The ultimate aim of faculty development programmes (FDPs) is to boost teachers’ competence in their journey of becoming a respectable educator. It takes place when a faculty member joins such activity with a hope of cultivating their knowledge and skills in desired areas such as pedagogy, research, motivation, and administration. However, to design the best practices of FDPs, it needs a great deal of consideration on numerous factors. This paper discusses principles of the best practice in FDPs, challenges and its solutions, its impacts on professional identity, and finally highlights the future trend of FDPs. Since it is beneficial in fostering professionalism of a faculty member, it is important for school administrators to address FDPs as a prominent agenda in seeking a professional medical teacher.
Standards of physiotherapy practice by respective regulatory bodies and authorities is well documented. However, the triad alignment reported, and efforts taken by physiotherapy stakeholders is unclear and limited. This article aims to highlight any constructive alignment that exist between the three stakeholders namely the regulatory bodies, employers and the higher educational institutions (HEIs). Literature searched was conducted using Google Scholar using keywords on “physiotherapy standards”, “clinical competence”, “regulatory bodies” and “physiotherapy”. Results showed evidence of physiotherapy regulatory bodies, educational institutions and healthcare employers advocating standards of physiotherapy. Physiotherapy authorities advocates the standards of physiotherapy competence, while educational institutions develop various competency assessment tools to measure the outlined standards on their physiotherapy graduate’s. However, the healthcare providers’ (employers) feedback on their expected employability skills is not promising. Evidence suggest discrepancy in the alignment, between these stakeholders and an improved mechanism could be proposed to ensure these standards are well communicated and integrated. Such constructive alignment is imperative in ensuring the physiotherapy workforce produced meet the current 21st century health care demands for optimal patient outcome.
One of the challenges in mentoring relationships is to understand the real issues faced by the mentees. A mechanism has been established to offer a credible mentoring inventory. The aim of the study was to determine the construct validity and reliability index of the Universiti Sains Malaysia Mentoring Inventory (USM-MT-i) among early phase medical students in a Malaysian public medical school. A cross-sectional study was conducted in June 2017 among 208 early phase of the medical students of School of Medical Sciences, Universiti Sains Malaysia. USM-MT-i is a self-administered inventory and was established based on the information gained from the mentors and mentees. The prevalidated inventory entailed 44 primary items. Exploratory factor analysis (EFA) and Cronbach’s alpha reliability analysis were utilised to determine the construct validity and reliability of such inventory. The result revealed three potential constructs with 39 items extracted from the USMMT- i; academic leadership (19 items), communication skills (12 items) and examination competence (8 items) with factor loading ranges from 0.50–0.77, 0.51–0.80 and 0.65–0.87, respectively. Internal consistency reliability (Cronbach’s alpha) for each domain were 0.95, 0.93 and 0.92, respectively. The overall Cronbach’s alpha was 0.96. The present study promoted that the three factors with 39 items of the USM-MT-i has a good validity and reliability value to survey for mentoring needs among medical students in their early phase.
There are five sources of validity evidence that are content, response process, internal structure, relation to other variables, and consequences. Content validity is the extent of a measurement tool represents the measured construct and it is considered as an essential evidence to support the validity of a measurement tool such as a questionnaire for research. Since content validity is vital to ensure the overall validity, therefore content validation should be performed systematically based on the evidence and best practice. This paper describes a systematic approach to quantify content validity in the form of content validity index based on the evidence and best practice.
We describe a case of nephrotic syndrome case who defaulted treatment but presented with acute medical complication due to non-compliance to treatment. He subsequently developed neurological sequalae following definitive hemodialysis. Due to disease severity and its complication, active dialysis has been abandoned. There are many factors leading to this decision, but are palliative care physician right to follow the primary team’s decision, in palliating a patient with chronic kidney disease with potential hyperkalaemia consequences? The article focuses on potential ethical dilemma faced by the palliative care team in the subsequent management of this scenario.
The flipped classroom (FC), an innovative teaching and learning pedagogy has grown in medical education since last decade. In FC modality, students learn by means of print, audio or video-based material self-reliantly, before built-in teaching sessions in the classroom to overcome passive learning. In this review, the key concepts, benefits and best practices of the FC in health professions education have been described. The review was carried out using Medline, Scopus, Ovid, and Cochrane. The keywords were “Flipped method, Teaching strategy, Role of the teacher, and Medical students”. Flipped is an effective teaching modality which enables learners to be independent. Students do take ownership of what they learn. Tutors are also satisfied with what their learners acquire. The benefits of FC are robust and likely to augment the learning abilities of the students as well as supplementing the learning course content; group events can deliver added benefits too.
This case illustrates the issue of truth-telling about a diagnosis of a potentially terminal illness. A family member of an elderly patient requests that the treating doctor does not disclose the diagnosis to the mother for fear that it will distress her and cause her anxiety. The challenge of the treating doctor is how to deal with this in a professional and ethical manner.
Disease trajectory in children can be difficult to determine. This is primarily, despite the life limiting condition, healthcare professionals are unable to pin the exact time when these children’s lives will end. We illustrate an unusual case of dicephalic parapagus, an inseparable conjoined twin which was complicated by anomalies, psychosocial and safeguarding issues. Such case posed a challenge even to paediatric palliative care team as the trajectory of the disease, in this case, is rather difficult to predict. Anticipatory symptoms management perhaps is the best way forward, despite having to face many ethical challenges and medical enigma.
Professionalism is considered as one of the most inspiring as well as challenging proficiency to teach and evaluate, because of its multifaceted and context-specific nature. This paper defines an orderly and useful escort on how to incorporate the problem-based learning (PBL) as a teaching and assessing modality, within a course of medical professionalism. While answering Harden’s 10 questions, course planners shall find this approach doable, allowing them to design and utilising this in an undergraduate medical education context. An enlightening approach, as this will prepare our students to be future professional doctors, equipped with all necessary professionalism attributes, in our fast varying professional environment.
Chronic kidney disease (CKD) causes 70% of all death globally. The prevalence of CKD has shown an increasing trend for the past 20 years in Malaysia. Thus, determining the knowledge and awareness of CKD among healthcare students in preparing them to be a good healthcare provider in the future is important. This study aimed to determine the association between knowledge and awareness about CKD among International Islamic University Malaysia (IIUM) undergraduate students. A crosssectional study was conducted among 108 students using simple random sampling method. The questionnaire was given to the class representative to be self-administered to interested students. It had close-ended questions consisting of Part A to Part D. The scoring given for correctly answered items was one and the total score for Part C was 7 marks. Most of the students were female (70.4%). The mean knowledge score of CKD was 3.65 (SD = 1.12) with nearly half of the students (43.5%) classified as having poor knowledge. Most respondents were aware about CKD (99.1%) and have heard about it from medical personnel (48.1%) and the Internet (25.9%). Further analysis showed that only courses taken by the respondents were significantly associated with knowledge on CKD (p = 0.039). The level of knowledge among undergraduate students is still poor, yet they are aware about the existence of CKD and its aetiology. Therefore, the health sciences curriculum should emphasise on CKD management from a multidisciplinary aspect of care. It is recommended to conduct similar research among different student populations to create awareness and obtain important baseline findings.
Validity evidence can be supported by five sources that are content, response process, internal structure, relation to other variables, and consequences. Response process validity measures the thought processes of users of the tested inventory as they respond to the assessment tool. These are commonly evaluated in the form of clarity of instructions and language used in the assessment tool, as well as the comprehension of instruction after training or an observation session. Response process validity contributes to the overall validity of an assessment tool; therefore, it should be quantified systematically based on the evidence and best practice. This paper describes a systematic approach to quantify response process validity in the form of face validity index based on the evidence.
Simulated patient (SP) is defined as a layperson who simulates to portray the role of a patient with health-related conditions based on varying levels of training. SP allows students to practice various skills under guided experience in a realistic, safe, and controlled setting. The purpose of this integrative review is to examine original research relating to the experience towards simulated patient-based simulation session. A rapid review included three electronic databases search of articles published between 2008 to 2018 with inclusive and exclusive criteria. Seventeen articles were eventually selected for inclusion in the review. These articles were subjected to basic thematic analysis. Descriptive analysis of the study design, study location, professional area, and study variables were reported. Six themes were identified: SP’s perspective, evaluation of SP’s performance, euthenticity of SP role play, SP feedback, student’s development, and evaluation of student’s performance. SP methodology has been widely used to train healthcare students in the development of medical knowledge, clinical skills, as well as important soft skills. SPs, students, and facilitators play a role to ensure the success of an SP-based simulation session. The outcome of the training with SP was examined through an assessment of either the student’s performance or the SP’s performance. The outcome of the review concluded that SPs’ development indirectly influences students’ development.
The Ministry of Higher Education introduced the integrated cumulative grade point average (iCGPA)
system in 2016 as an aspiration to produce holistic and well-balanced graduates based on Malaysian
Qualification Agency’s (MQA) learning domains. In this article, we provide a comparison of iCGPA
with other established medical competency frameworks and share our experience in implementing
iCGPA in the medical faculty. Throughout the process, it was noted that medical educators require
several core competencies in order to successfully implement iCGPA in their courses. Two of the most
important core competencies are understanding the pedagogies of the 21st century (heutagogies,
paragogies, and cybergogies) and apprehending the concept of outcome-based education. On top of
the requirement of core competencies, there were also challenges in tailoring teaching and learning to
meet the requirement of the Industrial Revolution 4.0. We also describe in detail the benefits and other
challenges of iCGPA implementation in our faculty. We conclude this article with our recommendation
for successful iCGPA implementation in the future for the medical faculty.
Simulation-based medical education enables knowledge, skills and attitudes to be taught in a safe,
realistic manner. Flipped classroom teaching encourages self-learning. Emergency medicine exposes
students to diverse group of patients and physicians’ decision making. This study aims to determine
students’ perception on knowledge, skills and confidence after combined flipped classroom and
simulated teaching. Two cohorts of Semester 7 students Group 1 (n = 120) and Group 2 (n = 78)
completed a 5-point Likert scale questionnaire. Group 1 completed the questionnaire after a lapse
of six months while Group 2 at the end the posting. Responses from both cohorts were compared
using the Mann-Whitney U test. Of 198 (Groups 1 and 2) students, 91.41% (n = 181) felt the
simulated sessions helped better understand care of emergency patients. The sessions helped identify
knowledge gaps (89.90%; n = 178), improve knowledge and understanding of oxygen therapy devices
(85.35%; n = 169), and airway equipment (90.91%; n = 180). They prepared better for the flipped
classroom teaching than traditional sessions (80.81%; n = 160). They felt that their communication
skills (82.32%; n = 163) and confidence (63.64%; n = 126) improved. Significant differences noted
to questions (p = 0.006, p = 0.005, p = 0.041 respectively) targeting knowledge on oxygen therapy
devices, confidence, and identification of gaps in knowledge respectively. Combined simulation and
flipped classroom teaching was well received by students though this requires more preparation.
This study aimed to translate Oldenburg Burnout Inventory (OLBI) into Malay language, and test its
response process (face validity) and internal structure (factor structure and internal consistency). To
the author’s knowledge, OLBI is not yet validated in Malay language, thus this study aimed to produce
a validated Malay version of OLBI (OLBI-M) in order to measure burnout among the healthcare
learner population in Malaysia. OLBI has great potentials mainly due to its accessibility and free of
any cost to use it, thus might promote more researchers to conduct burnout research in Malaysia. The
forward-backward translation was performed as per standard guideline. The OLBI-M was distributed
to 32 medical students to assess face validity and later to 452 medical students to assess construct
validity. Data analysis was performed by Microsoft Excel, Statistical Package for the Social Sciences
(SPSS), and Analysis of Moment Structures (AMOS). The face validity index of OLBI-M was more
than 0.70. The two factors of CBI-M achieved good level of goodness of fit indices (Cmin/df = 3.585,
RMSEA = 0.076, GFI = 0.958, CFI = 0.934, NFI = 0.912, TLI = 0.905) after removal of several
items. The composite reliability values of the two factors ranged from 0.71 to 0.73. The Cronbach’s
alpha values of the three factors ranged from 0.70 to 0.74. This study shows OLBI-M is a reliable
and valid tool to measure burnout in medical students. Future burnout studies in Malaysia are highly
recommended to utilise OLBI-M. However, it is crucial for further validity to be carried out to verify
the credential of OLBI-M.
Immediate feedback assessment technique (IF-AT) are self-scoring answer sheets, based on the
concepts of immediate feedback for choosing the correct answer in multiple choice questions (MCQs)
during group readiness assurance tests (GRATs) in team-based learning (TBL). IF-AT scratch card
system rewards a student with partial credit for proximate knowledge. This technique motivates
students to pursue learning with just-in-time feedback and gives them the opportunity for collaborative
learning and analytic reasoning among group members. A rubric for partial credit is decided pre-hand
depending upon the number of options used in MCQs. In this study, we assessed students’ perception
about immediate feedback assessment technique before and after the training. To determine students’
perception of the IF-AT scratch card system in instruction and assessment. Students perceptions
about the IF-AT system has been explored using a 25-item questionnaire administered to 60 students
assigned randomly to control and training groups using pre-test and post-test analysis. Paired-sample
t-test and independent-sample t-test statistics were employed and the data was analysed. Descriptive
statistics observed for mean (SD) was found greater in trained group = 58.48 (4.87) vs. control group
= 66.43 (5.81) with t-statistics significant at p = < 0.001. A significant difference in mean (SD) of
pre-test minus post-test scores (5.16) of control and trained group = 5.37 (4.85) and 10.53 (8.36)
respectively was also found with independent t-test analysis. It was found highly significant with
t = –2.92, p < 0.05 and the effect size of 78.1%, established by Cohen’s d criteria. The IF-AT system
provides an individualised and instantaneous instruction as feedback in an assessment, which is
marked with collaborative learning as in team-based learning. The IF-AT system promotes analytic
reasoning with problem solving skills through partial credit for proximate knowledge. Students’
perceive the concept of immediate feedback and partial credit for proximate knowledge as the most
important features of the IF-AT scratch card system.
Delivery and implementation strategies are key to curriculum success. There is growing evidence
that team-based learning (TBL) is an effective way of interactive teaching. TBL is a method that uses
learning teams to enhance student engagement and quality of learning. Individual accountability for
out-of-class reading is followed by individual and group assessment. In-class application exercises,
which is the hallmark of team-based learning promotes both learning and team development. TBL
uses educational principles of transforming traditional content into application of knowledge
and problem solving skills in an interactive learning environment. To experience the structural
framework and to determine the students’ perception about TBL in clinical setting of MBBS
program in a Malaysian medical school. A total of 120 students assigned to 22 small subgroups of
5–6 per group underwent a number of TBL sessions delivered in three phases. In Phase I, students
were assigned reading material. In Phase II, students were assessed through One Best Answer
(OBA) items for individual and group readiness assessment test as individual readiness assessment
test (IRAT) and group readiness assurance test (GRAT) respectively followed by a mini-lecture.
In Phase III, in-class application of learning activity was performed. Finally, peer assessment
evaluated the contribution of peer in TBL. A TBL Classroom Evaluation Inventory (TBLCEI)
developed to probe student’s perception of TBL, comprised of 40 items composite scale with
Cronbach’s alpha at 0.881. In addition, students were asked to provide their estimated grade in
end of the posting assessment. Grades were categorised into excellent pass >85%, high pass 70%–
84%; average to good pass 50%–69% and fail
It is generally accepted that assessment is a single powerful tool that drives students’ learning.
However, assessment of anatomy subject in medical curriculum is disputable as it focusses more on
testing the low order thinking skills. In medical education context, it is of paramount importance to
align the assessment with the curriculum (i.e., learning outcomes) and teaching methods as to enhance
learning through a meaningful learning experience. Hence, the use of learning taxonomy should be
emphasised in designing a proper and suitable assessment for anatomy subject. Among the most
commonly used taxonomies in higher education, are the Bloom’s taxonomy, Miller’s pyramid, SOLO
taxonomy, Krathwohl’s taxonomy of affective domain, and Simpson’s psychomotor domain. However,
being a core basic medical subject with high cognitive input, it is often difficult to achieve contextual
learning in anatomy through application of these taxonomies. Therefore, with raising concern of lack
in the evaluation of higher order thinking skills, affective and psychomotor domains, the anatomy
assessment in modern medical curriculum have been improvised to address the aforementioned
issues. The modern form of assessment in anatomy facilitates the contextual learning with beneficial
attributes gained by students including better understanding of anatomy knowledge, synthesis of
anatomical concept, appreciation of the clinical importance of anatomy, increases communication
skills, and increase in the confidence level.
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.
Lecturers are expected to teach effectively and evaluating their teaching effectiveness are essential to
ensure students get the best learning experience. A systematic evaluation of teaching behaviours with a
proper feedback mechanism will help to improve their teaching effectiveness. Improvement of teaching
effectiveness will result in better students’ learning experience, and thus attaining the intended
educational outcomes. This study aimed to evaluate teaching effectiveness among lecturers by
assessing their teaching behaviours during lectures. A cross-sectional study was conducted on lecturers
in a Malaysian public medical school. Their teaching behaviours were rated by 30 trained pre-clinical
medical students using Teacher Behaviour Inventory (TBI) on seven aspects – organisation, speechpacing,
clarity, enthusiasm, interaction, rapport, and disclosure. A total of 55 lecturers were rated
by the medical students. The organisation and speech-pacing aspects were highly rated as the mean
scores were 4.02 and 4.15, respectively. The clarity, enthusiasm, interaction, and rapport aspects
attained satisfactory level as the mean scores ranged from 3.10 to 3.59. The disclosure aspect was
poorly rated as the mean score was 2.20. Eventhough all lecturers in this school are considered expert
in their area, findings from this study suggest that some teaching behaviour need some improvement.
Findings from this study also provide useful data for the medical school to chart direction of faculty
development activities to improve their lecturers’ teaching effectiveness during lectures.