In this article, the author guides the reader to calculation of standard deviation of difference from standard deviation of each separate occasion.
Objective: The idea of humanitarianism is evolving with progressing life. Awareness about this global issue has to be emphasized particularly among the younger generation and thus be encouraged to be exposed and involved in humanitarian projects in need. Being responsible citizens of the country one should develop concern about the humanitarian issues, and this attitude needs to be developed from student life. Methods: A cross sectional survey was conducted on 200 participants of the Malaysian and Indian (100 each) health science students using faculty validated close ended questionnaire. Results of the data were analyzed statistically by testing with chi square analysis from SPSS software. Results: From the present study, it has been observed that, despite the cultural and economical diversity between the two nations, there was no observable difference in student’s point of view on humanitarian issues in most of the areas concerned. Overall evaluation also reflected effect of the socio-economic status of the countries on the perception of the issue amongst the students. Conclusion: Despite of different geography, diverse culture and dissimilar socio-economic status, the need of concern towards humanitarian issues is observable. Students of both nations have positive attitude towards the humanitarian issues as well.
This case illustrates the role of a woman's autonomy in deciding her medical management and the ethical issue which occurred when a husband refuses the management for her even though it was clearly indicated.
House officers who are suffering from stress, anxiety or depression are at risk of harm to themselves, colleagues and even patients, as well as affecting their livelihood. Objective: This
study is aimed to find the prevalence of stress, anxiety and depression among house officers working
in Kota Kinabalu, Sabah. Method: A cross-sectional study was done using a self-administered
questionnaire containing socio-demographic factors and Depression, Anxiety and Stress Scale (DASS)
21. Results: Prevalence of stress, anxiety and depression were 57.1%, 63.7%, and 42.9% respectively. Multiple logistic regression analysis found that house officers who thought of quitting Housemanship was associated with stress (adjusted OR = 3.64, 95% CI: (1.44, 9.20), p = 0.006), and depression (adjusted OR = 8.26, 95% CI: (2.96, 23.02), p < 0.001). House officers who perceives that they are bullied is associated with anxiety (adjusted OR = 4.16, 95% CI: (1.33, 13.07), p = 0.015). Work
experience of the house officers in months have a protective effect to stress (adjusted OR = 0.92, 95%
CI: (0.87, 0.97), p = 0.004), anxiety (adjusted OR = 0.93, 95% CI: (0.88, 0.98), p = 0.006) and
depression (adjusted OR = 0.92, 95% CI: (0.87, 0.98), p = 0.006). Conclusion: The prevalence of
stress, anxiety and depression among house officers in Kota Kinabalu, Sabah is high. Management
should look into the findings and understand the importance of addressing this problem as it may
affect patient care and safety, and the livelihood of house officers. Future studies identifying why
house officers are thinking of quitting service and why they do feel that they are being bullied may be
warranted.
Students-t test is the most popular statistical test. The test compares two mean values to judge if they are different or not. For small data it is possible to conduct it using manual calculation – however that is not the case. Researchers would need to use statistical software and packages to conduct their analysis. This guide will help the junior researchers to conduct independent- and paired-t test using STATA software.
This study aimed to evaluate the perceptions of medical students towards use of internet in problembased learning (PBL). Methods: A descriptive observational approach was followed in analysis of perceptions about use of internet in a convenience sample of 141 students. A questionnaire was selected after analysis of perceptions received from a pilot study and was divided into three aspects of the PBL sessions. Students’ and facilitators’ role in PBL, mode and scope of use of internet in PBL and reasons for use of internet in PBL. Descriptive analysis of the data was done. Significant difference between the mean values was analyzed. A difference in agreement among the students was observed about the role of lecturer in the process of PBL. A higher percentage of students (65.2%) agreed that they used internet to search for information during PBL session 1 compared to PBL session 2 (58.2%). Majority of the students (81%) agreed on searching internet for new information. Regarding preparation for PBL session 2, comparatively more students from earlier semesters agreed about using textbooks than using internet. Higher percentage of students searched internet for information on clinical sciences (52.5%) compared to basic sciences (24.8%). Among basic science subjects, information related to pathology was searched more often and information on management was searched more often among clinical science topics. Students actively use internet for searching new information and learning during PBL sessions. They also use textbooks to prepare for PBL session. Online search for journal articles is not popular.
Identifying physiotherapy stakeholders for program evaluation. The Health Professional Education plays a pivotal role in providing quality health work force thus improved care in health service to the public in our country. As such all Allied Health Programs conducted by Higher Education Providers (HEP) should keep close surveillance of the quality of Allied Health Programs to mould health professional graduates to deliver quality healthcare service through proper competency measures. Stakeholders have been defined as on-campus and off campus group for the sake of identifying respective views in institutional effectiveness. Allied health programs are emerging enormously in our country and this revolution is creating major crustal deformation, forming folds and faults towards its profession as many educational institutions in the country is with the enterprising objectives of running such programs and not for the benefits of the society.
To address the diverse preferred learning styles, one of the oft-cited recommendations for educatorsis to tailor teaching instructions accordingly. This pedagogy however, lacks scientific evidences.Furthermore, in medical curriculum, tailoring instructions according to preferred learning styles isnot pragmatic. This is because different subjects and in different settings matter may be best deliveredin specific delivery mode. Furthermore, patients’ presentations are often multi-sensorial. As such, theonus is on the students themselves to adjust the amount of learning efforts they put in according totheir preferred or not preferred learning styles.
Medical students in Malaysia face enormous amount of stress that can compromise their medical training. A brief group Mindfulness-based Cognitive Therapy (bMBCT)/Mindful-Gym) programme has been developed to help medical students cope more effectively with stress. The intervention was found to be effective for reducing stress and increasing subjective well-being among medical students in University Putra Malaysia (UPM). One of the training methodologies used in the programme, ‘Mindful-S.T.O.P.,’ was particularly popular among the students. The aim of this paper is to describe the concept and application of this mindfulness-based psychological tool (Mindful-S.T.O.P.) for stress reduction in medical students.