Displaying publications 1 - 20 of 237 in total

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  1. Hisham R, Ng CJ, Liew SM, Hamzah N, Ho GJ
    BMJ Open, 2016 Mar 09;6(3):e010565.
    PMID: 26962037 DOI: 10.1136/bmjopen-2015-010565
    OBJECTIVE: To explore the factors, including barriers and facilitators, influencing the practice of evidence-based medicine (EBM) across various primary care settings in Malaysia based on the doctors' views and experiences.
    RESEARCH DESIGN: The qualitative study was used to answer the research question. 37 primary care physicians participated in six focus group discussions and six individual in-depth interviews. A semistructured topic guide was used to facilitate both the interviews and focus groups, which were audio recorded, transcribed verbatim, checked and analysed using a thematic approach.
    PARTICIPANTS: 37 primary care doctors including medical officers, family medicine specialists, primary care lecturers and general practitioners with different working experiences and in different settings.
    SETTING: The study was conducted across three primary care settings-an academic primary care practice, private and public health clinics in Klang Valley, Malaysia.
    RESULTS: The doctors in this study were aware of the importance of EBM but seldom practised it. Three main factors influenced the implementation of EBM in the doctors' daily practice. First, there was a lack of knowledge and skills in searching for and applying evidence. Second, workplace culture influenced doctors' practice of EBM. Third, some doctors considered EBM as a threat to good clinical practice. They were concerned that rigid application of evidence compromised personalised patient care and felt that EBM did not consider the importance of clinical experience.
    CONCLUSIONS: Despite being aware of and having a positive attitude towards EBM, doctors in this study seldom practised EBM in their routine clinical practice. Besides commonly cited barriers such as having a heavy workload and lack of training, workplace 'EBM culture' had an important influence on the doctors' behaviour. Strategies targeting barriers at the practice level should be considered when implementing EBM in primary care.
    Study site: klinik kesihatan, general practice clinics, Klang Valley, Malaysia
    Matched MeSH terms: Clinical Competence/standards*
  2. Lim AS, Ling YL, Wilby KJ, Mak V
    Curr Pharm Teach Learn, 2024 Mar;16(3):212-220.
    PMID: 38171979 DOI: 10.1016/j.cptl.2023.12.028
    BACKGROUND: Objective structured clinical examinations (OSCEs) remain an integral part of pharmacy education. This study aimed to characterize key researchers, areas, and themes in pharmacy education OSCEs using a bibliometric review with content analysis.

    METHODS: A bibliometric review was conducted on literature from over 23 years from January 2000 to May 2023. Articles focusing on any type of OSCE research in pharmacy education in both undergraduate and postgraduate sectors were included. Articles were excluded if they were not original articles or not published in English. A summative content analysis was also conducted to identify key topics.

    RESULTS: A total of 192 articles were included in the analysis. There were 242 institutions that contributed to the OSCE literature in pharmacy education, with the leading country being Canada. Most OSCE research came from developed countries and were descriptive studies based on single institution data. The top themes emerging from content analysis were student perceptions on OSCE station styles (n = 98), staff perception (n = 19), grade assessment of OSCEs (n = 145), interprofessional education (n = 11), standardized patients (n = 12), and rubric development and standard setting (n = 8).

    IMPLICATIONS: There has been a growth in virtual OSCEs, interprofessional OSCEs, and artificial intelligence OSCEs. Communication rubrics and minimizing assessor variability are still trending research areas. There is scope to conduct more research on evaluating specific types of OSCEs, when best to hold an OSCE, and comparing OSCEs to other assessments.

    Matched MeSH terms: Clinical Competence
  3. Chan SC
    Singapore Med J, 2012 Mar;53(3):196-202.
    PMID: 22434295
    This study aimed to determine the views of Malaysian interns and their supervisors on whether undergraduate clinical skills training adequately equipped them for internship and their suggestions for improvement.
    Matched MeSH terms: Clinical Competence*
  4. Norhayati MN, Nawi ZM
    PLoS One, 2021;16(4):e0249660.
    PMID: 33886615 DOI: 10.1371/journal.pone.0249660
    BACKGROUND: Evidence-based medicine (EBM) is a widely accepted scientific advancement in clinical settings that helps achieve better, safer, and more cost-effective healthcare. However, presently, validated instruments to evaluate healthcare professionals' attitude and practices toward implementing EBM are not widely available. Therefore, the present study aimed to determine the validity and reliability of a newly developed knowledge, attitude, and practice (KAP) questionnaire on EBM for use among healthcare professionals.

    METHODS: The Noor Evidence-Based Medicine Questionnaire was tested among physicians in a government hospital between July and August 2018. Exploratory factor analysis and internal consistency reliability-based Cronbach's alpha statistic were conducted.

    RESULTS: The questionnaire was distributed among 94 physicians, and 90 responded (response rate of 95.7%). The initial number of items in the KAP domains of the Noor Evidence-Based Medicine Questionnaire were 15, 17, and 13, respectively; however, two items in the practice domain with communalities <0.25 and factor loadings <0.4 were removed. The factor structure accounted for 52.33%, 66.29%, and 55.39% of data variance in the KAP domains, respectively. Cronbach's alpha values were 0.81, 0.81, and 0.84 for KAP domains, respectively, indicating high reliability.

    CONCLUSIONS: This questionnaire can be used to evaluate the knowledge, attitudes, and behaviour of healthcare professionals toward EBM. Future testing of this questionnaire among other medical personnel groups will help expand the scope of this tool.

    Matched MeSH terms: Clinical Competence/statistics & numerical data
  5. Muhamad Z, Ramli A, Amat S
    Sultan Qaboos Univ Med J, 2015 May;15(2):e266-74.
    PMID: 26052461
    OBJECTIVES: The aim of this study was to determine the content validity, internal consistency, test-retest reliability and inter-rater reliability of the Clinical Competency Evaluation Instrument (CCEVI) in assessing the clinical performance of physiotherapy students.
    METHODS: This study was carried out between June and September 2013 at University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia. A panel of 10 experts were identified to establish content validity by evaluating and rating each of the items used in the CCEVI with regards to their relevance in measuring students' clinical competency. A total of 50 UKM undergraduate physiotherapy students were assessed throughout their clinical placement to determine the construct validity of these items. The instrument's reliability was determined through a cross-sectional study involving a clinical performance assessment of 14 final-year undergraduate physiotherapy students.
    RESULTS: The content validity index of the entire CCEVI was 0.91, while the proportion of agreement on the content validity indices ranged from 0.83-1.00. The CCEVI construct validity was established with factor loading of ≥0.6, while internal consistency (Cronbach's alpha) overall was 0.97. Test-retest reliability of the CCEVI was confirmed with a Pearson's correlation range of 0.91-0.97 and an intraclass coefficient correlation range of 0.95-0.98. Inter-rater reliability of the CCEVI domains ranged from 0.59 to 0.97 on initial and subsequent assessments.
    CONCLUSION: This pilot study confirmed the content validity of the CCEVI. It showed high internal consistency, thereby providing evidence that the CCEVI has moderate to excellent inter-rater reliability. However, additional refinement in the wording of the CCEVI items, particularly in the domains of safety and documentation, is recommended to further improve the validity and reliability of the instrument.
    KEYWORDS: Clinical Competence; Malaysia; Physiotherapy Speciality; Validity and Reliability
    Matched MeSH terms: Clinical Competence*
  6. Omar AA, Zon EM, Ismail MP, Mahdi M, Ibrahim A, Engku-Husna EI, et al.
    Med J Malaysia, 2023 Nov;78(6):711-716.
    PMID: 38031211
    INTRODUCTION: In gynaecology, laparoscopy is the choice of treatment for a lot of procedures as it is considered safe and effective. However, laparoscopic surgery requires skills that are different from those required for open surgery. In order to acquire the skills, a surgeon needs specific training. The aim of this study was to validate the AR Gynae endotrainer, a new mobile laparoscopic simulator, as a comparable box trainer for gynaecology laparoscopic training, comparing it with the well-established Karl Storz SZABO-BERCISACKIER laparoscopic trainer.

    MATERIALS AND METHODS: A randomised prospective crossover study was designed to compare the AR Gynae endotrainer versus Karl Storz SZABO-BERCI-SACKIER laparoscopic trainer as a tool for training gynaecology laparoscopic skills. Participants were assigned to perform two specially designed tasks used for laparoscopic training using both endotrainers. All subjects evaluated both simulators concerning their performance by the use of a questionnaire comparing: design, ports placement, visibility, ergonomics, triangulation of movement, fulcrum effect, depth perception, ambidexterity, resources for training, and resources for teaching. The overall score was defined as the median value obtained. The ability and time taken for participants to complete the tasks using both endotrainers were also compared. A total of 26 participants were enrolled in this study, including 13 Masters's students from the Department of Obstetrics & Gynaecology and 13 Masters's students from the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.

    RESULTS: A better performance was observed with AR Gynae as compared to Karl Storz endotrainer in five out of ten items evaluated in the questionnaire. Additionally, the overall score of AR Gynae endotrainer (median of 3.98) was comparable to that of Karl Storz endotrainer (median of 3.91) with p=0.519. For the items design and resources for teaching, the evaluation for AR Gynae endotrainer was significantly higher with p-values of 0.003 and 0.032, respectively. All participants were able to complete both tasks using both endotrainers. The time taken to complete both tasks was comparable on both endotrainers. Also, the AR Gynae endotrainer was cheaper.

    CONCLUSIONS: The AR Gynae endotrainer was found to be a convenient and cost-effective laparoscopic simulator for gynaecology laparoscopic training and was comparable to the established Karl Storz SZABO-BERCI-SACKIER laparoscopic trainer.

    Matched MeSH terms: Clinical Competence
  7. Morgan G, Melson E, Davitadze M, Ooi E, Zhou D, Hanania T, et al.
    J R Coll Physicians Edinb, 2021 06;51(2):168-172.
    PMID: 34131679 DOI: 10.4997/JRCPE.2021.218
    BACKGROUND: Simulation via Instant Messaging - Birmingham Advance (SIMBA) aimed to improve clinicians' confidence in managing various clinical scenarios during the COVID-19 pandemic.

    METHODS: Five SIMBA sessions were conducted between May and August 2020. Each session included simulation of scenarios and interactive discussion. Participants' self-reported confidence, acceptance, and relevance of the simulated cases were measured.

    RESULTS: Significant improvement was observed in participants' self-reported confidence (overall n = 204, p<0.001; adrenal n = 33, p<0.001; thyroid n = 37, p<0.001; pituitary n = 79, p<0.001; inflammatory bowel disease n = 17, p<0.001; acute medicine n = 38, p<0.001). Participants reported improvements in clinical competencies: patient care 52.0% (n = 106/204), professionalism 30.9% (n = 63/204), knowledge on patient management 84.8% (n = 173/204), systems-based practice 48.0% (n = 98/204), practice-based learning 69.6% (n = 142/204) and communication skills 25.5% (n = 52/204).

    CONCLUSION: SIMBA is a novel pedagogical virtual simulation-based learning model that improves clinicians' confidence in managing conditions across various specialties.

    Matched MeSH terms: Clinical Competence
  8. McKay DA
    Med J Malaysia, 1979 Mar;33(3):198-200.
    PMID: 522722
    Matched MeSH terms: Clinical Competence
  9. Vashe A, Devi V, Rao R, Abraham RR, Pallath V, Umakanth S
    Adv Physiol Educ, 2019 Dec 01;43(4):522-528.
    PMID: 31642706 DOI: 10.1152/advan.00067.2019
    Today most education institutions around the world have adopted the philosophy of outcome-based education. The emphasis in outcome-based education is achievement of outcomes; hence the curriculum should be designed in a way that it includes the components targeted specifically at achieving these outcomes. A discipline-based approach results in fragmentation of learning and lack of clinical applicability. Integrated teaching could be a solution to achieve required outcomes in a holistic way. Hence, the aim of this study was to develop, implement, and evaluate an integrated teaching module. Temporal coordination of the basic sciences, along with correlation of learned topics to clinical settings, was done in the first year of the undergraduate medical program. The module was evaluated by obtaining qualitative and quantitative feedback from students. Student assessment was conducted with a test that had case vignettes and multiple-choice questions. In addition, students' change in learning approaches and self-directed learning readiness were collected. Students' perception regarding the educational environment was also obtained. Analysis of the data showed positive feedback from the students regarding the integrated teaching. Students' average score in the test was 86%. There was a significant increase in the scores for the deep approach and self-directed learning readiness in the posttest compared with the pretest. Moreover, students were found to be satisfied with the educational environment. Evaluation of integrated teaching revealed that it was well accepted by the students. Moreover, it facilitated the achievement of the students' outcomes.
    Matched MeSH terms: Clinical Competence
  10. Menon V
    MyJurnal
    Background: Facebook is a popular social networking site with more than five hundred million users. This study assessed whether Facebook Groups can be used to teach clinical reasoning skills.
    Methods: Sixty-seven final year medical students from the International Medical University, Malaysia, were exposed to interactive online learning through a Facebook Group for a period of six months in this study. The purpose was to determine if supervised interactive online learning could be used to augment the deep learning that comes from learning medicine at the bedside of patients. The interactive online discussions were entirely triggered by clinical problems encountered in the medical wards of the general hospital to which these students were attached.
    Results: A total of 10 topics were discussed in this forum during the duration of this study and an example of one such discussion is provided to illustrate the informal nature of this kind of learning. The results showed a high degree of student involvement with 76 percent of students actively participating in the discussions.
    Conclusion: The high degree of voluntary participation in the clinical discussions through the Facebook Group in this study tells us that Facebook Groups are a good way of engaging students for learning and can be used in medical education to stimulate creative clinical thinking.
    Matched MeSH terms: Clinical Competence
  11. Sattar MU, Palaniappan S, Lokman A, Shah N, Riaz Z, Khalid U
    J Pak Med Assoc, 2021 Jul;71(7):1730-1735.
    PMID: 34410236 DOI: 10.5455/JPMA.22992
    OBJECTIVE: To investigate the effects of design parameters on the user experience of virtual reality medical training.

    Methods: The quantitative study was conducted at Punjab (Pakistan) from July 2018 to October 2018, and comprised final year students from eight medical colleges in Pakistan. Each respondent was given to experience laparoscopy operation in text, video and virtual reality-based learning methodologies. User experience and usefulness was assessed against a pre-validated scale and compared with the three learning methodologies.

    RESULTS: Of the 87, students, 50(57.5%) were male and 37(42.5%) were female. The overall mean age was 22.5±4 years. Result of virtual reality was better than others (p<0.05). Data was analysed using SPSS 20.

    CONCLUSIONS: Virtual reality-based learning provided better user experience than traditional learning methodologies.

    Matched MeSH terms: Clinical Competence
  12. Vaiyapuri GR, Han HC, Lee LC, Tseng LA, Wong HF
    Int Urogynecol J, 2011 Jul;22(7):869-77.
    PMID: 21479713 DOI: 10.1007/s00192-011-1400-9
    INTRODUCTION AND HYPOTHESIS: This retrospective study reports the 1-year outcome in women who underwent mesh-augmented Prolift surgery performed from 2006 to 2008. There were a total of 254 patients, with 128, 106 and 20 patients receiving total, anterior and posterior Prolift, respectively.

    METHODS: Incidence of thigh pain was lower in 2008 compared to 2006 and 2007 (p < 0.0001). The percentage of patients requiring blood transfusions (p = 0.09), duration of IDC ≥ 7 days (p = 0.27), wound dehiscence and re-operation rate were lower in 2008 in contrast to 2006 and 2007 (p = 0.43). Only 209 patients (82.3%) were available for review at 1 year. There were two (1.0%) cases of recurrent vault prolapse.

    RESULTS: The subjective and objective cure rates at 1 year after this mesh implant surgery in 2006, 2007 and 2008 were 92.1% and 92.1%; 97.0% and 92.4% and 100% and 97%, respectively. The mesh erosion rate was remarkably lower in 2008 as compared to 2007 and 2006 (p < 0.001).

    CONCLUSIONS: This synthetic mesh-augmented implant surgery is effective and safe, and surgical outcome appears related to the learning curve of the surgeon.

    Matched MeSH terms: Clinical Competence
  13. Azer SA
    Kaohsiung J. Med. Sci., 2008 Jul;24(7):361-6.
    PMID: 18805751 DOI: 10.1016/S1607-551X(08)70133-5
    Portfolios have been used in the medical curriculum to evaluate difficult-to-assess areas such as students' attitudes, professionalism and teamwork. However, their use early in a problem-based learning (PBL) course to foster deep learning and enhance students' self-directed learning has not been adequately studied. The aims of this paper are to: (1) understand the uses of portfolios and the rationale for using reflection in the early years of a PBL curriculum; (2) discuss how to introduce portfolios and encourage students' critical thinking skills, not just reflection; and (3) provide students with tips that could enhance their skills in constructing good portfolios.
    Matched MeSH terms: Clinical Competence*
  14. Sharma A, U V, Dong V, Raut A, Tawfik GM, Ng SJ, et al.
    Clin Med (Lond), 2021 Mar;21(Suppl 2):25-26.
    PMID: 34078684 DOI: 10.7861/clinmed.21-2-s25
    Matched MeSH terms: Clinical Competence
  15. Ludin SM, Fathullah NM
    Nurse Educ Today, 2016 Sep;44:79-85.
    PMID: 27429333 DOI: 10.1016/j.nedt.2016.05.007
    BACKGROUND: Clinical teachers are a critical determinant of the quality of nursing students' clinical learning experiences. Understanding students' perceptions of clinical teachers' behaviours can provide the basis for recommendations that will help improve the quality of clinical education in clinical settings by developing better clinical teachers.

    OBJECTIVES: To understand clinical teaching behaviours and their influence on students' learning from the perspective of undergraduate nursing students.

    DESIGN: A cross-sectional, correlational survey.

    SETTING: A nursing faculty in Kuantan, Pahang, Malaysia.

    PARTICIPANTS: A sample of 120/154 (78%) students from Year 2-Year 4 were recruited according to set criteria.

    METHODS: A self-administered questionnaire was employed to collect demographic data, and students' perceptions of clinical teaching behaviours and their impact on learning using the Nursing Clinical Teaching Effectiveness Inventory (NCTEI).

    RESULTS: Year 3 and 4 students perceived faculty clinical teaching behaviours positively. There was a significant association between clinical teaching behaviours and their influence on students' clinical learning. Teachers' competence rated as the most significant influential factor, while teachers' personality rated as least influential.

    CONCLUSION: Participants were able to identify the attributes of good clinical teachers and which attributes had the most influence on their learning. Overall, they perceived their teachers as providing good clinical teaching resulting in good clinical learning. Novice clinical teachers and nursing students can use this positive association between teaching behaviours and quality of clinical learning as a guide to clinical teaching and learning.

    Matched MeSH terms: Clinical Competence
  16. Ab-Murat N, Sheiham A, Watt R, Tsakos G
    BMC Oral Health, 2015 Mar 13;15:36.
    PMID: 25887142 DOI: 10.1186/s12903-015-0015-9
    The traditional measure for assessing dental treatment needs and workforce requirements based solely on normative need (NN) has major shortcomings. The sociodental approach (SDA) to assess needs overcomes some of the shortcomings as it combines normative and subjective needs assessments and also incorporates behavioural propensity (Sheiham and Tsakos 2007). The objective of this study was to estimate and compare prosthodontic treatment needs and workforce requirements, using the normative and the sociodental approaches for different skill mix models.
    Matched MeSH terms: Clinical Competence*
  17. Abdul Rahman NF, Davies N, Suhaimi J, Idris F, Syed Mohamad SN, Park S
    Educ Prim Care, 2023 Jul;34(4):211-219.
    PMID: 37742228 DOI: 10.1080/14739879.2023.2248070
    Clinical reasoning is a vital medical education skill, yet its nuances in undergraduate primary care settings remain debated. This systematic review explores clinical reasoning teaching and learning intricacies within primary care. We redefine clinical reasoning as dynamically assimilating and prioritising synthesised patient, significant other, or healthcare professional information for diagnoses or non-diagnoses. This focused meta-synthesis applies transformative learning theory to primary care clinical reasoning education. A comprehensive analysis of 29 selected studies encompassing various designs made insights into clinical reasoning learning dimensions visible. Primary care placements in varying duration and settings foster diverse instructional methods like bedside teaching, clinical consultations, simulated clinics, virtual case libraries, and more. This review highlights the interplay between disease-oriented and patient-centred orientations in clinical reasoning learning. Transformative learning theory provides an innovative lens, revealing stages of initiation, persistence, time and space, and competence and confidence in students' clinical reasoning evolution. Clinical teachers guide this transformation, adopting roles as fortifiers, connoisseurs, mediators, and monitors. Patient engagement spans passive to active involvement, co-constructing clinical reasoning. The review underscores theoretical underpinnings' significance in shaping clinical reasoning pedagogy, advocating broader diversity. Intentional student guidance amid primary care complexities is vital. Utilising transformative learning, interventions bridging cognitive boundaries enhance meaningful clinical reasoning learning experiences. This study contributes insights for refining pedagogy, encouraging diverse research, and fostering holistic clinical reasoning development.
    Matched MeSH terms: Clinical Competence
  18. Sunjaya DK, Herawati DMD, Indraswari N, Megawati G, Sumintono B
    J Environ Public Health, 2021;2021:5515712.
    PMID: 34603456 DOI: 10.1155/2021/5515712
    Background: Inappropriate anthropometric measurements of infants and toddlers lead to a misclassification in nutritional status and loss of important interventions. Considering the practice conducted in this program within a country, its impact on millions of children must be considered. This study assesses the ability of community health volunteers (CHVs) before and after anthropometric training on infants and toddlers. Methods. This study used a quantitative approach with a quasiexperimental and pretest-posttest design. The pre- and posttraining assessments of CHVs were conducted by standardized trainers using instruments developed according to WHO standards. There were 11 and 13 statement items for infants' and toddlers' indicators of assessment in anthropometric measurements, respectively. The result of the assessment was then analyzed using Rasch modeling with stacking and racking data analysis techniques.

    Results: The CHVs' skills before training were far from adequate. Although widely varied, all trainees improved their abilities. Stacking analysis showed that the skills of all CHVs in measuring infants and toddlers increased by 2.68 and 3.34 logits (p < 0.01), respectively. Racking analysis showed a decrease in the perceived difficulty of all items by 2.61 and 3.07 logits for infant and toddler measurements, respectively (p < 0.01). The results of the racking analysis showed that the difficulty in measuring the anthropometrics of infants decreased more than that of toddlers.

    Conclusions: CHVs' capacity to monitor child growth must be refreshed regularly. Standardized and proper training and assessment were developed to make CHVs reliable in taking anthropometric measurements of infants and toddlers.

    Matched MeSH terms: Clinical Competence*
  19. Sim SM, Foong CC, Tan CH, Lai PS, Chua SS, Mohazmi M
    Med Teach, 2014 Feb;36(2):182.
    PMID: 24156275 DOI: 10.3109/0142159X.2013.848977
    Matched MeSH terms: Clinical Competence
  20. Tan CP, Rokiah P
    Med J Malaysia, 2005 Aug;60 Suppl D:48-53.
    PMID: 16315624
    Formative and summative student assessment has always been of concern to medical teachers, and this is especially important at the level of graduating doctors. The effectiveness and comprehensiveness of the clinical training provided is tested with the use of clinical cases, either with real patients who have genuine medical conditions, or with the use of standardised patients who are trained to simulate accurately actual patients. The Objective Structured Clinical Examination (OSCE) is one method of assessing the adequacy of clinical skills of medical students, and their level of competence. It can be used to test a variety of skills such as history taking (communication and interpersonal skills) and performing aspects of physical examination, undertaking emergency procedures, and interpreting investigational data. It can also be used to ensure an adequate depth and breadth of coverage of clinical skills expected of a graduating doctor.
    Matched MeSH terms: Clinical Competence*
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