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  1. A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education : White paper by the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD)
    Al Maini M, Al Weshahi Y, Foster HE, Chehade MJ, Gabriel SE, Saleh JA, et al.
    Clin Rheumatol, 2020 Mar;39(3):627-642.
    PMID: 31127461 DOI: 10.1007/s10067-019-04544-y
    Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  2. Fulltext A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine
    Ilic D, Nordin RB, Glasziou P, Tilson JK, Villanueva E
    BMC Med Educ, 2015;15:39.
    PMID: 25884717 DOI: 10.1186/s12909-015-0321-6
    BACKGROUND: Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM.
    METHODS: A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the 'Assessing Competency in EBM' (ACE) tool. Students' self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results.
    RESULTS: A total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=-0.68, (95% CI-1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities.
    CONCLUSIONS: BL is no more effective than DL at increasing medical students' knowledge and skills in EBM, but was significantly more effective at increasing student attitudes toward EBM and self-reported use of EBM in clinical practice. Given the various learning styles preferred by students, a multifaceted approach (incorporating BL) may be best suited when teaching EBM to medical students. Further research on the cost-effectiveness of EBM teaching modalities is required.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  3. Fulltext A simple model to demonstrate the movements and the axes of the eyeball
    Nayak S, Soumya KV
    Adv Physiol Educ, 2009 Dec;33(4):356-7.
    PMID: 19948688 DOI: 10.1152/advan.00047.2009
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  4. Academic staff perspectives on delivering a shared undergraduate medical module on three transnational campuses: Practical considerations and lessons learned
    Morgan MP, Thomas W, Rashid-Doubell F
    Med Teach, 2020 01;42(1):36-38.
    PMID: 31411913 DOI: 10.1080/0142159X.2019.1649380
    The Royal College of Surgeons in Ireland (RCSI) was among the first medical institutions to establish a global education community which now provides high-quality transnational health professions education aligned across three locations: Europe, the Middle East and South-East Asia. The successful implementation of a shared modularized curriculum in this context can be complex and challenging. Here we describe our insights, gained from a decade of working together as shared module Academic Leads to deliver a system-based medical module to an international student cohort. The themes covered are some of the areas where we consider our joint deliberations have led to improved outcomes for the delivery and assessment of the module, which may be helpful to academic staff embarking on similar module sharing experiences.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  5. Adopting programmatic feedback to enhance the learning of complex skills
    Yusoff MS, Hadie SN, Abdul Rahim AF
    Med Educ, 2014 Feb;48(2):108-10.
    PMID: 24528391 DOI: 10.1111/medu.12403
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  6. An approach to enrich online medical Problem-Based Learning with tacit healthcare knowledge
    Cheah YN, Rashid FA, Abidi SS
    Stud Health Technol Inform, 2003;95:744-9.
    PMID: 14664077
    Existing Problem-Based Learning (PBL) problems, though suitable in their own right for teaching purposes, are limited in their potential to evolve by themselves and to create new knowledge. Presently, they are based on textbook examples of past cases and/or cases that have been transcribed by a clinician. In this paper, we present (a) a tacit healthcare knowledge representation formalism called Healthcare Scenarios, (b) the relevance of healthcare scenarios in PBL in healthcare and medicine, (c) a novel PBL-Scenario-based tacit knowledge explication strategy and (d) an online PBL Problem Composer and Presenter (PBL-Online) to facilitate the acquisition and utilisation of expert-quality tacit healthcare knowledge to enrich online PBL. We employ a confluence of healthcare knowledge management tools and Internet technologies to bring tacit healthcare knowledge-enriched PBL to a global and yet more accessible level.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  7. An innovative method of teaching clinical therapeutics through role-play
    Loh KY, Kwa SK
    Med Educ, 2009 Nov;43(11):1101-2.
    PMID: 19874515 DOI: 10.1111/j.1365-2923.2009.03501.x
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  8. Anatomy education environment measurement inventory: A valid tool to measure the anatomy learning environment
    Hadie SNH, Hassan A, Ismail ZIM, Asari MA, Khan AA, Kasim F, et al.
    Anat Sci Educ, 2017 Sep;10(5):423-432.
    PMID: 28135037 DOI: 10.1002/ase.1683
    Students' perceptions of the education environment influence their learning. Ever since the major medical curriculum reform, anatomy education has undergone several changes in terms of its curriculum, teaching modalities, learning resources, and assessment methods. By measuring students' perceptions concerning anatomy education environment, valuable information can be obtained to facilitate improvements in teaching and learning. Hence, it is important to use a valid inventory that specifically measures attributes of the anatomy education environment. In this study, a new 11-factor, 132-items Anatomy Education Environment Measurement Inventory (AEEMI) was developed using Delphi technique and was validated in a Malaysian public medical school. The inventory was found to have satisfactory content evidence (scale-level content validity index [total] = 0.646); good response process evidence (scale-level face validity index [total] = 0.867); and acceptable to high internal consistency, with the Raykov composite reliability estimates of the six factors are in the range of 0.604-0.876. The best fit model of the AEEMI is achieved with six domains and 25 items (X2  = 415.67, P 
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  9. Fulltext Answering questions in a co-created formative exam question bank improves summative exam performance, while students perceive benefits from answering, authoring, and peer discussion: A mixed methods analysis of PeerWise
    Guilding C, Pye RE, Butler S, Atkinson M, Field E
    Pharmacol Res Perspect, 2021 Aug;9(4):e00833.
    PMID: 34309243 DOI: 10.1002/prp2.833
    Multiple choice questions (MCQs) are a common form of assessment in medical schools and students seek opportunities to engage with formative assessment that reflects their summative exams. Formative assessment with feedback and active learning strategies improve student learning outcomes, but a challenge for educators, particularly those with large class sizes, is how to provide students with such opportunities without overburdening faculty. To address this, we enrolled medical students in the online learning platform PeerWise, which enables students to author and answer MCQs, rate the quality of other students' contributions as well as discuss content. A quasi-experimental mixed methods research design was used to explore PeerWise use and its impact on the learning experience and exam results of fourth year medical students who were studying courses in clinical sciences and pharmacology. Most students chose to engage with PeerWise following its introduction as a noncompulsory learning opportunity. While students perceived benefits in authoring and peer discussion, students engaged most highly with answering questions, noting that this helped them identify gaps in knowledge, test their learning and improve exam technique. Detailed analysis of the 2015 cohort (n = 444) with hierarchical regression models revealed a significant positive predictive relationship between answering PeerWise questions and exam results, even after controlling for previous academic performance, which was further confirmed with a follow-up multi-year analysis (2015-2018, n = 1693). These 4 years of quantitative data corroborated students' belief in the benefit of answering peer-authored questions for learning.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  10. Fulltext Appreciation of learning environment and development of higher-order learning skills in a problem-based learning medical curriculum
    Mala-Maung, Abdullah A, Abas ZW
    Med J Malaysia, 2011 Dec;66(5):435-9.
    PMID: 22390096 MyJurnal
    This cross-sectional study determined the appreciation of the learning environment and development of higher-order learning skills among students attending the Medical Curriculum at the International Medical University, Malaysia which provides traditional and e-learning resources with an emphasis on problem based learning (PBL) and self-directed learning. Of the 708 participants, the majority preferred traditional to e-resources. Students who highly appreciated PBL demonstrated a higher appreciation of e-resources. Appreciation of PBL is positively and significantly correlated with higher-order learning skills, reflecting the inculcation of self-directed learning traits. Implementers must be sensitive to the progress of learners adapting to the higher education environment and innovations, and to address limitations as relevant.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  11. Fulltext Assessing undergraduate competence in evidence based medicine: a preliminary study on the correlation between two objective instruments
    Lai NM, Teng CL, Nalliah S
    Educ Health (Abingdon), 2012 Jul;25(1):33-9.
    PMID: 23787382
    CONTEXT: The Fresno test and the Berlin Questionnaire are two validated instruments for objectively assessing competence in evidence-based medicine (EBM). Although both instruments purport to assess a comprehensive range of EBM knowledge, they differ in their formats. We undertook a preliminary study using the adapted version of the two instruments to assess their correlations when administered to medical students. The adaptations were made mainly to simplify the presentation for our undergraduate students while preserving the contents that were assessed.
    METHODS: We recruited final-year students from a Malaysian medical school from September 2006 to August 2007. The students received a structured EBM training program within their curriculum. They took the two instruments concurrently, midway through their final six months of training. We determined the correlations using either the Pearson's or Spearman's correlation depending on the data distribution.
    RESULTS: Of the 120 students invited, 72 (60.0%) participated in the study. The adapted Fresno test and the Berlin Questionnaire had a Cronbach's alfa of 0.66 and 0.70, respectively. Inter-rater correlation (r) of the adapted Fresno test was 0.9. The students scored 45.4% on average [standard deviation (SD) 10.1] on the Fresno test and 44.7% (SD 14.9) on the Berlin Questionnaire (P = 0.7). The overall correlation between the two instruments was poor (r = 0.2, 95% confidence interval: -0.07 to 0.42, P = 0.08), and correlations remained poor between items assessing the same EBM domains (r = 0.01-0.2, P = 0.07-0.9).
    DISCUSSION: The adapted versions of the Fresno test and the Berlin Questionnaire correlated poorly when administered to medical students. The two instruments may not be used interchangeably to assess undergraduate competence in EBM.
    Matched MeSH terms: Education, Medical, Undergraduate/methods
  12. Fulltext Assessors for communication skills: SPs or healthcare professionals?
    Liew SC, Dutta S, Sidhu JK, De-Alwis R, Chen N, Sow CF, et al.
    Med Teach, 2014 Jul;36(7):626-31.
    PMID: 24787534 DOI: 10.3109/0142159X.2014.899689
    The complexity of modern medicine creates more challenges for teaching and assessment of communication skills in undergraduate medical programme. This research was conducted to study the level of communication skills among undergraduate medical students and to determine the difference between simulated patients and clinical instructors' assessment of communication skills.
    Matched MeSH terms: Education, Medical, Undergraduate/methods
  13. Fulltext Attitude towards problem-based learning and its relationship with locus of control and academic self-concept among medical students
    Abdalla MMI, Abdelal MS, Soon SC
    Korean J Med Educ, 2019 Mar;31(1):11-18.
    PMID: 30852857 DOI: 10.3946/kjme.2019.114
    PURPOSE: This study aimed to assess the degree of acceptance of problem-based learning (PBL) among phase one medical students and its association with academic self-concept (ASC) and internal locus of control (ILOC).

    METHODS: A 5-point Likert scale valid and reliable questionnaire assessing the attitude towards PBL, ASC, and ILOC was given to phase one medical students at MAHSA University. Data were analysed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA).

    RESULTS: Out of 255 participants, there were 84 males and 171 females, 175 Malaysians and 80 non-Malaysians. The results showed an overall acceptance of PBL with a mean of 3.7±0.07, ASC of 3.5±0.05 and ILOC of 2.9±0.05. Females showed a higher significant acceptance of PBL, ASC, and ILOC as compared with males. There was no difference between Malaysians and non-Malaysians in any of the variables measured. Simple regression analysis revealed a significant predictive effect of acceptance of PBL on ASC and ILOC (r=0.44 and r=0.88, respectively).

    CONCLUSION: The higher the acceptance of PBL among students, the higher is the ASC and ILOC. This reflects the importance of PBL as a teaching method as well as the importance of increasing the level of appreciation of PBL amongst students.

    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  14. Clinically oriented physiology teaching: strategy for developing critical-thinking skills in undergraduate medical students
    Abraham RR, Upadhya S, Torke S, Ramnarayan K
    Adv Physiol Educ, 2004 Dec;28(1-4):102-4.
    PMID: 15319191
    Medicine is an applied science, interpreting evidence and applying it to real life by using clinical reasoning skills and experience. COPT (clinically oriented physiology teaching) was incorporated in physiology instruction aiming to relate the study of physiology to real-life problems, to generate enthusiasm and motivation for learning, and to demonstrate the vocational relevance of physiology among students by integrating clinical experience with teaching. COPT consisted of two elements: 1) critical-thinking questions (CTQ) and 2) clinical case studies. After a few topics were taught, CTQ and case studies were given as an assignment. Answers were discussed in the next class. Two exams, each of which contained CTQ and recall questions, were conducted, one before (exam 1) and one after (exam 2) the implementation of COPT. Analysis of student performance in the examinations revealed that the students did better in exam 2 (P < 0.0001). Feedback from students indicated that this method was useful and challenging.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  15. Community Residency Programme (CRP)--a tool for research and rural health training for medical students
    Yadav H
    Med J Malaysia, 2002 Dec;57 Suppl E:94-8.
    PMID: 12733201
    Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  16. Fulltext Comparative assessment of students' performance and perceptions on objective structured practical models in undergraduate pathology teaching
    Htwe TT, Ismail SB, Low GK
    Singapore Med J, 2014 Sep;55(9):502-5.
    PMID: 25273936
    INTRODUCTION: Assessment is an important factor that drives student learning, as students tend to mainly focus on the material to be assessed. The current practice in teaching pathology extensively applies objective-structured practical examination for the assessment of students. As students will have to deal with real patients during clinical years, it is preferred that students learn and practise via potted specimens and slides instead of picture plates. This study aimed to assess the preferred assesment method of pathology practical exercises.

    METHODS: This was a cross-sectional survey carried out in two consecutive batches of Phase 2 medical students. Student competency was assessed using both the traditional (TD) (i.e. use of potted specimens and slides) and picture plate (PP) methods. To compare the two assessment methods, we compared the mean scores obtained by the students and examined student perception of the two methods.

    RESULTS: The mean scores obtained via the PP method were significantly higher than those obtained via the TD method for almost all the components tested.

    CONCLUSION: We found that students performed significantly better (p < 0.05) when assessed using the PP method instead of the TD method. PP preparations might provide better visuals, thus aiding understanding, than the TD method. The findings of this study are valuable in identifying and improving our current teaching and assessment methods of medical students, in line with advancements in information technology.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  17. Core curriculum and special study modules at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak
    Malik AS, Malik RH
    Educ Health (Abingdon), 2004 Nov;17(3):292-302.
    PMID: 15848816
    The Faculty of Medicine and Health Sciences (FMHS), follows a problem-based learning, integrated and community-based curriculum which reflects the specific needs of doctors working in Sarawak. Using paediatrics as an example, this paper describes the process of development of core content (knowledge, procedural and communication skills, attitudes), additional knowledge and special study modules at the FMHS.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  18. Dance, drama and laughter: the best medicine
    Foong CC, Tong WT, Daniel EG, Vadivelu J
    Med Educ, 2013 May;47(5):516-7.
    PMID: 23574067 DOI: 10.1111/medu.12155
    Study site: Universiti Malaya, Phase 2 clinical students.
    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  19. Design, Implementation, and Evaluation of a Simulation-Based Clinical Correlation Curriculum as an Adjunctive Pedagogy in an Anatomy Course
    Coombs CM, Shields RY, Hunt EA, Lum YW, Sosnay PR, Perretta JS, et al.
    Acad Med, 2017 04;92(4):494-500.
    PMID: 27680320 DOI: 10.1097/ACM.0000000000001387
    PROBLEM: Because reported use of simulation in preclinical basic science courses is limited, the authors describe the design, implementation, and preliminary evaluation of a simulation-based clinical correlation curriculum in an anatomy course for first-year medical students at Perdana University Graduate School of Medicine (in collaboration with Johns Hopkins University School of Medicine).

    APPROACH: The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions.

    OUTCOMES: A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention.

    NEXT STEPS: Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.

    Matched MeSH terms: Education, Medical, Undergraduate/methods*
  20. Developing a facilitation skills training programme for problem-based learning tutors
    Kukkamalla A, Lakshminarayana SK
    Med Educ, 2011 Nov;45(11):1152-3.
    PMID: 21936865 DOI: 10.1111/j.1365-2923.2011.04107.x
    Matched MeSH terms: Education, Medical, Undergraduate/methods
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