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Academic surgery in Asia

Yip CH

ANZ J Surg, 2008 May;78(5):345-6.
PMID: 18380727 DOI: 10.1111/j.1445-2197.2008.04471.x
Matched MeSH terms: Professional Practice
Review paper: gender competencies in the medical curriculum: addressing gender bias in medicine

Wong YL

Asia Pac J Public Health, 2009 Oct;21(4):359-76.
PMID: 19661102 DOI: 10.1177/1010539509337730

Gender inequalities in health and gender bias in medicine are interrelated challenges facing health care providers and educators. Women and girls are disadvantaged in accessing health care because of their low social status and unequal treatment in medical care. Gender bias has long been inherent in clinical practice, medical research, and education. This can be traced to the medical curriculum that shapes the perceptions, attitudes, and behavior of the future doctor. The author advocates medical curricula change to address gender inequalities in health and gender bias in medicine. She analyses the reasons for integration of gender competencies in the medical curriculum, discusses what gender competencies are, and reviews ways to in-build gender competencies and their assessment. Efforts to change and gender sensitize medical curricula in developed and developing countries are also reviewed. The review hopes to contribute to strategic medical curriculum reform, which would lead to gender-sensitive health services and equity in health.

Matched MeSH terms: Professional Practice
Fulltext Dietary inquiries in public health practice

Wadsworth GR

Med J Malaysia, 1996 Mar;51(1):18-22.
PMID: 10967974

Public health administrations are responsible for monitoring the availability and use of foods. The information required can be obtained cheaply and easily by asking schoolchildren about the foods they have consumed. When the mean weights of adults is low and the number of kinds of food in use is small, nutritional problems probably exist and must be investigated. The same indicators may also be useful in the identification of families affected by poverty.

Matched MeSH terms: Professional Practice*
Fulltext Multicentre study of preoxygenation practices by anaesthesia providers

Wong AK, Sushila S, Thomas H, Tong JMG

Med J Malaysia, 1999 Mar;54(1):102-9.
PMID: 10972012

A total of 155 consecutive anaesthetics in three public Malaysian hospitals were prospectively studied to assess preoxygenation practices by their anaesthesia providers. Preoxygenation was practised in 96.1% of patients. Specialist and non-specialist anaesthesiologist did not preoxygenate 8.8% and 2.3% of their patients, respectively. Overall incidence of arterial oxygen desaturation during induction was 15.5%. Arterial oxygen desaturation occurred more frequently with emergency surgery (30.2%) in comparison to elective surgery (9.8%). Arterial oxygen desaturation occurred more frequently with non-specialist (18.9%) than specialist anaesthesia providers (3.0%).

Matched MeSH terms: Professional Practice*
Fulltext Medical standards

Thuraisingham V

Med J Malaysia, 1982 Dec;37(4):296-7.
PMID: 7167077
Matched MeSH terms: Professional Practice/standards*
Fulltext Knowledge and practice among nurses on management of tuberculosis in a teaching hospital

Hng, S.H., Siti Nabihah, S., Siti Nabilah, S.

Medicine & Health, 2018;13(1):153-164.
MyJurnal

Tuberculosis (TB) has become a worldwide public concern with 10.4 million new cases reported in 2015 and 1.4 million deaths. More importantly, an increase in trend in TB incidence among healthcare workers has become a major concern. Therefore, the present study was conducted to explore the knowledge and practice towards TB and the factors associated with it among nurses in a teaching hospital. The present study used cross-sectional design and stratified sampling method. A total of 275 nurses in a teaching hospital participated in this study. The knowledge and practice on management of TB was measured using a structured questionnaire. Majority of the respondents had good knowledge and practice on management of TB represented by 70.2% and 63.3%, respectively. However, knowledge gap (1.8%) and practice gap (0.4%) were identified in method of sputum collection. Work place setting was the only demographic factor found significantly associated with level of knowledge and practice (p=0.028). Level of knowledge and practice on management of TB identified among nurses was not associated with many socio-demographic factors. Nurses as frontline healthcare workers are at high risk of being exposed due to frequent contact with various patients especially those who are undiagnosed and TB suspect patients. Hence, implementation of TB Infection Control (TBIC) measures is important to minimize the risk of infection and cross-infection within hospital.

Matched MeSH terms: Professional Practice Gaps
Fulltext Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

Cheek C, Hays R, Allen P, Walker G, Shires L

Rural Remote Health, 2017 Jul-Sep;17(3):4292.
PMID: 28846850 DOI: 10.22605/RRH4292

INTRODUCTION: Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices.

METHODS: This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences.

RESULTS: There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania but most left for specialty training. All 15 interview participants intended to remain in Australia for at least their intern year, although at enrolment only six had planned to remain. Factors influencing workplace location decisions were (1) 'professional': greater appeal of Australian medical workplaces, intention to pursue a speciality, and to complete this at an Australian metropolitan hospital; (2) 'social': proximity to family/partner or opportunity to meet a prospective partner, family obligations, positive rural experiences; and (3) 'location': direct travel access to family.

CONCLUSIONS: IFP graduates from the Tasmanian medical program make an important contribution to the Australian mainland metropolitan medical workforce, but play only a small role in workforce development for both Tasmania and the broader Australian rural and remote context. Most IFPs do not choose to work rurally. Rurally focused medical programs need to consider how they place IFP students to meet both the learning and career needs of IFP students and the goal of the rural medical programs in developing a rural workforce.

Matched MeSH terms: Professional Practice Location/statistics & numerical data*
Fulltext Student nurses’ knowledge and practice on performing and interpreting electrocardiography: a cross sectional study

Hasfena Lamdin, Segaran Ramodran, Regidor III Dioso

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):57-0.
MyJurnal

Introduction: In clinical settings, nurses are often the first to be called upon to perform ECG procedures and as such, it is imperative nurses can interpret and immediately report basic anomalies in electrocardiograms. In Universiti Malaysia Sabah (UMS), although student nurses are taught ECG both in theory and hands-on learning through sim- ulation, there is no study examining the extent of student’s knowledge-skill retention regarding ECG. This study is to determine the learning attitude, level of knowledge and skill retention on electrocardiography among student nurses in UMS. Methods: A study entails a descriptive cross-sectional design. Nonprobability purposive sampling was used, where 100 (N) nursing students (2nd year n=50, 3rd-year n= 50) with selection criteria of respondents with prior learning on ECG were recruited for the study. A validated questionnaire (Cronbach α=0.81) benchmarked from a previous study was used to assessed learning attitude, level of knowledge and practice (skills) regarding ECG. Results: 85% (n=80) of the student nurses in this study had good to fair level knowledge and 15% (n=15) scored poor level of knowledge regarding ECG. With regards to practice competency, 87% (n=87) had fair to good level and 13% (n=13) scored poor skill level regarding ECG. Learning attitude towards ECG was positive among 88% (n=88) with 12% having a negative stance on readiness towards learning ECG. Sub-analyses showed a strong positive correlation between knowledge on ECG and practice (r=0.64). Conclusion: There is fair to good learning attitude, knowledge, and practice competency regarding ECG among the majority of nursing students in this study but a small cohort of students in this study have competency deficit regarding ECG. The deficit may compromise their ability to report critical anomalies present in patient electrocardiograms and there is a need to address this knowledge- practice gap.

Matched MeSH terms: Professional Practice Gaps
Fulltext Practical Learning and Theory-Practice as Perceived by Student Nurses in Universiti Malaysia Sabah

Hairie Aiery, Nur Izzati M. T, Ivyta D., Farah Ezora Shafine A. B., Sukhbeer K. Darsin Singh, R. Segaran

Borneo Journal of Medical Sciences, 2018;12(101):75-76.
MyJurnal

The theory-practice gap is arguably the most important issue in nursing today, given that it challenges the concept of research-based practice, which is the basis of nursing as a profession. Majority of the student nurses shared their views that some of the practical procedures that they learned during their theory sessions were different from what was practised in the wards which caused some worries among the students that it may affect their performance during their Obstructive Structured Clinical Examination.

Matched MeSH terms: Professional Practice Gaps
Fulltext Is it my fault? contemplative reactions among nurses toward the existence of blamingculture in relation to their documentation: a Malaysian context

Rekaya Vincent Balang, Robert L. Burton, Nichola A. Barlow

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):19-0.
MyJurnal

Introduction: Nursing documentation is the key to nursing care in hospitals. Nursing documentation contains ev- idences which demonstrate a significant association between the comprehensive level of nursing care and nurses’ professional practice. Therefore, nurses in Malaysia are trained to abide with the code of professional practice (1998) which required them to contrive a complete and comprehensive nursing documentation. Despite the importance of nursing documentation in the nursing professional practice, such study almost non-existent in Malaysia. Hence, there is a need to explore nurses understanding about existence of professionalism within their documentation, from a Malaysian context. Methods: The study utilized a qualitative approach which aimed to explore the perceptions among nurses in Malaysia on their documentation with relation to professionalism in nursing. Forty semi structured interviews were conducted in order to obtain an understanding of nurses’ views on their documentation and its influ- ence on their ways of preparing and completing their documentation. Thematic analysis was used to identify catego- ries and themes in nurses’ accounts of their documentation with relation to professionalism in nursing. Results: One of many profound findings from the study is the fear among nurses of “blaming culture” in that occurs their clinical setting. The nurses perceive “blaming culture” do not tolerate mistakes and they are more likely to be blamed for poor patient safety and insufficient quality of care. This is because nurses are directly involved in delivering care to patient or client in the hospital. “Blaming culture” however motivates nurses to ensure their documentation is com- plete, comprehensive and contemporaneous. Conclusion: Interestingly, the nurses perceive their documentation as an important evidence if there are possible future medical legal issues that they might have to involve with.

Matched MeSH terms: Professional Practice
Knowledge, awareness and practice regarding familial hypercholesterolaemia among primary care physicians in Malaysia: The importance of professional training

Azraii AB, Ramli AS, Ismail Z, Abdul-Razak S, Mohd-Kasim NA, Ali N, et al.

Atherosclerosis, 2018 10;277:508-516.
PMID: 30270092 DOI: 10.1016/j.atherosclerosis.2018.08.018

BACKGROUND AND AIMS: This study aimed to determine knowledge, awareness and practice (KAP) regarding familial hypercholesterolaemia (FH) among Malaysian primary care physicians (PCP), and to compare KAP between PCP with postgraduate qualification (PCP-PG-Qual) and PCP without PG qualification (PCP-noPG-Qual).
METHODS: This was a cross-sectional study involving PCP with ≥1-year working experience in Malaysian primary care settings. An adapted and validated 25-item FH-KAP questionnaire was disseminated during primary care courses. Total score for each domain was calculated by summing-up the correct responses, converted into percentage scores. Normality distribution was examined and comparisons of mean/median percentage scores were made between the two groups of PCP.
RESULTS: A total of 372 PCP completed the questionnaire. Regarding knowledge, 77.7% correctly defined FH. However, only 8.3% correctly identified coronary artery disease risk in untreated FH. The mean percentage knowledge score was significantly higher in PCP-PG-Qual compared to PCP-noPG-Qual (48.9, SD ± 13.92 vs. 35.2, SD ± 14.13), t(370) = 8.66, p 

Matched MeSH terms: Professional Practice Gaps
Mediation--the Malaysian Dental Association experience

Purmal K, Nambiar P

Int Dent J, 2009 Jun;59(3):155-60.
PMID: 19637524

To study the success and failures of the mediation process of complaints from 2004-2007 by the Complaints Bureau Steering Committee and the Public Complaints Bureau Committee of the Malaysian Dental Association (MDA).

Matched MeSH terms: Professional Practice Location
Good clinical practice

Merican I

Med J Malaysia, 2000 Aug;55 Suppl B:35-7.
PMID: 11125519
Matched MeSH terms: Professional Practice*
Fulltext Take a fresh look at IUDs. Things have changed

Mazza D

Aust Fam Physician, 2002 Oct;31(10):903-7.
PMID: 12404827

Over the past few years, the intrauterine contraceptive device (IUD) has overcome many of the problems that had initially made it unpopular. Today it is probably the most cost effective reversible form of contraception available.

Matched MeSH terms: Professional Practice
Practice of Sealants and Preventive Resin Restorations Among Malaysian Dentists

Chin ZW, Chong WS, Mani SA

Oral Health Prev Dent, 2016;14(2):125-35.
PMID: 26525124 DOI: 10.3290/j.ohpd.a34999

PURPOSE: To assess the knowledge, attitude and utilisation regarding fissure sealants (FS) and preventive resin restorations (PRR) among Malaysian dentists.
MATERIALS AND METHODS: A questionnaire consisting of 35 questions was distributed by mail or an online survey to 425 registered dentists selected according to place of work by stratified random sampling.
RESULTS: One hundred fifty-three dentists responded to the survey. A positive attitude towards FS and PRR was noted among most Malaysian dentists. About half of the respondents used FS/PRR occasionally (48.4%), while few (13.7%) applied them routinely. The majority of the dentists agreed that minimally invasive dentistry is important and FS are effective in caries prevention, using them on high caries-risk individuals. Most of the dentists used pumice or paste to clean teeth before placing FS/PRR. A significant number of dentists used a bonding agent prior to placing FS. Although only 57.5% dentists were aware of guidelines for FS use, most dentists agreed that guidelines are important.
CONCLUSION: Although there was a positive attitude towards FS/PRR, few dentists applied them routinely. Some of the steps undertaken for placement of FS and PRR were outdated. Updating local guidelines for dentists to ensure uniform practice of FS and PRR is justified.

Matched MeSH terms: Professional Practice
Fulltext A case study: wrong patient; wrong blood transfusion:is there a theory – practice – ethics gap?

Manfred Mortell

The Malaysian Journal of Nursing, 2019;10(3):22-28.
MyJurnal

This case study illustrates an ongoing therapeutic dilemma which continues to place the patient's welfare at risk. The safety predicament is associated with the transfusion of blood or their products to the correct patient. Predictably, healthcare scholars declare that when clinical practice is ineffective, a “theory-practice gap” is typically responsible. Within this paradigm there is often a gap between theoretical knowledge and its application in clinical practice. Most of the evidence relating to the non-integration of theory and practice makes the premise that environmental factors will influence learning and practice outcomes, hence the "gap". However, it is the author's belief, that to "bridge the gap" between theory and practice an additional component called “Ethics” must be appreciated. This introduces a new concept “theory-practice-ethics gap” which must be considered when reviewing some of the unacceptable appalling outcomes in health care practice

Matched MeSH terms: Professional Practice Gaps
Overview of reviews of standardised occupation-based instruments for use in occupational therapy practice

Romli MH, Wan Yunus F, Mackenzie L

Aust Occup Ther J, 2019 08;66(4):428-445.
PMID: 30821362 DOI: 10.1111/1440-1630.12572

INTRODUCTION: Using standardised instruments is one approach to support evidence-based practice. Referring to systematic reviews is an option to identify suitable instruments. However, with an abundance of systematic reviews available, therapists are challenged to identify an appropriate instrument to use. Therefore, this overview of reviews aimed to summarise relevant systematic review findings about standardised occupation-based instruments relevant for occupational therapy practice.
METHODS: An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR).
RESULTS: A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play.
DISCUSSION: Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.

Matched MeSH terms: Professional Practice
Medicine in Malaysia: haematology

Cheong SK, Lopez CG

Med J Malaysia, 1995 May;50 Suppl A:S46-50.
PMID: 10968015
Matched MeSH terms: Professional Practice/trends
Patient education and preventive care in Malaysian dental practice

Abdul Razak I, Lind OP

J Clin Pediatr Dent, 1994;18(4):313-22.
PMID: 7811664

A questionnaire survey was conducted to examine the attitudes of Malaysian dentists toward patient education and preventive dentistry and the level of preventive care adopted in Malaysian dental practice. An adjusted response rate of 73.1% was obtained. Generally the Malaysian dentists had positive attitudes towards patient education and preventive dentistry including fluoridation. However, a sizable proportion of them considered that preventive measures were no challenge for the dentist. The common preventive measures given to patients were scaling, dental health education, prophylaxis and instruction in correct brushing and flossing in as much as 40 to 50 percent of the queried dentist claimed that these preventive items were provided to most or all of their new patients. In spite of the fact that the majority of the dentists had good knowledge about the application and effects of sealants only about 41 percent of the dentists claimed to have used sealants. More dentists in the private sector reportedly having done so. Also many Malaysian dentists (18.5%) did not use leaded protection for any of their new patients when taking radiographs.

Matched MeSH terms: Professional Practice/statistics & numerical data*
Fulltext Teleprimary care in Malaysia: a tool for teleconsultation and distance learning in health care

Yadav H, Lin WY

Asia Pac J Public Health, 2001;13 Suppl:S58-61.
PMID: 12109251

Malaysia enjoys a comprehensive range of health services, the government being committed to the principles of universal access to high quality health care, which the Ministry of Health provides through a wide variety of nation wide network of clinics and hospitals. One of the major problems is the availability of comprehensiveness and quality of health care in remote health centres. When patients are transferred from the health centres to the hospitals for further treatment, this not only incurs inconvenience to the patients and their family but also increases the cost to the health care system. Teleprimary care is one of the tools to overcome this problem. The doctors in the remote clinics are able to discuss the problem cases through teleconsultation with the doctors and specialist in the hospitals using an audiovisual system to provide better care in the health centers without transferring the patients to the hospitals. Only the essential and needy patients are referred to the hospitals. This has not only reduced the number of patients referred to the hospitals but it has reduced the cost to the health care system. It has also provided a more comprehensive care to the patients in the health centres. The doctors in the health centers are also provided training and are also updated on the latest in medicine. This method of training has made doctors in the health centers more efficient and satisfied.

Matched MeSH terms: Professional Practice Location

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